Intervention for HIV+ Adults With Childhood Sexual Abuse

描述（由申请人提供）：本申请提供了一个研究和培训项目，重点是将艾滋病毒预防策略整合到创伤心理健康治疗中。具体而言，拟议的项目旨在为儿童期性虐待（CSA）的艾滋病毒阳性成年幸存者（性活跃且表现出与创伤相关的精神痛苦）开发和试点测试一种干预措施。CSA在艾滋病毒阳性成人中的广泛流行令人担忧，因为CSA与精神健康状况不佳、药物滥用、艾滋病毒风险行为、治疗依从性和结果差有关。培训目标是发展PI在以下方面的专业知识：(1)开发具有文化敏感性的创伤和CSA心理健康治疗方法；(2)将艾滋病毒预防策略整合到创伤和CSA的心理健康治疗中；(3)学习先进的定量数据分析技能，用于纵向数据和结果分析。Drs。Kathleen Sikkema和John Briere将监督培训。本研究的主要目标是：(1)基于自我创伤理论，针对HIV感染者的需求，为有CSA史的HIV+成人开发一套16期的个体认知行为干预；(2)以80名参与者为样本对该干预措施进行试点测试，其中40人将随机分为初始治疗状态，随后进行为期4个月的随访，40人将随机分为为期4个月的候补状态，随后接受研究干预措施的治疗；(3)评估干预措施减少痛苦和艾滋病毒传播风险行为的能力，并为未来的研究收集效应量的估计。该奖项将导致一项干预措施，将艾滋病毒预防策略整合到经历过CSA的艾滋病毒阳性成年人的心理健康治疗中，这是一个艾滋病毒传播行为风险较高的群体，可以在随机对照干预试验中进行评估。该奖项还将支持PI的长期目标，即将艾滋病毒预防战略纳入弱势群体（如创伤幸存者）的精神卫生保健。

DESCRIPTION (provided by applicant): This application presents a program of research and training that focuses on integrating HIV-prevention strategies into mental health treatments for trauma. Specifically, the proposed project aims to develop and pilot test an intervention for HIV-positive adult survivors of childhood sexual abuse (CSA) who are sexually active and exhibit psychiatric distress related to trauma. The widespread prevalence of CSA among HIV+ adults is concerning as CSA has been linked to poor mental health, substance abuse, HIV risk behavior, and poor treatment adherence and outcome. The training objectives are to develop the PI's expertise in: (1) developing culturally sensitive empirically supported mental health treatments for trauma and CSA, (2) integrating HIV-prevention strategies into mental health treatments for trauma and CSA, and (3) learning advanced quantitative data analytic skills for longitudinal data and outcome analysis. Drs. Kathleen Sikkema and John Briere will supervise the training. The primary goals of the proposed project are to: (1) develop a 16 session individual cognitive-behavioral intervention for HIV+ adults with a history of CSA based on self- trauma theory and tailored to meet the needs of those living with HIV; (2) pilot test this intervention with a sample of 80 participants, 40 who will be randomized into an initial treatment condition followed by a four- month follow-up, and 40 who will be randomized into a four-month waitlist condition followed by treatment with the study intervention; and (3) evaluate the intervention's ability to reduce distress and HIV transmission risk behavior, and collect estimates of effect size for future research. This award will result in a intervention that integrates HIV-prevention strategies into mental health treatment for HIV-positive adults who have experienced CSA, a group with elevated risk for HIV-transmission behavior, that can be evaluated in a randomized, controlled intervention trial. The award will also support the PI's long term goal of integrating HIV-prevention strategies into the mental health care of vulnerable populations, such as survivors of trauma.