INTERVENTION FOR COPING WITH HIV AND TRAUMA

描述（改编自申请人摘要）： 性虐待和性创伤造成的情感后果是众所周知的。 虽然描述性研究已经建立了一个历史 儿童性虐待和艾滋病风险行为，一直有有限的研究重点 艾滋病毒感染者性虐待史的经历和影响 疾病该应用程序要求四年的支持，以评估其有效性 对艾滋病毒感染者进行二级预防干预， 与性虐待有关的创伤压力干预模式将 压力和应对的认知理论和交易框架下， 持续性虐待的结果多时段小组干预将包括 五个关键组成部分：1）发展社会支持，建立一个意识， 安全和稳定; 2）识别和表达与过去有关的情绪 创伤和当前与艾滋病毒相关的压力源; 3）发展适应性应对技能 和掌握创伤症状和艾滋病毒相关的压力; 4）认知和 行为技能，以加强自我保健活动，包括艾滋病毒药物治疗的依从性， 药物滥用治疗和减少性风险行为;以及，5）目标 建立、解决问题和寻求支持的技能， 行为和情绪变化。240名感染艾滋病毒的男女， 经历与创伤有关的压力和精神痛苦将被随机 分配到艾滋病毒和创伤应对小组或支持小组比较 条件在基线、干预后以及第4、8和 12-月随访点将用于确定干预结果 方面的影响.据推测，相对于艾滋病毒感染者， 分配到比较条件，HIV感染者中的HIV和 创伤应对干预将表现出：（a）减少心理困扰， 通过创伤压力，整体精神痛苦， （B）制定和实施适应性方法， 应对艾滋病毒和创伤压力;（c）生活质量评分较高; (d)减少物质使用和性风险行为;（e）增加治疗 坚持和保健服务利用;以及（f）改善健康状况 如HIV感染学、CD4细胞和病毒载量计数所示。如果 如果成功，这项研究将确定一种艾滋病毒和创伤应对干预措施 精神健康障碍和疾病二级预防模式 艾滋病毒感染者的进展，这是迫切需要的医疗 以及为艾滋病毒感染者提供服务的心理健康项目。

DESCRIPTION (adapted from the applicant's abstract): The prevalence and adverse emotional consequences of sexual abuse and trauma are well established. Although descriptive studies have established the relationship between a history of child sexual abuse and HIV risk behavior, there has been limited research focused on the experience and impact of sexual abuse histories among people living with HIV disease. This application requests four years of support to evaluate the effectiveness of a secondary prevention intervention for people with HIV infection who are coping with traumatic stress related to sexual abuse. The intervention model integrates the cognitive theory of stress and coping and the transactional framework for under- standing sexual abuse outcomes. The multi-session group intervention will include five key components: 1) development of social support to establish a sense of safety and stability; 2) identification and expression of emotions related to past trauma and current HIV-related stressors; 3) development of adaptive coping skills and mastery over trauma symptoms and HIV-related stressors; 4) cognitive and behavioral skills to enhance self-care activities, including HIV medication adherence, substance abuse treatment, and reduction of sexual risk behaviors; and, 5) goal setting, problem-solving and support-seeking skills development for maintenance of behavioral and emotional changes. 240 men and women with HIV infection who are experiencing trauma-related stress and psychiatric distress will be randomly assigned to an HIV and trauma coping group or a support group comparison condition. Assessments collected at baseline, post-intervention, and 4-, 8- and 12- month follow-up points will be used to determine intervention outcome effects. It is hypothesized that, relative to HIV-infected participants assigned to the comparison condition, HIV infected participants in the HIV and trauma coping intervention will exhibit: (a) reduced psychological distress as assessed by measures of traumatic stress, global psychiatric distress, depression and anxiety; (b) development and implementation of adaptive ways of coping with HIV and traumatic stress; (c) higher ratings of quality-of-life; (d) decreased substance use and sexual risk behavior; (e) increased treatment adherence and health care services utilization; and, (f) improved health status as indicated by HIV symptomatology, CD4 cell and viral load counts. If successful, this research will identify an HIV and trauma coping intervention model for the secondary prevention of mental health disorders and disease progression among HIV-infected persons, which is urgently needed for medical and mental health programs that serve persons with HIV infection.