Intervention Targeting Medication Adherence and Methamphetamine Use for HIV + Men

描述（由申请人提供）：本提案的目的是评估一种干预措施，该干预措施可以随时传播并整合到现有的艾滋病毒诊所和其他社区组织（CBO）中，这些组织提供解决有甲基苯丙胺问题的艾滋病毒阳性者需求的方案。总体而言，该干预措施旨在通过制定旨在提高艾滋病毒药物依从性、减少甲基苯丙胺使用并积极影响其他健康相关行为（性冒险、其他药物使用等）的简短干预措施，改善艾滋病毒+甲基苯丙胺使用男性的健康和生活质量。具体而言，拟议的随机临床试验旨在测试简短的8次治疗条件对8次教育的有效性。此外，该干预将测试Fisher & Fisher（1992）信息-动机-行为技能（IMB）模型的适用性，以了解HIV+甲基苯丙胺使用者的依从性和物质使用行为的变化。拟议的干预措施将针对纽约市的HIV+甲基苯丙胺使用男性，他们报告对HIV药物治疗方案的依从性低于90%。治疗条件将接受8次单独定制的动机访谈和认知行为技能培训，而教育（比较）条件将接受8次围绕HIV药物依从性，甲基苯丙胺使用和其他健康相关行为（性冒险，其他药物使用等）的教育。利用几个措施的坚持（生物标志物，客观和自我报告的措施）和甲基苯丙胺的使用（自我报告和生物），这项研究将测试干预的有效性，在3，6，9和12个月后干预，以确定任何即时和长期的干预效果。此外，我们将考虑信息，动机和行为技能的中介作用，以确定这种理论为基础的干预最有效的组成部分。 这项研究的结果可能有助于减少甲基苯丙胺的使用，并增加艾滋病毒阳性男性的艾滋病毒药物依从性。具体而言，如果有效，干预措施将有助于尽量减少与甲基苯丙胺相关的负面身心影响，并提高艾滋病毒药物治疗的依从性，这对生存和健康以及艾滋病毒传播和艾滋病毒耐药性具有潜在影响。

DESCRIPTION (provided by applicant): The purpose of this proposal is to evaluate an intervention that can be readily disseminated and integrated into existing HIV clinics and other community-based organizations (CBOs) offering programs addressing the needs of HIV+ persons with methamphetamine problems. Broadly, this intervention aims to improve the health and quality of life of HIV+ methamphetamine-using men by developing a brief intervention designed to increase HIV medication adherence, decrease methamphetamine use, and positively impact other health related behaviors (sexual risk-taking, other drug use, etc.). Specifically, the proposed randomized clinical trial aims to test the efficacy of a brief, 8-session therapy condition against 8 sessions of education. Additionally, this intervention will test the applicability of Fisher & Fisher's (1992) Information-Motivation-Behavioral Skills (IMB) model to understand changes in adherence and substance use behaviors among HIV+ methamphetamine users. The proposed intervention will target HIV+ methamphetamine-using men in New York City who report less than 90% adherence to their HIV medication regimens. The treatment condition will receive 8 sessions of individually tailored motivational interviewing and cognitive behavioral skills training, while the education (comparison) condition will receive 8 sessions of education surrounding HIV medication adherence, methamphetamine use, and other health-related behaviors (sexual risk-taking, other drug use, etc.). Utilizing several measures of adherence (biological markers, objective, and self-report measures) and methamphetamine use (self-report and biological), this study will test the efficacy of the intervention at 3, 6, 9, and 12 months post-intervention to determine both any immediate and long-lasting effects of the intervention. Additionally, we will consider the mediating role of information, motivation, and behavioral skills to determine the most effective components of this theoretically-based intervention. The findings of this study could help to reduce methamphetamine use and increase HIV medication adherence among HIV+ men. Specifically if effective, the intervention will help minimize the negative physical and psychological effects associated with methamphetamine and improve HIV medication adherence, which has potential effects for survival and health as well as HIV transmission and HIV drug resistance.