Treatments Of Drug Dependence In Hiv Infected Patients

该项目评估减少药物滥用者艾滋病毒风险行为的方法，并评估药物和行为治疗对已感染艾滋病毒的阿片类药物依赖的安全性和有效性。一项随机临床试验研究了是否可以通过在基于凭证的应急管理中增加认知行为应对技能和复发预防干预来实现持续的艾滋病毒保护行为。城市内美沙酮维持可卡因滥用者被教导：1）识别和寻找不携带艾滋病毒风险的强化来源; 2）发展适应性问题和情绪为重点的应对反应，以应对可能引发艾滋病毒风险行为的一般和药物特异性压力源。数据正在分析中。在另一项研究中，我们评估了住院的艾滋病毒感染的非洲裔美国妇女是否报告了不同的药物使用模式，并提出了不同的医疗条件比男性同行。参与者是321名非洲裔美国人艾滋病毒+患者，他们在两年的时间里住进了市中心的三级护理教学医院。参与者是根据自我报告的过去或现在的阿片类药物使用情况选择的。与男性相比，女性更有可能报告药物治疗史，但也更有可能报告目前对海洛因的依赖感和目前使用海洛因的情况。女性的CD 4细胞计数也明显高于男性，并且更有可能因“软组织感染/发热”而不是“肠道感染”而入院。“医疗表现（CD 4计数和入院原因）的性别差异集中在目前的海洛因使用者中。因此，在这一住院的艾滋病毒阳性非裔美国人样本中，尽管有更多寻求治疗的报告，但妇女更有可能是目前的使用者，并且更有可能因目前使用药物的健康后果而入院。

This project assesses methods for decreasing HIV-risk behaviors in substance abusers, and assesses the safety and efficacy of pharmacological and behavioral treatments for opioid dependence in those already infected with HIV. A randomized clinical trial examined whether sustained HIV-protective behaviors can be achieved by adding a cognitive-behavioral coping-skills and relapse-prevention intervention to voucher-based contingency management has been completed. Inner-city methadone-maintained cocaine abusers were taught: 1) to identify and seek out sources of reinforcement that do not carry risks of HIV; and 2) to develop adaptive problem-focused and emotion-focused coping responses to general and drug-specific stressors that might otherwise trigger HIV-risk behaviors. Data are being analyzed. In another study, we evaluated whether hospitalized HIV-infected African-American women reported different dru-use patterns and presented with different medical conditions than their male counterparts. Participants were 321 African-American HIV+ patients admitted to an inner-city tertiary-care teaching hospital over a two-year period. Participants were selected on the basis of self-reported past or current opiate use. Compared to men, women were more likely to report a history of drug treatment, but were also more likely to report feeling currently dependent on heroin and to report current heroin use. Women also had significantly higher CD4 cell counts than men, and were more likely to be admitted for "Soft Tissue Infection/Fever" as opposed to "Opportunistic Infections." Sex differences in medical presentation (CD4 count and reason for admission) were concentrated among current users of heroin. Thus, in this sample of hospitalized, HIV-positive African-Americans, women were more likely to be current users, despite more reports of treatment seeking, and were more likely to be admitted due to the health consequences of current drug use.