HEALTH RELATED INTERVENTIONS FOR PERSONS LIVING WITH HIV

描述(申请人摘要)：本项目的目标是设计 并测试一种降低性行为和注射行为风险的干预措施 1,200名艾滋病病毒感染者的行为调查 艾滋病毒携带者将感染传播给其他人和 促进PLH中其他与健康相关的行为改变。这项研究将是 重点关注三个HIV+亚群：女性、男男性行为者(MSM)、 和注射吸毒者(IDU)。研究将在下午4点进行。 地点：洛杉矶、纽约、旧金山和密尔沃基。该项目 将从为期一年的形成性第一阶段研究开始， 150名PLH，使用定性和生活史访谈来描述 影响风险行为的生理、社交和人际环境 在PLH中；了解适应血清状态的阶段；并确定 实施安全性行为、积极保健法案的障碍，以及 生活质量。形成性研究阶段还将允许 侦查人员量身定做指导社会行动的理论模型 采取干预措施，解决影响每个亚群的问题。紧随其后的是 形成性研究阶段，将编写一份手册，以进行干预 15个单独授课的课程，分成三个模块， 旨在促进健康、降低传播风险和 心理应对/人际关系问题。在第二阶段主要干预中 试验中，三个亚组的HIV感染者最近从事了 高危行为将在每个地点招收同等数量的人员 整个研究范围的样本包括艾滋病毒阳性妇女(N=400)、男男性接触者(N=400)和注射吸毒者(N=400)。 总共1,200个公共卫生服务计划将被随机平均分配 每个子组内的号码到立即干预条件或到 干预控制条件滞后。在两次基线访谈之后， 参与者将在接下来的35个月内每隔5个月接受一次评估。 除了预测主要风险行为(传播风险行为)的变化 以及随时间推移的次要结果(卫生保健行为和生活质量) 针对每个模块，调查人员将检查 社会行动理论中出现的中介因素(应对技能、社会 支持问题解决、艾滋病毒相关态度/信念和环境 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财团在 以便提供足够的样本量来评估 干预；增强研究结果的概括性；并利用 每个研究团队的专业知识。成本效益 作为本研究的一部分，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.