MIAMI INJECTING DRUG USERS AND THEIR SEXUAL RISK FOR HIV

为响应该计划，提出了一个为期五年的IRPG合作项目 第94-054号公告，“减少艾滋病毒性行为风险的战略， 吸毒者。“在佛罗里达的迈阿密的研究项目将集中在 制定和实施减少性风险的干预措施， 注射毒品使用者及其现时未吸毒的性伴侣 艾滋病毒感染/传播风险增加的人作为一种治疗方法， 毒品/性行为的后果。 研究将分两个阶段进行。 第一阶段将 包括两个分阶段，1A和1B，这两个分阶段将共同评估 性风险行为的个人、社会和环境背景， 减少性风险，并为制定干预措施提供信息， 降低目标吸毒人群的性风险。第1A阶段将 关于行为和规范信念的深入定性信息， 障碍和促进因素、社会影响和网络因素 降低性风险。在第1B阶段， 关于具体的降低风险的性行为及其 将根据收集的数据制定和管理先行措施 在1A阶段。 此外，一个正式的行为背景研究， 将与注射毒品使用者进行降低风险的性行为 和他们的性伴侣 基于第1阶段获得的信息，理论驱动，经验 知情的干预措施将在一个随机的 用于第2阶段的田间试验设计。迈阿密的干预 是一个有序的加法模型，其中三种类型的干预措施， 将进行比较：l）个人咨询干预，2）夫妇 咨询干预; 3）基于网络的干预。 干预战略将以经验得出的 行为改变准备框架。随机化将提供 测量二分体对个体的加性效应的机会 个别辅导+网络辅导 辅导将对这三种干预措施进行排序，以便 衡量每种干预措施的单独效果。 虽然所述研究目标将通过以下方式基本实现： 本提案中规定的迈阿密（FL）研究设计， 预计将大大加强拟议的倡议， 与其他六个地点（亚利桑那州凤凰城;德克萨斯州休斯顿;朗 加州的海滩;佛罗里达的迈阿密;路易斯安那州的新奥尔良;和华盛顿， （华盛顿特区）建议进行独立的补充研究， 制定减少性风险的干预措施， 理论和分析框架。每个合作网站将开发 针对当地人口的独特干预措施， 使用在各站点之间统一的标准化控制干预。 对网站的监测（执行委员会对网站访问者的监测） 确保干预完整性和数据管理的质量控制 并进行分析。

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.