MOTIVATION AND PATCH TREATMENT FOR HIV POSITIVE SMOKERS

艾滋病病毒感染者的治疗 艾滋病病毒（HIV）或已发展为艾滋病的人已经发展到 死亡不再是最有可能的诊断结果。组合 抗逆转录病毒疗法和蛋白酶抑制剂疗法已经 使艾滋病毒感染成为一种可控的慢性疾病。努力改善 艾滋病患者或艾滋病毒携带者的健康和生活质量， 因此，积极是一个高度优先事项。吸烟危害极大 艾滋病毒阳性人群特有的健康风险，包括 细菌性肺炎、口腔念珠菌病，甚至 发展成艾滋病的风险增加。很明显，辞职 吸烟将有助于改善这些风险状况。然而，到目前为止，没有 已经进行了临床研究以评估 专门针对艾滋病毒的戒烟治疗的有效性- 吸烟的积极人群。 在添加剂设计中，本提案将评估以下两种处理： 在四个治疗艾滋病毒感染者的门诊诊所戒烟 人士目标是招募所有符合条件的吸烟者，无论他们是否 戒烟的动机，进入研究。患者随机分配至 简短的治疗条件将从他们的医生那里得到戒烟的建议 根据NCI指南，从短暂戒烟 辅导他们还将收到尼古丁贴片的处方。 医生和患者之间将安排一次随访访视， 检查他们戒烟的进展。患者随机分配至 动机增强条件将收到他们的进展， 戒烟。患者随机分配至动机增强组 条件将收到上述，除了两个人的访问 (over两个月的时间，以配合病人的常规门诊 访问），由经过培训的健康教育者为您量身定制戒烟方案 干预患者戒烟的动机水平。所有 将对患者进行2个月、4个月和6个月的随访。点 6个月时的吸烟率（7天，CO验证）将 是主要的利益结果。我们假设9%的 动机增强患者在这一点上戒烟， 相比之下，3%的患者在简短的治疗条件。一些 治疗结果的重要介质（例如，自我效能，动机 决策平衡）也将被审查和成本效益的 将对治疗进行评估。这项研究将首先研究 艾滋病毒阳性人群中的不同戒烟治疗， 这些结果将对重要的成本效益停止产生影响 临床护理环境中的干预措施。

Treatments for persons who are infected with the Human Immunodeficiency virus (HIV) or who have developed AIDS have advanced to there point where death is no longer the most likely outcome of a diagnosis. Combination anti-retroviral therapies and treatments with protease inhibitors have made HIV-infection a manageable, chronic conditions. Efforts to improve the health and quality of life of persons living with AIDS or who are HIV- positive is therefore a high priority. Cigarette smoking posses several health risks that are unique to the HIV-positive population, including increased risk of bacterial pneumonia, oral candidiasis, and perhaps even increased risk for progression to full-blown AIDS. Clearly, quitting smoking would help to improve these risk profiles. However, to date, no clinical research studies have been conducted to evaluate the effectiveness of stop smoking treatments specifically tailored to the HIV- positive population of smokers. In a additive design, this proposal will evaluate two treatments for smoking cessation in four outpatient clinics which treat HIV-infected persons. The goal is to enroll all eligible smokers, regardless of their motivation to quit smoking, into the study. Patients randomized into the Brief Treatment condition will receive from their physician a stop smoking intervention, following NCI guidelines from brief smoking cessation counseling. They will also receive a prescription for the nicotine patch. One follow-up visit will be scheduled between the physician and patient to check on their progress at quitting smoking. Patients randomized into the Motivational Enhancement condition will receive on their progress in quitting smoking. Patient randomized into the Motivational Enhancement condition will receive the above, in addition to two in-person visits (over a two month period, to coincide with the patient's regular clinic visits) with a trained Health Educator who will tailor the cessation intervention to the patient's level of motivation to quit smoking. All patients will be followed for a 2-, 4-, and 6-month follow-up. Point prevalence smoking status (7-day, CO verified) at the 6-month point will be the primary outcome of interest. We hypothesize that 9% of the Motivational Enhancement patients will have quit smoking at this point, compared to 3% to patients in the Brief treatment condition. A number of important mediators of treatment outcome (e.g., self-efficacy, motivation decisional balance) also will be examined and the cost effectiveness of the treatments will be evaluated. This study will be the first to examine different smoking cessation treatments in an HIV-positive population and the results will have implications for important cost effective cessation interventions into clinical care settings.