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

描述(申请人提供)：尽管有广泛的艾滋病毒预防方法和相关研究，但美国有一个长达十年的趋势，每年有40,000例新的艾滋病毒诊断(CDC，2004；Copenhaver&Fisher，正在出版中)。注射吸毒者仍然是目标人群，因为他们是通过可预防的毒品和与性有关的艾滋病毒危险行为传播新的艾滋病毒感染的重要媒介(Avants等人，2004年；MarGolin等人，2003年)。许多以证据为基础的减少艾滋病毒风险干预措施现已作为完整的一揽子干预措施广泛提供。然而，很少有循证干预措施被设计用于在常见的药物治疗CBO中实施，例如美沙酮维持计划(MMPs)，许多高风险吸毒者在MMPs中寻求治疗。此外，基于传播治疗药物依赖的循证行为干预措施的类似努力(Morgenstein等人，2001年；医学研究所，1998年)，少数几个适用于药物治疗CBO的循证干预措施并不是设计成对社区友好的，因此不太可能在这些关键环境中按照预期或持久的方式实施。我们的研究团队已经开发了一个大大缩短的、对社区友好的全面循证整体健康恢复计划的版本(HHRP；Avants等人，2004年；MarGolin等人，2003年)。简化版本，社区友好健康恢复计划(CHRP)，已经在资源有限的药物治疗CBO内的一项非对照研究中证明了可行性和可接受性，并提供了有效性的初步证据(Copenhaver等人，在印刷中；见附录)。在这个修订的R01应用中，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被发现是有效的，CHRP有可能如设计的那样，完全整合到许多其他资源有限的CBO中，在这些组织中，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.