Drug Abuse, Depression and Responses to HIV Counseling

描述：（由申请人提供）本研究的长期目标 是为了减少人类免疫缺陷病毒感染的发生， 1（艾滋病毒）在工业化国家通过开发方法来识别和治疗 对艾滋病毒检测和咨询的反应受到阻碍的高危人群 精神病理学。该项目的具体目标是（1）描述 接受艾滋病毒检测的人中精神病的分布情况， 咨询，和（2）测试的假设，高风险，艾滋病毒血清阴性 轻度至中度抑郁的人更有可能采用 保护性行为的变化时，提供药物治疗， 与安慰剂治疗相比，抑郁症。本研究旨在实现特定的 目的2是安非他酮的随机双盲临床试验 盐酸盐与安慰剂给药共7个月。研究 人口最初将是高风险的，艾滋病毒血清反应阴性的男子， 男男性接触者。不符合条件或拒绝进入临床研究的个人 试验将进入观察性研究。主要结局指标 临床试验将是自我报告的未受保护的伴侣数量， 接受性肛交次要结果将是使用的物质， 通过自我报告和毒理学分析的药物使用频率;（c）新感染 性传播感染包括淋病梅毒卡波西氏病 肉瘤相关疱疹病毒和丙型肝炎病毒（HCV）和HIV;和（d） 心理因素的测量已经被证明是，或被认为是 与艾滋病毒发病率有关，包括自我效能的衡量， 自尊、变化阶段和抑郁。登记数据来自 观察性研究将与来自临床研究的入组数据相结合。 试验旨在描述精神病理学的分布情况， 高风险男男性接触者滥用药物。纵向数据来自观察 研究将用于评估精神病理学、物质 使用的药物和药物使用频率与不良后果。

DESCRIPTION: (provided by applicant) The long-term objective of this research is to reduce the incidence of infection with human immunodeficiency virus type 1 (HIV) in industrialized countries by developing methods to identify and treat high-risk individuals whose response to HIV testing and counseling is hindered by psychopathology. The project's specific aims are (1) to describe the distribution of psychopathologies among persons undergoing HIV testing and counseling, and (2) to test the hypotheses that high-risk, HIV-seronegative persons with mild-to-moderate depression will be more likely to adopt protective behavior changes when provided with pharmacotherapy for their depression than when treated with placebo. The study design to achieve specific aim 2 will be a randomized, double-blinded clinical trial of bupropion hydrochloride versus placebo administered for a total of 7 months. The study population will be initially high-risk, HIV-seronegative men who have sex with men (MSM). Individuals who are ineligible or decline entry into the clinical trial will be entered into an observational study. The primary outcome measure of the clinical trial will be self-reported numbers of partners in unprotected receptive anal intercourse. Secondary outcomes will be substances used and frequency of substance use by self-report and toxicology; (c) new infections with sexually transmitted infections including gonorrhea, syphilis, Kaposi's sarcoma-associated herpesvirus, and hepatitis C virus (HCV) and HIV; and (d) measures of psychological factors that have been shown to be, or are thought to be, associated with HIV incidence rates, including measures of self-efficacy, self-esteem, stage of change, and depression. Enrollment data from the observational study will be combined with enrollment data from the clinical trial to provide a description of the distribution of psychopathologies and substance abuse among high-risk MSM. Longitudinal data form the observational study will be used to assess the associations of psychopathologies, substances used and frequency of substance use with adverse outcomes.