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.
研究概览
地位
条件
研究类型
注册 (实际的)
阶段
- 不适用
联系人和位置
学习地点
-
-
Colorado
-
Denver、Colorado、美国、80218
- Project Safe
-
-
参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
描述
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
学习计划
研究是如何设计的?
设计细节
- 主要用途:治疗
- 分配:随机化
- 介入模型:交叉作业
- 屏蔽:无(打开标签)
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
|
有源比较器:HIV Testing and Counseling
|
A manualized individual-level model consisting of two education and counseling sessions that structurally bracket confidential HIV antibody screening.
|
|
有源比较器: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.
|
|
实验性的: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.
|
研究衡量的是什么?
主要结果指标
结果测量 |
大体时间 |
|---|---|
|
Reduction of drug use, specifically methamphetamine
大体时间: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
大体时间:12-month follow-up interview
|
12-month follow-up interview
|
|
Improved mental health status
大体时间:12-month follow-up interview
|
12-month follow-up interview
|
合作者和调查者
调查人员
- 首席研究员:Karen F Corsi, ScD, MPH、University of Colorado, Denver
研究记录日期
研究主要日期
学习开始
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (估计)
研究记录更新
最后更新发布 (估计)
上次提交的符合 QC 标准的更新
最后验证
更多信息
此信息直接从 clinicaltrials.gov 网站检索,没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求,请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改,我们的网站上也会自动更新.