Drug Abuse, Depression and Responses to HIV Counseling

描述：(申请人提供)本研究的长期目标 是为了减少感染人类免疫缺陷病毒类型的发病率 1(艾滋病毒)在工业化国家通过开发识别和治疗方法 对艾滋病毒检测和咨询反应受阻的高危个人 被精神变态学折磨。该项目的具体目标是(1)描述 精神病理学在接受艾滋病毒检测和治疗的人群中的分布 咨询，以及(2)检验高危、艾滋病毒血清阴性的假设 患有轻度到中度抑郁症的人更有可能采用 为其提供药物治疗时保护性行为的变化 比用安慰剂治疗时更抑郁。本研究设计实现了具体的 目标2将是安非他酮的随机、双盲临床试验 盐酸组与安慰剂组共服药7个月。这项研究 人群最初将是高危、艾滋病毒血清阴性的男性，他们与 男性(MSM)。不符合资格或拒绝进入临床的个人 试验将进入观察性研究。主要结果衡量标准 临床试验将自行报告未受保护的合作伙伴数量 容易接受的肛交。次要结果将是使用的物质和 自我报告使用药物的频率和毒理学；(C)新感染 性传播感染，包括淋病、梅毒、卡波西氏症 肉瘤相关疱疹病毒、丙型肝炎病毒(丙型肝炎病毒)和艾滋病毒；以及 对已经被证明是或被认为是 BE与艾滋病毒发病率有关，包括自我效能的衡量标准， 自尊、变化的阶段和抑郁。注册数据来自 观察性研究将与临床登记数据相结合 试验以提供精神病理学的分布和 高危男男性接触者中的药物滥用情况。来自观测数据的纵向数据 研究将被用来评估精神病理学、物质 使用和使用有不良后果的物质的频率。

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.