HEALTH RELATED INTERVENTIONS FOR PERSONS LIVING WITH HIV

描述（申请人的摘要）：该项目的目标是设计 并测试干预措施，以减少性行为和注射行为的风险， 在1,200名艾滋病毒感染者中， 艾滋病毒感染者将感染传染给他人的可能性 促进PLH中其他与健康相关的行为改变。 这项研究将 重点关注三个艾滋病毒阳性亚组：妇女，男男性行为者（MSM）， 注射毒品使用者（IDUs） 这项研究将于四时进行。 地点：洛杉矶、纽约、弗朗西斯科和密尔沃基。 项目 将开始为期1年的形成性I期研究， 150 PLH，使用定性和生活史访谈来描述 影响风险行为的物理、社会和人际环境 了解适应血清状态的阶段;并确定 实施安全性行为的障碍，积极的卫生保健法案， 生活质量 形成性研究阶段还将允许 研究人员定制社会行动理论模型， 采取干预措施，解决影响每个亚群的问题。 后 在形成性研究阶段，将编写一份手册， 15个单独交付的会议分为三个模块， 以促进健康、减少传播风险为目标的组成部分，以及 心理应对/关系问题。 在第二阶段主要干预中 试验中，三个艾滋病毒感染者谁最近从事亚组 高风险行为将在每个站点以相等的数量招募， HIV阳性女性（N=400）、MSM（N=400）和IDUs（N=400）的研究范围样本。 总共有1，200个PLH将在项目范围内随机分配， 每个亚组内的数字与立即干预条件或 滞后干预控制条件 在两次基线访谈之后， 参与者将在未来35个月内每隔5个月接受一次评估。 除了预测主要（传输风险行为）的变化之外， 和次要（医疗保健行为和生活质量）结果随时间的变化 针对每个模块，调查人员将研究 社会行动理论中的中介因素（应对技能、社会 支持解决问题，与艾滋病毒有关的态度/信念，以及环境 风险行为的背景），以及参与者背景因素（性别， 种族、传播行为史）或原发和继发 结果。 这项研究将由一个由四个地点组成的联合体进行， 为了提供足够的样本量来评估 干预;提高调查结果的普遍性;并利用 每个研究团队的专业知识。 成本效益 作为这项研究的一部分，计划进行分析和传播。

DESCRIPTION (Applicant's Abstract): The goal of this project is to design and test an intervention to reduce sexual and injection practice risk behaviors among 1,200 HIV-infected men and women in order to decrease the likelihood that persons with HIV will transmit infection to others and to promote other health-related behavior changes in PLH. The research will be focused on three HIV+ subgroups: women, men who have sex with men (MSM), and injection drug users (IDUs). The study will be undertaken at four sites: Los Angeles, New York, San Francisco, and Milwaukee. The project will begin with a 1-year period of formative Phase 1 studies conducted with 150 PLH, using qualitative and life-history interviews to characterize the physical, social, and interpersonal contexts that influence risk behavior among PLH; understand stages of adaptation to serostatus; and identify barriers to implementation of safer sex, positive health care acts, and quality of life. The formative research phase will also allow the investigators to tailor the social action theoretical model guiding the intervention to address issues affecting each subpopulation. Following the formative research phase, a manual will be prepared for an intervention of 15 individually-delivered sessions organized into three modules with components that target health promotion, transmission risk reduction, and psychological coping/relationship issues. In the Phase 2 main intervention trial, three subgroups of HIV-infected person who have recently engaged in high-risk behavior will be recruited in equal numbers at each site yielding study-wide samples of HIV+ women (N=400), MSM (N=400), and IDUs (N=400). Altogether, 1,200 PLHs project-wide will be randomly assigned in equal numbers within each subgroup to an immediate intervention condition or to a lagged intervention control condition. Following two baseline interviews, participants will be evaluated at 5-month intervals for the next 35 months. In addition to anticipating changes in the primary (transmission risk acts) and secondary (health care behaviors and quality of life) outcomes over time and in response to each module, the investigators will examine the impact of mediating factors emerging from social action theory (coping skills, social support problem solving, HIV-related attitudes/beliefs, and environmental context of risk acts), as well as participant background factors (gender, ethnicity, history of transmission behaviors) or primary and secondary outcomes. The study will be implemented by a consortium of four sites in order to provide sufficient sample sizes to assess the impact of the intervention; to enhance generalizability of the findings; and to utilize the specialized expertise of each research team. Cost-effectiveness analyses and dissemination are planned as part of this study.