Family Therapy Mechanisms in HIV+ Women in Drug Recovery

描述（由申请人提供）：本申请拟研究结构生态系统疗法（SET; Mitrani et al，2000）对药物恢复期HIV阳性女性的影响的家庭机制。这项拟议的研究是NIDA Grant DA 15004（SETA方案）的伴侣，该方案调查了SET在药物恢复期HIV+女性临床试验中的疗效。在SETA协议中，176名女性被随机分配到SET或艾滋病毒健康小组。干预持续4个月。SET致力于改变家庭制度，以加强清醒，增加对艾滋病毒医疗护理的坚持，并减少目标妇女的性传播风险行为。SETA协议只评估SET对康复中的妇女的影响，而不是她的家庭。由于SET的目标是改变整个家庭作为帮助妇女的一种手段，我们假设，对整个家庭（家庭功能）和个别家庭成员的影响将有助于解释妇女的结果。这项拟议的研究将招募SETA协议中的妇女及其家庭。预计共有528名家庭成员。每隔4个月对家庭进行一次评估，为期12个月。SET被假设为影响家庭功能（通过自我报告和观察方法测量）。家庭功能的变化被假设为影响妇女的药物滥用，艾滋病毒药物治疗的依从性，艾滋病毒的危险行为，以及她的家庭成员的个人功能（心理困扰，药物使用和儿童问题行为的父母报告）。将使用潜在增长曲线模型对假设进行检验。了解这些机制将有助于为吸毒康复中的艾滋病毒阳性妇女制定下一代以家庭为基础的干预措施。这将是该研究者的第一个R 01奖项。

DESCRIPTION (provided by applicant): This application proposes to investigate the family mechanisms by which Structural Ecosystems Therapy (SET; Mitrani et al, 2000) has its impact on HIV+ women in drug recovery. This proposed study is a companion to NIDA Grant DA15004 (SETA Protocol), which investigates the efficacy of SET in a clinical trial with HIV+ women who are in drug recovery. In the SETA Protocol, 176 women are randomly assigned to either SET or an HIV health group. The interventions last 4 months. SET works to transform the family system to reinforce sobriety, increase adherence with HIV medical care, and decrease sexual transmission risk behaviors in the target woman. The SETA Protocol only assesses the effect of SET on the recovering woman, not her family. Because SET targets changing the whole family as a means of helping the woman, we hypothesize that effects on the family as a whole (family functioning) and on individual family members will help to explain the woman's outcomes. The proposed study will enroll the women in the SETA Protocol and their families. A total of 528 family members are anticipated. Families are assessed at 4-month intervals for a period of 12 months. SET is hypothesized to affect family functioning (measured by self-report and observational methods). Changes in family functioning are hypothesized to affect the woman's drug abuse, HIV medication adherence, and HIV risk behaviors as well as the individual functioning of her family members (psychological distress, drug use and parent report of problem behaviors in children). The hypotheses will be tested using Latent Growth Curve Modeling. Understanding these mechanisms will facilitate the development of the next generation of family-based interventions for HIV+ women in drug recovery. This will be the first R01 award for this investigator.