Intervention Targeting Medication Adherence and Methamphetamine Use for HIV + Men

描述（由申请人提供）：本提案的目的是评估一种干预措施，这种干预措施可以很容易地传播并整合到现有的艾滋病毒诊所和其他社区组织（cbo）中，这些组织提供解决有甲基苯丙胺问题的艾滋病毒阳性患者需求的方案。总的来说，这一干预措施旨在通过制定一项旨在增加艾滋病毒药物依从性、减少甲基苯丙胺使用并对其他健康相关行为（性冒险、其他药物使用等）产生积极影响的简短干预措施，改善艾滋病毒+甲基苯丙胺使用男性的健康和生活质量。具体来说，提出的随机临床试验旨在测试简短的8次治疗条件与8次教育的疗效。此外，该干预将测试Fisher & Fisher（1992）的信息-动机-行为技能（IMB）模型的适用性，以了解艾滋病毒+甲基苯丙胺使用者的依从性和物质使用行为的变化。拟议的干预措施将针对纽约市使用艾滋病毒+甲基苯丙胺的男性，他们报告的艾滋病毒药物治疗方案的依从性低于90%。治疗组将接受8次个性化的动机访谈和认知行为技能培训，而教育（比较）组将接受8次关于艾滋病药物依从性、甲基苯丙胺使用和其他健康相关行为（性冒险、其他药物使用等）的教育。利用一些依从性测量（生物标记、客观和自我报告测量）和甲基苯丙胺使用测量（自我报告和生物测量），本研究将在干预后3、6、9和12个月测试干预的有效性，以确定干预的任何即时和长期影响。此外，我们将考虑信息、动机和行为技能的中介作用，以确定这种基于理论的干预的最有效组成部分。

DESCRIPTION (provided by applicant): The purpose of this proposal is to evaluate an intervention that can be readily disseminated and integrated into existing HIV clinics and other community-based organizations (CBOs) offering programs addressing the needs of HIV+ persons with methamphetamine problems. Broadly, this intervention aims to improve the health and quality of life of HIV+ methamphetamine-using men by developing a brief intervention designed to increase HIV medication adherence, decrease methamphetamine use, and positively impact other health related behaviors (sexual risk-taking, other drug use, etc.). Specifically, the proposed randomized clinical trial aims to test the efficacy of a brief, 8-session therapy condition against 8 sessions of education. Additionally, this intervention will test the applicability of Fisher & Fisher's (1992) Information-Motivation-Behavioral Skills (IMB) model to understand changes in adherence and substance use behaviors among HIV+ methamphetamine users. The proposed intervention will target HIV+ methamphetamine-using men in New York City who report less than 90% adherence to their HIV medication regimens. The treatment condition will receive 8 sessions of individually tailored motivational interviewing and cognitive behavioral skills training, while the education (comparison) condition will receive 8 sessions of education surrounding HIV medication adherence, methamphetamine use, and other health-related behaviors (sexual risk-taking, other drug use, etc.). Utilizing several measures of adherence (biological markers, objective, and self-report measures) and methamphetamine use (self-report and biological), this study will test the efficacy of the intervention at 3, 6, 9, and 12 months post-intervention to determine both any immediate and long-lasting effects of the intervention. Additionally, we will consider the mediating role of information, motivation, and behavioral skills to determine the most effective components of this theoretically-based intervention. The findings of this study could help to reduce methamphetamine use and increase HIV medication adherence among HIV+ men. Specifically if effective, the intervention will help minimize the negative physical and psychological effects associated with methamphetamine and improve HIV medication adherence, which has potential effects for survival and health as well as HIV transmission and HIV drug resistance.