Reduction of Drug Use and HIV Risk Among Out-of-Treatment Methamphetamine Users
There is a need to identify and test effective strategies to reduce meth use and human immunodeficiency virus (HIV) risk behaviors in heterosexuals. This project will compare the efficacy of a manually-driven HIV testing and counseling (HIV T/C) intervention, with HIV T/C plus a manualized Contingency Management (CM), with HIV T/C plus CM plus a manualized Strengths-Based Case Management (CM/SBCM) model. As HIV T/C is the standard of care, the investigators are testing to determine if the investigators can enhance this standard. The specific aims and hypotheses of this protocol are:
- To compare the relative efficacy of HIV T/C vs. CM vs. CM/SBCM on reducing drug use, specifically meth use. Hypothesis 1: CM/SBCM will reduce drug use more than those in CM (which will have more reduction than HIV T/C), potentially mediated through increased service utilization.
- To compare the relative efficacy of HIV T/C vs. CM vs. CM/SBCM on reducing HIV and STI risk behaviors, specifically sex risk behaviors but also needle risk for injection drug users (IDUs). Hypothesis 2: CM/SBCM will have greater decreases in HIV risk behaviors than those in CM (which will have greater decreases than HIV T/C), potentially mediated through reduced drug use.
- To compare the relative efficacy of HIV T/C vs. CM vs. CM/SBCM on improving mental health status. Hypothesis 3: CM/SBCM will have greater improvements in mental health status than those in CM (which will have greater improvements than HIV T/C), potentially mediated through increased service utilization and reduction of drug use, and potentially moderated by baseline meth use.
調査の概要
状態
条件
研究の種類
入学 (実際)
段階
- 適用できない
連絡先と場所
研究場所
-
-
Colorado
-
Denver、Colorado、アメリカ、80218
- Project Safe
-
-
参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- 18 years of age or older
- Be competent (not too intoxicated or mentally disabled) to give informed consent at the time of the interview
- Meth use (verified through urine drug screening and a self-report of meth use of at least 4 times per month for the last 3 months)
- Self-reported sex with someone of the opposite sex in last 30 days
- Ability to provide a reliable address and phone number for contact
- Not in drug treatment in the past 30 days
- Willingness to be tested for HIV at baseline and follow-up
- Not transient and no know reason why he/she will not be available for follow-up interviews
- Not currently mandated by the criminal justice system to receive treatment based on self-report.
Exclusion Criteria:
- Participation in drug treatment in the past 30 days
- Currently participating in another Project Safe study
- Pregnant or attempting to become pregnant
- Intoxicated or impaired mentally to the point that they cannot voluntarily consent to participate tin the project and/or respond to the interview
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:ランダム化
- 介入モデル:クロスオーバー割り当て
- マスキング:なし(オープンラベル)
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
|
アクティブコンパレータ:HIV Testing and Counseling
|
A manualized individual-level model consisting of two education and counseling sessions that structurally bracket confidential HIV antibody screening.
|
|
アクティブコンパレータ:Contingency Management (CM)
Contingency management is based on Skinner's principles of operant conditioning in behavioral psychology, dating back to the 1930s (Skinner 1938).
The basis of this model is that behavior is learned and reinforced by environmental contingencies that reward or punish.
|
A manualized individual-level model consisting of two education and counseling sessions that structurally bracket confidential HIV antibody screening.
In voucher-based CM programs, drug users who submit urine samples that are negative for specified drugs are reinforced with vouchers.
Based on operant conditioning, CM rewards those who comply with the targeted behavior and does not reward when compliance is not achieved.
In this study a mid-value reinforcement CM schedule will be used in order to balance community cost concerns with the need to show comparative efficacy in reducing meth use and concomitant sex risk behaviors in a largely unstudied risk group.
Participants in the CM arm will be asked to come to the study site three times a week to leave a urine sample, get the result, and will then be offered a voucher if their urine is clean and given brief verbal feedback.
|
|
実験的:CM with Strengths-based case management
Strengths-based case management (SBCM) is a specific type of case management that is based on the following principles: 1) clients are most successful when they identify and use their strengths, abilities, and assets; 2) goal-setting is guided by the clients' perceptions of their own needs; 3) the client-case manager relationship is promoted as essential; 4) a creative approach to the use of the community will lead to the discovery of needed resources; and 5) case management is conducted in the community.
|
A manualized individual-level model consisting of two education and counseling sessions that structurally bracket confidential HIV antibody screening.
In voucher-based CM programs, drug users who submit urine samples that are negative for specified drugs are reinforced with vouchers.
Based on operant conditioning, CM rewards those who comply with the targeted behavior and does not reward when compliance is not achieved.
In this study a mid-value reinforcement CM schedule will be used in order to balance community cost concerns with the need to show comparative efficacy in reducing meth use and concomitant sex risk behaviors in a largely unstudied risk group.
Participants in the CM arm will be asked to come to the study site three times a week to leave a urine sample, get the result, and will then be offered a voucher if their urine is clean and given brief verbal feedback.
Strengths-based case management (SBCM) is a specific type of case management that is based on the following principles: 1) clients are most successful when they identify and use their strengths, abilities, and assets; 2) goal-setting is guided by the clients' perceptions of their own needs; 3) the client-case manager relationship is promoted as essential; 4) a creative approach to the use of the community will lead to the discovery of needed resources; and 5) case management is conducted in the community.
It differs from more traditional case management models that emphasize resource brokerage and client advocacy in its recognition that only the individual can change his/her behavior.
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この研究は何を測定していますか?
主要な結果の測定
結果測定 |
時間枠 |
|---|---|
|
Reduction of drug use, specifically methamphetamine
時間枠:12-month follow-up interview
|
12-month follow-up interview
|
|
Reduction of HIV and STI risk behaviors, specifically sex risk behaviors but also needle risk for injection drug users
時間枠:12-month follow-up interview
|
12-month follow-up interview
|
|
Improved mental health status
時間枠:12-month follow-up interview
|
12-month follow-up interview
|
協力者と研究者
捜査官
- 主任研究者:Karen F Corsi, ScD, MPH、University of Colorado, Denver
研究記録日
主要日程の研究
研究開始
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (見積もり)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
追加の関連 MeSH 用語
その他の研究ID番号
- 10-0518
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
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