CBSM INTERVENTION IN WOMEN WITH HIV/AIDS

这是一个为期5年的项目，旨在测试12周的小组认知的有效性。 行为压力管理(CBSM)干预--以及每月 养生计划--论健康行为、情绪和心理 老年人的适应、生活质量和身体健康状况及预后 210名艾滋病毒感染妇女正在使用联合抗逆转录病毒药物 治疗(CART)(范围从无症状、有症状而无艾滋病、 到出现艾滋病症状)。该研究是一项2x4的随机实验 在实验条件下设计(CBSM加CART与通常护理相比 [CART]作为群体因素和时间点之间的变量(治疗前、治疗后 治疗、6个月和12个月的随访)作为组内因素。 对一组有症状的前期患者进行试点测试的初步证据 艾滋病HIV阳性的非裔美国妇女(n=24)提示 两种情绪困扰干预的缓冲效应 (抑郁症和回避性思维)以及在 随着时间的推移控制状况。这与我们之前的情况一致 发表的关于无症状和有症状的艾滋病前HIV+男同性恋者的论文 我们证明了CBSM缓冲了心理和免疫力 对艾滋病毒血清阳性诊断(或处理症状)的影响， 减少社会孤立，改进适应性应对策略。在……里面 我们提出的扩大试点调查范围的拟议项目 妇女包括艾滋病毒全过程中的妇女。在……里面 此外，由于艾滋病毒/艾滋病疫情的变化特点 (即，成功地引入了蛋白酶抑制剂和抗逆转录病毒 联合疗法)我们还打算关注(A)CBSM是否 可以实施干预以提高健康行为(用药 坚持、减少药物使用和减少不安全的性行为)和 生活质量的其他方面(职业、教育 独立/赋权、社会/社区参与)，(B)这些 行为、心理和免疫方面的影响伴随着低水平 病毒载量和疾病进展的减少，以及(C)如何有效 CBSM将适用于处于艾滋病毒/艾滋病连续体不同阶段的妇女 包括那些当时已经发展到全面艾滋病的人 干预的结果。

This is a 5-year project to test the efficacy of a 12-week group cognitive behavioral stress management (CBSM) intervention--and a monthly maintenance program--on health behaviors, mood and psychological adjustment, quality of life and physical health status and prognosis in 210 women with HIV infection who are using combination antiretroviral therapy (CART) (and who range from asymptomatic, symptomatic without AIDS, to symptomatic with AIDS). The study is a 2x4 randomized experimental design with experimental conditions (CBSM plus CART versus usual care [CART] as a between group factor and time point (pre-treatment, post- treatment, 6- and 12-month follow up) as a within group factor. Preliminary evidence from pilot testing with a group of symptomatic pre- AIDS HIV positive African American women (n=24) is suggestive of a buffering effect for the intervention for both affective distress (depression and avoidant thoughts) and for CD4 decline observed in the control condition over time. This is consistent with our previously published papers on asymptomatic and symptomatic pre-AIDS HIV+ gay men where we demonstrated that CBSM buffered the psychological and immune impact on an HIV-seropositive diagnosis (or dealing with symptoms), decreased social isolation, and improved adaptive coping strategies. In the proposed project we proposed to extend our pilot investigation with women to include women spanning the full range of the HIV continuum. In addition, because of the changing characteristics of the HIV/AIDS epidemic (i.e., successful introduction of protease inhibitors and antiretroviral combination therapies) we intend to focus also on (a) whether a CBSM intervention can be implemented to enhance health behaviors (medication adherence, reduced substance use, and reduced unsafe sexual behaviors) and other aspects of quality of life (vocational, educational independence/empowerment, social/community involvement), (b) whether these behavioral, psychological and immune effects are accompanied by low levels of viral load and decreased disease progression, and (c) how effective CBSM would be in women at various stages along the HIV/AIDS continuum including those who have already progressed to full-blown AIDS at the time of intervention.