MIAMI INJECTING DRUG USERS AND THEIR SEXUAL RISK FOR HIV

为响应计划，提出了一个为期五年的合作IRPG项目 公告94-054，“#年减少艾滋病毒性行为风险的战略” 佛罗里达州迈阿密的研究计划将重点放在 制定和实施针对性的减少性风险干预措施 注射吸毒者及其性伴侣目前未吸毒 将艾滋病毒感染/传播风险增加的患者作为 他们吸毒/性行为的后果。 研究将分两个阶段进行。第一阶段将 由两个子阶段(1A和1B)组成，这两个子阶段将共同评估 性危险行为的个人、社会和环境背景以及 减少性风险，并为制定干预措施提供信息 降低目标吸毒者人群的性风险。第1A阶段将引发 关于行为和规范信仰的深入定性信息， 障碍和促进者，以及社会影响和网络因素 与减少性风险有关。在1B阶段，全面面谈 关于特定的降低风险的性行为的工具及其 将以收集的数据为指导，制定和管理先例 在第1A阶段。此外，形式化的行为语境研究 将对注射吸毒者进行降低性行为风险的行为 以及他们的性伴侣。 基于第一阶段获得的信息，理论驱动，经验性的 知情干预措施将以随机方式制定和评估 用于第二阶段的现场实验设计。迈阿密干预 是一个顺序相加模型，在该模型中有三种类型的干预 将进行比较：L)个人咨询干预，2)夫妻 咨询干预；3)基于网络的干预。 干预策略将由经验派生的 行为改变准备框架。随机化将提供 测量二联体对个体的加性效应的机会 心理咨询与个体心理咨询+双人心理咨询走向网络 心理咨询。将对三种类型的干预措施进行排序，以便 衡量每种干预类型的单独效果。 虽然所述研究目标将通过以下方式基本实现 在佛罗里达州迈阿密的这项提案中提出的研究设计，价值 拟议的倡议将得到极大的加强，预计 与其他六个网站(亚利桑那州凤凰城；德克萨斯州休斯顿；Long 加利福尼亚州的比奇、佛罗里达州的迈阿密、路易斯安那州的新奥尔良和华盛顿州， (华盛顿特区)建议对以下项目进行独立的补充研究 在同一时期内开展减少性风险的干预措施 理论和分析框架。每个合作网站都将开发 针对当地人口的独特干预措施将进行比较 通过标准化的控制干预，在各个地点都是统一的。 对网站的监测(执行委员会的网站访问者)将有所帮助 确保干预完整性和数据管理的质量控制 和分析。

A five-year collaborative IRPG project is proposed in response to Program Announcement 94-054, "Strategies to Reduce HIV Sexual Risk Practices in Drug Users." The research program in Miami, Florida will focus on developing and implementing sexual risk-reduction interventions targeting injecting drug users and their sex partners not currently in drug treatment who are at increased risk of HIV infection/transmission as a consequence of their drug/sexual practices. The research study will be conducted in two phases. The first phase will consist of two sub-phases, 1A and 1B, which together will assess the individual, social, and environmental context of sexual risk behavior and sexual risk reduction, and inform the development of interventions to reduce sexual risk in targeted drug-user populations. Phase 1A will elicit in-depth qualitative information about behavioral and normative beliefs, barriers and facilitators, and social influence and network factors related to sexual risk reduction. In Phase 1B, a comprehensive interview instrument about specific risk-reducing sexual behaviors and their antecedents will be developed and administered, guided by data collected in Phase 1A. Additionally, a formalized behavioral context study of sexual risk-reducing behaviors will be conducted with injecting drug users and their sexual partners. Based on information gained in Phase 1, theory-driven, empirically informed interventions will be developed and evaluated in a randomized field experimental design for use during Phase 2. The Miami intervention is a sequenced and additive model in which three types of interventions will be compared: l) an individual counseling intervention , 2) a couple counseling intervention, and 3) a network-based intervention. Intervention strategies will be guided by the empirically derived framework of behavior change readiness. Randomization will provide the opportunity to measure the additive effects of dyad to individual counseling and of individual counseling + dyad counseling to network counseling. The three types of interventions will be sequenced in order to measure the separate effects of each intervention type. Although the stated research objectives will be substantially realized by the study design set forth in this proposal for Miami, FL, the value of the proposed initiative will be greatly enhanced by an expected collaboration with six other sites (Phoenix, Arizona; Houston, Texas; Long Beach, California; Miami, Florida; New Orleans, Louisiana; and Washington, D.C.) that propose to conduct independent complementary studies for development of sexual risk-reduction interventions within the same theoretical and analytical framework. Each collaborating site will develop unique interventions targeting local populations that will be compared with a standardized control intervention that is uniform across sites. Monitoring of sites (site visitors by the executive committee) will help ensure quality control for intervention integrity, and for data management and analyses.