INTERVENING TO REDUCE DRINKING AND AIDS RISK IN GAY MEN

在美国，68%的艾滋病病例发生在男同性恋/双性恋男性中; 在像旧金山弗朗西斯科或匹兹堡这样的城市， 是同性恋在同性恋群体中，不受保护、不安全或"危险"的 性行为仍然是传播艾滋病毒的主要途径 会导致艾滋病 尽管教育项目让大多数男同性恋者 尽管意识到"更安全"的性行为，但不安全的性行为仍在继续。 因为酒精 药物中毒会损害判断力，而且由于 在同性恋群体中，酒精和毒品问题的比例上升， 据推测，酒精的使用会产生一种去抑制作用， 性冒险 事实上，饮酒和 无保护的性行为已经在以前的相关研究中得到证实。 如果药物使用和危险性行为之间存在因果关系， 干预措施侧重于减少酒精和药物使用 应该减少不安全性行为的数量。 拟议 研究比较了没有正式治疗和两种不同的干预措施。 一 干预的重点是减少艾滋病毒的风险，利用教学和技能 建筑技术。 另一个重点是艾滋病毒风险加上物质使用 减少，使用许多相同的技能建设技术，以及 从节制饮酒计划中借鉴的技巧。 大约有420名同性恋和双性恋男性，他们是中度到重度社交 将从社区中招募饮酒者。 他们将随机 分配到治疗或没有治疗计划，并将随访 一年的时间。 在随访期间，一半的干预对象将 接受每月的助推器会议，而其余的没有助推器 sessions. 我们的假设是，助推器将用于维持 在最初的干预中取得的进展。 两项类似的研究，一项在 白色社区（N = 300）和一个黑人社区（N = 120），将 在四年内同时进行。 每周详细 将保留有关酒精/毒品使用和性行为的记录; 主要结果测量是饮酒量的变化 以及危险性行为的数量 一个主要目标是测试 假设饮酒和药物使用的变化将产生一个 大幅度减少危险性行为的发生。

Across the U.S., 68% of all AIDS cases occur in gay/bisexual males; in cities like San Francisco or Pittsburgh, more than 80% of those with AIDS are gay. Within the gay community, unprotected or unsafe or "risky" sexual practices remain the primary means of transmitting the HIV virus that causes AIDS. Although educational programs have made most gay men aware of "safer" sexual practices, unsafe sex continues. Because alcohol and drug intoxication impairs judgment, and because of the apparently elevated rate of alcohol and drug problems in the gay community, it has been speculated that alcohol use produces a disinhibition that leads to sexual risk taking. In fact, strong associations between drinking and unprotected sex have been demonstrated in previous correlational studies. If a causal relationship exists between substance use and risky sexual practices, then interventions focused on reducing alcohol and drug use should produce reductions in the number of unsafe sex acts. The proposed study compares no formal treatment with two different interventions. One intervention focuses on HIV risk reduction, using didactic and skill building techniques. The other focuses on HIV risk plus substance use reduction, using many of the same skill building techniques, as well as techniques borrowed from moderation drinking programs. Approximately 420 gay and bisexual males who are moderate to heavy social drinkers will be recruited from the community. They will be randomly assigned to treatment or no treatment programs, and will be followed over a one year period. During follow-up, half the intervention subjects will receive a monthly booster session, while the remainder have no booster sessions. Our hypothesis is that the booster will serve to maintain gains made during the initial intervention. Two similar studies, one in the white community (N=300) and one in the black community (N=120), will be conducted simultaneously over a four year period. Detailed weekly records about alcohol/drug use and sexual practices will be maintained; the primary outcome measures are changes in amount of alcohol consumed and in the number of risky sex acts. A major goal is to test the hypothesis that changes in drinking and drug use will produce a significant reduction in the occurrence of risky sexual practices.