Testing a Community-Friendly Risk Reduction Intervention for Injection Drug Users

描述（由申请人提供）：尽管有各种各样的艾滋病毒预防方法和相关研究，但在美国每年有40，000例新的艾滋病毒诊断，这是一个长达十年的趋势（CDC，2004; Copenhaver & Fisher，出版中）。注射吸毒者仍然是目标人群，因为他们是新的艾滋病毒感染传播的重要媒介（Avants等人，2004; Margolin等人，2003），这是通过可预防的药物和性相关的艾滋病毒风险行为发生的。一些循证的减少艾滋病毒风险干预措施现已作为整套干预措施广泛提供。然而，很少有证据为基础的干预措施已被设计为在常见的药物治疗社区组织，如美沙酮维持计划（MMPs），许多高风险的药物使用者寻求治疗的实施。此外，基于传播用于治疗药物依赖的循证行为干预的类似努力（Morgenstern等人，二○ ○一年;医学研究所，1998年），为数不多的循证干预措施，适用于药物治疗社区组织的设计不是“社区友好”，因此不太可能在这些关键的环境中按计划或持久地实施。我们的研究团队已经开发了一个显着缩短，社区友好，全面的循证整体健康恢复计划（HRP; Avants等人，2004; Margolin等人，2003年）。缩短版本，社区友好健康恢复计划（CHRP），已经证明了可行性和可接受性，以及在资源有限的药物治疗CBO内的非对照研究中的有效性的初步证据（Copenhaver等人，见附录）。在这个修订的R 01申请中，我们建议在随机对照试验（RCT）中评估CHRP。如果在拟议的试验中发现有效，CHRP有可能按照设计完全整合到许多其他资源有限的社区组织中，这些组织中有大量高风险吸毒者参与药物治疗。

DESCRIPTION (provided by applicant): Despite a wide array of HIV prevention approaches and related research, there is a decade-long trend of 40,000 new HIV diagnoses per year in the U.S. (CDC, 2004; Copenhaver & Fisher, in press). Injection drug users (IDUs) remain a target population as they represent a significant vector for the transmission of new HIV infections (Avants et al., 2004; Margolin et al., 2003), which occur through preventable drug- and sex- related HIV risk behaviors. A number of evidence-based HIV risk reduction interventions are now widely available as complete intervention packages. However, very few evidence-based interventions have been designed for implementation within common drug treatment CBOs, such as methadone maintenance programs (MMPs), where many high-risk drug users seek treatment. Moreover, based on analogous efforts to disseminate evidence-based behavioral interventions for treating drug dependence (Morgenstern et al., 2001; Institute of Medicine, 1998), the few evidence-based interventions that are applicable to drug treatment CBOs are not designed to be "community-friendly" and are therefore unlikely to be implemented as intended or durable within these critical settings. Our team of investigators has developed a significantly shortened, community-friendly, version of the comprehensive evidence-based Holistic Health Recovery Program (HHRP; Avants et al., 2004; Margolin et al., 2003). The shortened version, the Community-friendly Health Recovery Program (CHRP), has demonstrated feasibility and acceptability as well as preliminary evidence of effectiveness in an uncontrolled study within a resource-limited drug treatment CBO (Copenhaver et al., in press; see Appendix). In this revised R01 application, we propose to evaluate CHRP in a randomized controlled trial (RCT). If found to be effective in the proposed trial, CHRP has the potential to be fully integrated, as designed, within many other resource-limited CBOs where large numbers of high risk drug users participate in drug treatment.