Cell Phone Technology Targeting ART and Suboxone Adherence and Injection Drug Use

描述（由申请人提供）：当前研究的目的是通过创新的短信策略增强丁丙诺啡药物治疗来改善注射阿片类药物使用者的治疗，以促进复发预防技能，减少HIV风险行为，并提高丁丙诺啡和HIV治疗方案的依从性。这个应用程序是为了响应PAS-10-098，“基于技术的艾滋病药物滥用人群依从性干预”，鼓励“社会科学家、医学研究人员和技术专家之间的多学科合作，开发和完善移动技术仪器....”作为促进坚持艾滋病毒治疗方案的干预措施（或干预措施的一部分）。”与PAS的既定目标相一致，本研究的具体目的是：1)根据用户反馈，开发和完善基于认知行为疗法的短信干预（TXT-CBT），以增强对艾滋病毒感染、阿片类药物依赖的注射吸毒者（IDUs）的丁丙诺啡药物治疗；2)开展一项试点随机临床试验，以评估招募和保留个体进行大规模研究的可行性，并确定TXT-CBT优于丁丙诺啡（MM）药物管理对阿片类药物使用、HIV药物依从性、丁丙诺啡依从性和医疗结局的效应大小。MM和MM+TXT-CBT参与者将在基线、治疗结束和治疗后12周进行评估；3)从自我效能感、情绪调节和社会支持三个方面探讨文本- cbt的潜在作用机制。我们假设，相对于单独使用MM，与MM联合使用的TXT-CBT将更大程度地减少阿片类药物的使用和艾滋病毒风险行为，并将改善丁丙诺啡和艾滋病毒治疗方案的依从性。此外，我们预计MM+TXT-CBT会促进负面情绪、自我效能和社会支持的更大变化，以及这些变化

DESCRIPTION (provided by applicant): The objective of the current research is to improve treatment for injection opioid users by augmenting buprenorphine pharmacotherapy with an innovative text-messaging strategy to promote relapse prevention skills, reduce HIV-risk behaviors, and improve buprenorphine and HIV treatment regimen adherence. This application is in response to PAS-10-098, "Technology Based Adherence Interventions for Substance Abusing Populations With HIV," which encourages "multidisciplinary colaboration between social scientists, medical researchers, and technology experts to develop and refine mobile technological instrumentation....as interventions (or part of interventions) that foster adherence to HIV treatment regimens." Consistent with this stated objective of the PAS, the specific aims of this research are 1) To develop and refine, with user feedback, a cognitive behavioral therapy-based text-messaging intervention (TXT-CBT) to augment buprenorphine pharmacotherapy in HIV-infected,injection drug users (IDUs) with opioid dependence; 2) To conduct a pilot randomized clinical trial to assess the feasibility of recruiting and retaining individuals for a lrge scale study and to determine the effect size of TXT-CBT over and above medication management with buprenorphine (MM) on opioid use, HIV medication adherence, buprenorphine adherence, and healthcare outcomes. Both MM and MM+TXT-CBT participants will be assessed at baseline, treatment-end, and 12 weeks post-treatment; and 3) To examine potential mechanisms of action of TXT-CBT, including self-efficacy, affect regulation, and social support. We hypothesize that TXT-CBT delivered in conjunction with MM will produce greater reductions in opioid use and HIV-risk behaviors, and will improve buprenorphine and HIV treatment regimen adherence, relative to MM alone. Further, we expect that MM+TXT-CBT will facilitate greater changes in negative affect, self-efficacy, and social support, and these changes will be associated with substance use outcomes. TXT- CBT incorporates specific substance- and adherence-focused cognitive therapy techniques with a concurrent emphasis on reducing HIV-risk behaviors. By providing support to maximize HIV treatment regimen adherence, coupled with coping skills to address withdrawal symptoms and stress, two important factors in opioid relapse, TXT-CBT may provide a promising, cost-effective, and easily deployable augmenting strategy for the treatment of opioid users who are HIV-infected.