Prevention among HIV+ Crack Users in the Hospital

HTV预防信息通常针对未感染的、有风险的个人，并将重点放在 预防艾滋病病毒的感染。最近，艾滋病毒预防领域的一个转变认识到了 制定针对艾滋病毒阳性个体的干预策略，因为每一次新感染都是从某个人开始的 世卫组织已经感染了艾滋病毒。先前的研究表明，许多艾滋病毒阳性的人继续从事 不安全的危险行为，使用毒品与这些危险行为显著相关。这些数据还表明 泰国吸食可卡因与使用初级门诊艾滋病毒护理呈负相关。医院或住院病房 可能是一个重要的，但在很大程度上尚未开发的环境，为高危、艾滋病毒阳性的人提供预防干预 吸毒者。医院也为艾滋病毒的预防干预提供了一个重要的环境 用户，因为住院可能是患者对行为改变持开放态度的“可教时刻” 干预措施。 我们在迈阿密大学和埃默里大学之间的多地点研究将在杰克逊进行 佛罗里达州迈阿密的纪念医院和佐治亚州亚特兰大的格雷迪纪念医院。我们将评估 对HIV阳性吸毒者进行简短的、理论指导的“预防护理倡导者”干预的效果 从杰克逊医院和格雷迪医院的艾滋病毒住院病房招募。我们将提供多个- 技能建设干预的组成部分，鼓励参与者倡导预防和接受 为自己和同龄人提供初级保健服务。这些干预策略是从策略改编而来的 最近在疾病预防控制中心资助的多点研究中开发和测试。我们将采取随机化的 实验设计：比较注意控制组和干预组的干预效果。参与者将是 在基线、干预完成后6个月和12个月进行评估。这项研究的主要结果 将会减少无保护措施的性行为。次要结果将包括增加对艾滋病毒初级门诊患者的使用 汽车和更多的准备和进入药物治疗。

HTV prevention messages have typically targeted uninfected, at-risk individuals and have focused on forestalling the acquisition of HIV. Recently, a shift in the HIV prevention field has recognized the importance of developing intervention strategies for HIV-positive individuals, since each new infection begins with someone who is already HIV-infected. Prior studies show that many HIV-positive individuals are continuing to engage in unsafe risk behaviors and that crack use is significantly associated with these risk behaviors. These data also show thai crack use is negatively associated with the use of primary outpatient HIV care. The hospital or inpatient ward may be an important, yet largely untapped setting to provide prevention interventionsto high-risk, HIV-positive crack users. Hospitals also provide an important setting for HIV prevention interventions with infected crack users, because hospitalization may serve as a "teachable moment" when patients are open to behavioral change interventions. Our multi-site study between the University of Miami and Emory University will be conducted at Jackson Memorial Hospital in Miami, Florida and Grady Memorial Hospital in Atlanta, Georgia. We will evaluate the efficacy of a brief, theoretically-guided, "Prevention Care Advocate" intervention with HIV-positivecrack users recruited from the HIV inpatient hospital wards at Jackson and Grady hospitals. We will provide a multi- component, skills-building intervention that encourages participants to advocate for prevention and receipt of primary care services for themselves and their peers. These intervention strategies are adapted from strategies recently developed and tested in previous CDC-funded multi-site studies. We will eTiploy a randomized experimental design to compare the intervention'sefficacy with an attention-control group. Participants will be assessed at baseline and 6 and 12 months after completing the intervention. The primary outcome of the study will be to reduce unprotected sex. Secondary outcomes will include increasingthe use of HIV primary outpatient cars and increasing readiness for and entry to drugtreatment.