Multi-level HIV Prevention for Pregnant Drug Abusers

描述(由申请人提供)：这项拟议的研究针对正在接受治疗的孕妇吸毒者，是一项关于增强型行为技能培训(E-BST)与时间和注意力匹配的健康促进比较(HPC)条件的随机试验。E-BST是原始BST干预的改编(Eldridge，St.Lawrence等人)。(1997)，旨在加强最初的BST基于关系的社会能力技能，对于维持对保护性行为的坚持至关重要。E-BST强调与性伴侣/重要他人的谈判/沟通技能，以及寻求帮助和利用服务的社会生态技能。这种在多个互动水平上的生态增强--在最初的BST试验中指出可能有助于拒绝技能--可能会在干预结束后继续加强行为改变。BST是女性在药物治疗中仅有的有效的行为干预措施之一；然而，只有温和的、短期的收益被证明。越来越多的证据表明，影响将继续微乎其微，直到干预措施超越个人，解决可使妇女在实际生活中赋权的背景因素，并解决采取和维持保护性行为的困难。参与者将是320名不同文化背景的孕妇吸毒者(30%西班牙裔，60%非裔美国人)，随机分配到E-BST和HPC接受治疗。我们将利用他来探索干预效果是如何通过理论上相关的个体认知-行为(例如，信息-动机-行为；Fisher and Fisher，1992)和语境(例如，药物滥用、服务和社会支持利用)因素以及关键背景因素：认知功能和创伤性虐待史来调节的。建议的项目响应了NIH关于翻译研究的优先事项，以使有效的以研究为基础的干预策略适应“现实世界”的条件。如果成功，这项研究将提供一种可实现的艾滋病毒干预战略，将研究与实践联系起来，可以在其社区内为怀孕吸毒者实施。

DESCRIPTION (provided by applicant): The proposed study, targeting Pregnant Drug Abusers in treatment, is a randomized trial of Enhanced- Behavioral Skills Training (E-BST) compared to a time- and attention-matched Health Promotion Comparison (HPC) condition. E-BST is an adaptation of the original BST intervention (Eldridge, St. Lawrence et al. 1997), designed to strengthen relationship-based social competency skills of the original BST were crucial in sustaining adherence to protective behavior. The E-BST emphasizes negotiation/communication skills with sexual partners/significant others and social ecological skills of help- seeking and service utilization. Such ecological enhancements at multiple interactive levels-pointed to in the original BST trial as potentially facilitative of refusal skills-may provide continued reinforcement of behavioral change even after the intervention has ended. BST is one of the only effective behavioral interventions for women in drug treatment; however, only modest, short-term gains were demonstrated. Growing evidence indicates that impacts will continue to be minimal until interventions go beyond the individual to address contextual factors that can empower women in their actual life situations and address the difficulty of adopting and sustaining protective behavior. Participants will be 320 culturally diverse (30% Hispanic, 60% African American) pregnant drug abusers in treatment with random assignment to the E-BST and HPC. We will use HIM to explore how intervention effects are mediated by theoretically relevant Individual Cognitive-Behavioral (e.g., Information-Motivation-Behavior; Fisher and Fisher, 1992) and Contextual (e.g., Drug Abuse, Service and Social Support Utilization) factors and moderated by key background factors: cognitive functioning and traumatic abuse history. The proposed project responds to the NIH priority on translational research to adapt effective research-based intervention strategies to "real world" conditions. If successful, this research will offer a realizable HIV intervention strategy, bridging research and practice, that can be implemented for pregnant drug abusers within their communities.