Behavioral activation and HIV risk reduction for MSM with crystal meth abuse

这是一个新的研究者R 03的建议，为一项行为治疗的随机对照试验奠定基础，以减少滥用甲基苯丙胺（冰毒）的男性与男性发生性关系（MSM）的性风险，并有感染艾滋病毒的风险。治疗将结合最先进的行为风险降低咨询方法（例如信息-动机-行为技能建设，IMB; Fisher & Fisher，1992; Fisher & Fisher，1993）和行为激活疗法来治疗抑郁症（IMB模型中的调节剂）。行为激活是一种治疗抑郁症的方法，专注于帮助个人重新参与他们的生活（Martell，2001，2002）。我们之所以选择这种策略，是因为我们的定性研究表明，许多滥用冰毒的男男性行为者无法享受他们以前享受的活动。在不涉及使用冰毒和/或性的活动中缺乏乐趣有助于继续使用冰毒和潜在的不安全性行为。虽然干预的主要结果将是减少性风险，但其他结果将是减少冰毒的使用和减少抑郁症。前6个月为干预发展阶段，后一年半在20名未感染艾滋病的男男性行为者中进行干预试点。该研究将使我们能够证明参与者的接受程度，招募能力，治疗师治疗的可行性以及临床显著的参与者改善。它将允许进一步评价所有研究程序的可行性，调整治疗手册，并将为初始随机对照试验的功效分析提供初步数据。这些目标与NIH关于心理社会治疗发展阶段模型的指南一致（Rounsaville等人，2001年）。PHS 398/2590（2004年9月修订版）第续页格式第页主要研究者/项目负责人（最后、第一、中间）：Mimiaga，Matthew

This is a proposal for a new investigator R03 to lay the groundwork for a randomized controlled trial of a behavioral treatment to reduce sexual risk taking in men who have sex with men (MSM) who abuse crystal methamphetamine (crystal meth), and are at risk for HIV acquisition. The treatment will incorporate state of the art behavioral risk reduction counseling approaches (e.g. information-motivation-behavioral skills building, IMB; Fisher & Fisher, 1992; Fisher & Fisher, 1993) with behavioral activation therapy to treat depression (a moderator in the IMB model). Behavioral activation is a treatment of depression that focuses on helping individuals reengage in their life (Martell, 2001, 2002). We chose this strategy for MSM who abuse crystal meth because our formative qualitative work revealed that many MSM who abuse crystal meth become unable to enjoy activities that they had previously enjoyed. This lack of enjoyment in activities that do not involve crystal meth use and / or sex contributes to the motivation for continued crystal use and potentially unsafe sex. While the main outcome of the intervention will be to reduce sexual risk taking, additional outcomes will be reduced crystal meth use and reduced depression. The first 6-months will be an intervention development phase, and the next year and a half will be a pilot of the intervention among 20 HIV-uninfected MSM. The study will allow us to demonstrate participant acceptance, ability to recruit, feasibility of treatment delivery with therapists, and clinically significant participant improvement. It will allow for further evaluation of the feasibility of all study procedures, adaptation of the treatment manual, and will provide pilot data for a power analysis for an initial randomized controlled trial. These goals are consistent with NIH guidelines for a stage model of psychosocial treatment development (Rounsaville et al., 2001). PHS 398/2590 (Rev. 09/04) Page Continuation Format Page Principal Investigator/Program Director (Last, First, Middle): Mimiaga, Matthew