BEHAVORIAL INTERVENTIONS FOR WOMEN WITH HIV/AIDS

描述(改编自申请者摘要)：主要目标 这项拟议的多点临床试验将继续努力开发 最有效的行为干预组合，以优化健康 受艾滋病影响的最受忽视和研究不足的人群的状况 在这个国家流行：贫穷的有色人种妇女感染艾滋病毒/艾滋病。发现 从目前对这一人群的研究中肯定了 认知-行为压力管理训练结合 表达支持疗法(CBSM+)在减少痛苦(抑郁， 焦虑)和否认，同时改善社会支持、自我效能、应对 技能和生活质量。拟议的研究将把这些发现扩展到 寻求确定暴露于CBSM+是否可以显著改善 参与者利用健康行为改变的能力 鼓励采用和维持更健康的生活方式的计划 行为(高水平的服药依从性，适当的营养摄入 和体力活动、更安全的性行为和减少药物使用/滥用) 在艾滋病毒/艾滋病携带者的背景下，这对最佳健康至关重要。一个 推论的目标将是确定拟议的干预措施 计划将有利于受影响的文化适应程度较低的部分 人口(即感染艾滋病毒/艾滋病的非英语妇女) 该节目的西班牙语和西班牙语版本具有文化和语言敏感性 克里奥尔语。 为了实现这些目标，拟议的第三阶段多站点临床试验 在两个相互关联的互动研究项目赠款申请中描述(迈阿密- S.Weiss，P.I.；纽约/新泽西-J.托宾，P.I.)将使450人随机化 在艾滋病毒/艾滋病的三个主要震中感染艾滋病毒/艾滋病的种族妇女 妇女(迈阿密：N=180；纽约：180；新泽西：N=90)组成一个小组 CBSM+条件和个体心理教育比较条件(阶段 i)。在第一阶段之后，参与者将按小组或队列随机分为 团体“更健康的生活方式”技能培训计划或个人健康 教育控制条件(第二阶段)致力于改善用药 坚持、营养、体力活动、更安全的性行为和减少物质使用。 在6个月、12个月和24个月后进行后续评估 治疗。

DESCRIPTION (Adapted from Applicant's Abstract): The principal objective of this proposed multisite clinical trial is to continue efforts to develop the most effective combination of behavioral interventions to optimize the health status of the most neglected and understudied population affected by the AIDS epidemic in this country: poor women of color living with HIV/AIDS. Findings from the current study with this population affirm the utility of cognitive-behavioral stress management training combined with expressive-supportive therapy (CBSM+) in reducing distress (depression, anxiety) and denial, while improving social support, self-efficacy, coping skills and quality of life. The proposed study will extend these findings in seeking to determine whether exposure to CBSM+ can significantly improve the ability of the participants to take advantage of a health behavior change program encouraging the adoption and maintenance of healthier lifestyle behaviors (high levels of medication adherence, appropriate nutritional intake and physical activity, safer sexual practices and reduced substance use/abuse) essential for optimal health in the context of living with HIV/AIDS. A corollary objective will be to determine whether the proposed intervention program will be beneficial to less-acculturated segments of the affected population (i.e., non-English speaking women with HIV/AIDS) by establishing culturally- and linguistically-sensitive versions of the program in Spanish and Creole. To accomplish these objectives, the proposed Phase III multisite clinical trial described in two linked interactive research project grant applications (Miami- S. Weiss, P.I.; New York/New Jersey- J. Tobin, P.I.) will randomize 450 ethnically diverse women living with HIV/AIDS in the three major epicenters for women (Miami: n = 180; New York: n = 180; New Jersey: n = 90) into a group CBSM+ condition and an individual psycoeducational comparison condition (Phase I). Following Phase I, participants will be randomized by group or cohort into a group "Healthier Lifestyles" skills training program or an individual health educational control condition (Phase II) devoted to improving medication adherence, nutrition, physical activity, safer sex and substance use reduction. Follow-up assessments will be carried out at 6, 12, and 24 months after treatment.