Intervening with HIV+ Alcohol Abusers: Influence of Neuro-Behavioral Factors

对艾滋病毒酗酒者进行干预：神经行为因素的影响

• 批准号: 7886896
• 负责人: ROBERT Michael MALOW
• 金额: $ 80.05万
• 依托单位: FLORIDA INTERNATIONAL UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-30 至 2012-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7886896
• 关键词: AIDS prevention; AIDS/HIV problem; Acute; Address; Adherence; Adult; Affect; African American; Alcohol abuse; Alcohol consumption; Alcohol or Other Drugs use; Alcohols; Area; Behavior; Behavior Therapy; Behavioral; Biological; Blood Tests; Caring; Centers for Disease Control and Prevention (U.S.); Characteristics; Chronic; Cognitive; Collaborations; Communication; Consensus; Diffusion; Dopamine; Drug abuse; Drug usage; Epidemic; Equilibrium; Ethics; Evidence based intervention; Female; Genetic; Genetic Determinism; HIV; HIV Seropositivity; Health; Health Promotion; Hispanics; Holistic Health; Hour; Hygiene; Individual; Informed Consent; Intervention; Intervention Studies; Life; Link; Low income; Manuals; Mediating; Memory; Minority; Modeling; Molecular Genetics; Moods; Motivation; Outcome; Patient Self-Report; Pharmaceutical Preparations; Play; Population; Poverty; Prevention; Prevention approach; Preventive; Preventive Intervention; Problem Solving; Problem behavior; Procedures; Protocols documentation; Psychiatric Social Work; Quality of life; Randomized; Randomized Controlled Trials; Recommendation; Recording of previous events; Recovery; Research; Research Design; Research Personnel; Resources; Risk; Risk Behaviors; Risk Reduction; Role; Safe Sex; Sampling; Schedule; Screening procedure; Self Management; Serotonin; Services; Sexual Transmission; Site; Social support; Specific qualifier value; Subgroup; Target Populations; Testing; Therapeutic; Time; Uninsured; Violence; Woman; Work; alcohol and other drug; base; biological research; cognitive function; cohort; community based treatment; community setting; comparison group; condoms; coping; design; evidence base; executive function; experience; follow up assessment; follow-up; health care service utilization; health disparity; improved; information processing; insight; intervention effect; male; medication compliance; men; multidisciplinary; neuropsychological; neurotransmission; post intervention; primary outcome; programs; prospective; psychosocial; response; safer sex; secondary outcome; sex risk; skills; theories; therapy design; transmission process; treatment effect; urban area

DESCRIPTION (provided by applicant): The proposed randomized controlled study will attempt to reduce HIV sexual transmission risk and substance use, increase the utilization of primary HIV care services, and improve psychosocial health among a sample of 320 alcohol abusing, HIV+ individuals. The experimental intervention will include an adaptation of the Holistic Health Recovery Program (HHRP; Margolin et al., 2003) that is the only evidence-based, HIV+ intervention for improving sexual risk and adherence outcomes for an addicted population. For this study, the intervention will be adapted for use in a culturally diverse, alcohol abusing sample. HHRP will be compared to a Health Promotion Comparison (HPC) condition, which addresses common health problems, including personal hygiene and healthy living. Specific aims include: 1) comparing the adapted HHRP to the HPC condition to evaluate if HHRP reduces HIV sexual transmission risk, alcohol and other drug use, and improves the utilization of primary HIV care services and psychosocial health; 2) evaluating how Information, Motivation, Behavioral Skills mediate intervention effects on safe sex outcome; and 3) evaluating how key neuropsychological and molecular-genetic factors moderate the effect of the intervention on HIV transmission risk outcomes. Recruitment sites are primarily located in densely populated, multicultural, low income, urban areas of Miami with high rates of AOD abuse, HIV, violence and poverty, with the vast majority of the population being uninsured and suffering from multiple health disparities. The study is a prospective, randomized by cohort two-group design. The scheduled sequence of procedures will be: a) informed consent, screening, and baseline assessment; b) a 120 minute group session of HHRP or HPC sessions administered once a week for 12 consecutive weeks; and c) a post- intervention assessment. Follow-up assessment protocols will be administered at 3, 6, and 12 months post-intervention. Neuropsychological and blood tests for molecular/genetic typing will also be conducted to assist in identifying factors which may influence the impact of the intervention study. The proposed study will attempt to reduce HIV sexual transmission risk and substance use among a sample of alcohol abusing, HIV+ individuals. In studying the memory, information processing, executive functioning as well as genetic factors of the individuals of this study, researchers will be better able to discern those factors which may have an impact on treatment effects. This study therefore has the potential to identify individual characteristics that may contribute to specific reductions in risky behaviors in this sample.

描述(由申请人提供)：拟议的随机对照研究将试图降低艾滋病毒的性传播风险和药物使用，增加对初级艾滋病毒护理服务的利用，并改善320名酗酒、艾滋病毒+患者的心理社会健康。实验干预措施将包括对整体健康恢复计划(HHRP；MarGolin等人，2003年)的修改，这是唯一以证据为基础的艾滋病毒+干预措施，用于改善成瘾人群的性风险和坚持结果。在这项研究中，干预措施将适用于不同文化背景的酗酒样本。HHRP将被比作健康促进比较(HPC)条件，后者解决常见的健康问题，包括个人卫生和健康生活。具体目标包括：1)将适应的HHRP与HPC条件进行比较，以评估HHRP是否降低了艾滋病毒的性传播风险、酒精和其他药物的使用，并改善了初级艾滋病毒护理服务和心理社会健康的利用；2)评估信息、动机、行为技能如何调节对安全性行为结果的干预效果；以及3)评估关键的神经心理和分子遗传因素如何调节干预对艾滋病毒传播风险结果的影响。招聘地点主要位于迈阿密人口稠密、多元文化、低收入的城市地区，AOD滥用、艾滋病毒、暴力和贫困的比率很高，绝大多数人口没有保险，并遭受多重健康差距。本研究为前瞻性研究，采用队列两组随机设计。预定的程序顺序将是：a)知情同意、筛查和基线评估；b)每周一次、连续12周进行120分钟的HHRP或HPC小组会议；c)干预后评估。后续评估方案将在干预后3、6和12个月进行。还将进行神经心理和血液分子/基因分型测试，以帮助确定可能影响干预研究影响的因素。 这项拟议的研究将试图降低HIV性传播风险和在酗酒、HIV+人群中使用药物。在研究这项研究的个体的记忆、信息处理、执行功能以及遗传因素时，研究人员将能够更好地识别那些可能对治疗效果产生影响的因素。因此，这项研究有可能确定个体特征，这些特征可能有助于在该样本中具体减少危险行为。