TREATMENT OF COCAINE ABUSING WOMEN AT HIGH RISK FOR HIV INFECTION

这项研究的目的是评估莫达非尼治疗是否能促进戒酒并降低高性欲。 吸食可卡因上瘾的女性中与艾滋病毒血清转换(HRSB)相关的危险性行为。 预防艾滋病的异性传播可以说是目前面临的最大挑战 医学界。对可卡因上瘾的女性在以下情况下有很大的艾滋病毒血清转换风险 从事HRSB(例如，用性行为换取可卡因，与多个伴侣发生无保护措施的性行为)以获得 可卡因，这在城市社区很容易买到。一种有效的识别和治疗手段 这些妇女应该减少危害她们、她们的性伴侣和伴侣的伴侣的HRSB。 该项目将利用一辆流动外展面包车(MOV)，将我们的研究团队安置在西部中心 费城附近的可卡因大量贩卖和消费，这让我们能够识别 急需教育和成瘾治疗的妇女。在知情同意和全面的 医学/精神病学筛查，符合条件的受试者将接受艾滋病毒检测，包括检测前和检测后 旨在提供有关艾滋病毒传播的有效教育的咨询。届时，主题将是 随机接受莫达非尼(300毫克/天)或安慰剂治疗，疗程为8周，同时服用研究药物 在MOV中进行分配和监控，以优化受试者的便利性和服药依从性。莫达非尼 是一种很有前途的药物，可以在受控条件下阻止可卡因诱导的快感，最近 据报道，在一项受控的试点研究中促进可卡因戒断。心理社会治疗将包括 电话监控和自适应咨询(TMAC)，这是一种创新且经济高效的方法 为目标人群提供一种可行的治疗方法。可卡因的戒断将是 通过每周两次的尿检进行客观测量，并通过风险评估来测量HRSB 电池(RAB)。随机化后3个月和6个月将安排后续评估，以进一步 评估可卡因戒断和HRSB。受试者将接受基因分型，以评估对可卡因的遗传易感性 依赖和药物遗传因素与其对莫达非尼的反应。因此，这个项目 采用创新的方法来识别、治疗和描述需要有效治疗的目标人群 旨在促进康复和预防HRSB的治疗。

The objective of this study is to assess whether modafinil treatment promotes abstinence and reduces high risk sexual behavior associated with HIV seroconversion (HRSB) in women who are addicted to cocaine. Preventing the heterosexual transmission of AIDS is arguably the greatest challenge that currently confronts the medical community. Women addicted to cocaine are at great risk of HIV seroconversion when they engage in HRSB (e.g., trading sex for cocaine, having unprotected sex with multiple partners) to obtain cocaine, which is readily available within urban communities. An effective means of identifying and treating these women should reduce HRSB that jeopardizes them, their sexual partners, and their partners' partners. This project will utilize a mobile outreach van (MOV) that places our research team in the center of West Philadelphia neighborhoods where cocaine is heavily trafficked and consumed, allowing us to identify women in urgent need of education and addiction treatment. After informed consent and a comprehensive medical/psychiatric screening, qualifying subjects will receive HIV testing with pre-test and post-test counseling designed to provide effective education regarding HIV transmission. Subjects will then be randomized to modafinil (300 mg/day) or placebo treatment for a period of 8 weeks with study medications dispensed and monitored in the MOV to optimize subject convenience and medication adherence. Modafinil is a promising agent that blocks cocaine-induced euphoria under controlled conditions, and was recently reported to promote cocaine abstinence in a controlled pilot study. Psychosocial treatment will involve Telephone Monitoring and Adaptive Counseling (TMAC), an innovative and cost-effective approach that provides a feasible means of treatment delivery to the target population. Cocaine abstinence will be measured objectively with twice weekly urine testing and HRSB will be measured with the Risk Assessment Battery (RAB). Follow-up assessments will be scheduled 3 and 6 months after randomization to further assess cocaine abstinence and HRSB. Subjects will be genotyped to assess genetic vulnerability to cocaine dependence and pharmacogenetic factors associated with their response to modafinil. Thus, this project employs innovative means of identifying, treating, and characterizing a target population in need of effective treatment designed to promote recovery and prevent HRSB.