Seth C Kalichman
University Of Connecticut Storrs
Project start date: 2008-02-15
Project end date: 2013-01-31
Sponsored Links Excellgen http://Excellgen.com
HIV TREATMENT ADHERENCE INTERVENTION FOR PEOPLE WITH POOR LITERACY SKILLS
Seth C Kalichman, Professor
University Of Connecticut Storrs, 438 Whitney Road Extension, Unit 1133, Storrs-mansfield, Ct 06269
Grant 5R01MH082633-03 from National Institute Of Mental Health
Abstract: Adherence to antiretroviral medications is necessary to achieve sufficient HIV suppression and non- adherence can lead to the development of treatment resistant genetic variants of HIV. Research has demonstrated that people living with HIV/AIDS who have low-levels of health literacy experience greater treatment non-adherence than their higher-literacy counterparts. Interventions are urgently needed to improve treatment adherence in people with poor literacy skills. This application proposes to test a theory- based behavioral intervention for improving HIV treatment adherence in people living with HIV/AIDS who have low-literacy skills. Grounded in the Information Motivation Behavioral Skills (IMB) model of health behavior change, the experimental intervention has been tailored for people with low-levels of health literacy and has been pilot tested in preliminary intervention development research. The intervention is delivered in three one-on-one counseling sessions and one maintenance-focused booster session. The intervention will be conducted in a community care setting in Atlanta. Men (n = 225) and women (n = 225) will be recruited from a AIDS services and infectious disease clinics throughout the Atlanta metropolitan area. Following screening, informed consent and baseline assessments participants will be randomly assigned to receive one of three conditions (a) Theory-based literacy tailored treatment adherence intervention; (b) standard of care non-tailored time-matched adherence counseling intervention; (c) non- contaminating time-matched attention control intervention. Participants will be followed for 12-months observation. Assessments will include measures of information, motivation, and behavioral skills pertaining to HIV treatment adherence, self-report and objective medication adherence, and viral load. The study will test the hypothesis that a theory-based HIV treatment adherence intervention that is tailored for people with low-literacy will improve HIV treatment adherence and health relative to the standard and attention control conditions. The study will also examine the influence of IMB theoretical constructs on intervention outcomes. The intervention under investigation will be among the first to address treatment adherence among people with poor literacy skills. If shown effective, the intervention model will be ready for immediate dissemination to clinical and community adherence enhancement services for people living with HIV-AIDS. Consistent adherence to antiretroviral therapy is necessary for treatment success. People with poor health literacy skills experience considerable difficulty adhering to their medications. Effective strategies for improving adherence in patients with poor health literacy must be tailored to achieve optimal adherence and therefore viral suppression
Keywords: 18 year old; AIDS; AIDS Drugs; AIDS Seroconversion; AIDS Seropositivity; AIDS Virus; AIDS/HIV; AIDS/HIV problem; AOD use; Acquired Immune Deficiency; Acquired Immune Deficiency Syndrome; Acquired Immune Deficiency Syndrome Virus; Acquired Immuno-Deficiency Syndrome; Acquired Immunodeficiency Syndrome; Acquired Immunodeficiency Syndrome Virus; Address; Adherence; Adherence (attribute); Alcohol or Other Drugs use; Anti-AIDS Agents; Anti-AIDS Drugs; Anti-HIV Agents; Anti-HIV Drugs; Anti-HIV Positivity; Anti-Human Immunodeficiency Virus Agents; Anti-Retroviral Agents; Antiretroviral Agents; Area; Attention; Behavior Conditioning Therapy; Behavior Modification; Behavior Therapy; Behavior Treatment; Behavior or Life Style Modifications; Behavioral; Behavioral Conditioning Therapy; Behavioral Modification; Behavioral Research; Behavioral Therapy; Behavioral Treatment; Caring; Clinic; Clinical; Communicable Diseases; Communities; Community Health Services; Comprehension; Conditioning Therapy; Counseling; Drugs; Education; Educational aspects; Elements; Gender; HIV; HIV Antibody Positivity; HIV Infections; HIV Positive; HIV Positivity; HIV Seroconversion; HIV Seropositivity; HIV/AIDS; HIV/AIDS problem; HTLV-III; HTLV-III Infections; HTLV-III Seroconversion; HTLV-III Seropositivity; HTLV-III-LAV Infections; Health; Health Status; Health behavior change; Human Immunodeficiency Viruses; Human T-Cell Leukemia Virus Type III; Human T-Cell Lymphotropic Virus Type III; Human T-Lymphotropic Virus Type III; Immunologic Deficiency Syndrome, Acquired; Individual; Infectious Disease Pathway; Infectious Diseases; Infectious Diseases and Manifestations; Infectious Disorder; Informed Consent; Instruction; Intervention; Intervention Strategies; Investigation; Knowledge; LAV-HTLV-III; Lead; Level of Health; Life; Life Style Modification; Low Literacy Population; Lymphadenopathy-Associated Virus; Maintenance; Maintenances; Measures; Mediation; Medical; Medication; Mental Health; Mental Hygiene; Modeling; Motivation; NIH RFA; Negotiating; Negotiation; Outcome; Participant; Patient Self-Report; Patients; Pb element; Persons; Pharmaceutic Preparations; Pharmaceutical Preparations; Programs (PT); Programs [Publication Type]; Protocols, Treatment; Psychological Health; RGM; Randomized; Randomized Clinical Trials; Reading; Recruitment Activity; Regimen; Relative; Relative (related person); Request for Applications; Research; Research Resources; Resistance; Resources; Risk; Screening procedure; Self-Report; Services; T-Lymphotropic Virus Type III Infections, Human; Testing; Time; Treatment Protocols; Treatment Regimen; Treatment Schedule; Treatment outcome; Trials, Randomized Clinical; Viral; Viral Burden; Viral Load; Viral Load result; Virus-HIV; Woman; anti-retroviral; antiAIDS agent; antibody positive AIDS test; antigen positive AIDS test; antiretroviral; antiretroviral therapy; base; behavior change; behavior intervention; behavioral intervention; drug/agent; educationally disadvantaged; effective intervention; eighteen year old; experience; genetic variant; health literacy; heavy metal Pb; heavy metal lead; improved; intervention design; intervention development; intervention effect; interventional strategy; literacy; medication adherence; medication compliance; meetings; men; men`s; metropolitan; patient population; post intervention; programs; randomisation; randomization; randomly assigned; recruit; resistant; screening; screenings; seropositive (AIDS test); skills; standard of care; substance use; success; theories; therapy design; therapy development; treatment adherence; treatment design; treatment development
Project start date: 2008-02-15
Project end date: 2013-01-31
Budget start date: 1-FEB-2010
Budget end date: 31-JAN-2011
PFA/PA: PA-07-338
5R01MH082633-03 (2010): $523016
Grants awarded to Seth C Kalichman
ASSESSMENT AND PREVENTION OF AIDS RISK BEHAVIOR RELAPSE
Seth C Kalichman, Professor
Medical College Of Wisconsin 8701 Watertown Plank Rd Milwaukee, Wi 532260509
Grant 5R01MH048286-03 from National Institute Of Mental Health IRG: MHAZ
Abstract: While gay men have made significant changes in behavior to reduce risk for HIV infection, there is growing evidence that long-term consistent maintenance of change is difficult for many persons. Because of high HIV prevalence in this population, even infrequent lapses to high-risk behavior confer great risk for contracting or transmitting HIV infection. While relapse has been well-studied in other health behavior areas, there has been very little systematic attention to interventions intended to promote long-term HIV risk behavior change maintenance. In a formative research phase, the proposed study will use focus groups and individual elicitation interviews to identify critical situational, interpersonal, and intrapersonal factors associated with unsuccessful handling of risk behavior lapse urges as well as coping strategies used by homosexually- active men who have been able to successfully resist lapse temptations. The primary study phase will then test the relative impact of four interventions on long-term behavior change maintenance among 600 homosexually-active, continued-risk African-American and white men. Two of the intervention conditions involve 6-hour single group sessions that each include cognitive, attitudinal, and risk-reduction skills training; one of these time-matched interventions will also include specific, intensive training in relapse prevention. The other two conditions will follow the 6-hour core intervention with three group followup sessions and ongoing telephone contacts for 12 months; one of these extended-contact time- matched interventions will also include relapse prevention-training and have followup contacts focused on change maintenance issues while the other will not. This randomized intervention trial will follow participants for 33 months postintervention and utilize multivariate analyses to examine differential intervention impact on indices of risk knowledge, cognitive problem-solving and assertiveness skills relevant to risk reduction implementation, self-reported and self-monitored risk behavior, behavioral and attitudinal intentions, and STD incidence. It is hypothesized that the intervention conditions with specific relapse prevention components will produce, relative to the time-matched conditions without these elements, greater long-term maintenance of risk reduction behavior change. The design will also allow us to explore format, content, delivery, and duration of intervention needed to best promote long-term consistent change; these yet-unstudied issues are of practical importance to public health efforts to curb HIV. The overall intent of this research is to employ and test models for HIV risk reduction which are conceptually based on findings concerning relapse prevention in other health behavior areas and to identify promising intervention strategies for better preparing individuals for the long-term, consistent and perhaps lifelong behavior changes required for the continuing threat of HIV. In addition to HIV prevention, this study is expected to identify better approaches for the prevention of other STD s.
Keywords: AIDS education /prevention, behavior modification, disease proneness /risk, high risk life style, relapse /recurrence, sex behavior, African American, caucasian American, coping, culture, health behavior, homosexuality, longitudinal human study, male, sexually transmitted disease, human subject
Project start date: 1992-04-01
Project end date: 1997-03-31
5R01MH048286-03 (1994): $475937
Gender Violence And HIV Risk Reduction In South Africa
Seth C Kalichman, Professor
University Of Connecticut Storrs 438 Whitney Road Extension, Unit 1133 Storrs-mansfield, Ct 06269
Grant 5R01MH071160-03 from National Institute Of Mental Health IRG: ZRG1
Abstract: This revised proposal requests 4 years of support to conduct developmental research to design and field-test a gender and theory-based behavioral risk reduction intervention for men who are at risk for perpetrating violence against women and at risk for contracting and transmitting HIV in Cape Town, South Africa. As many as one in five South Africans is HIV positive and there are an estimated 1,600 new HIV infections in South Africa each day. South Africa also has the world s highest rates of violence against women and sexual coercion is associated with women s increased risks for HIV infection. Guided by the social constructionist theory of gender and the Information-Motivation-Behavioral Skills model of health promoting behaviors we will conduct 3 stages of intervention development research (Stage 1) initial interviews, focus groups, and quantitative surveys with men and women in a community center in a Cape Town township. Based on information gained from rapid formative studies, this first phase of research will develop a theory-based gender-based violence and HIV-related risk reduction intervention; (Stage 2) Test the feasibility of the newly developed intervention with a small sample of men and receive feedback on the intervention content from women in the community. Stage 2 will also test the feasibility of an audio-computer assisted interview for data collection in the community center; and (Stage 3) Conduct a randomized field test to determine the potential efficacy of the risk reduction intervention for South African men at risk for gender-based violence and HIV. Participants in the field test will be randomly assigned to either receive the newly developed intervention or a time matched attention comparison condition. Following a 6-month follow-up period, we will assess differences between groups on behavioral outcomes. We will also test the moderating effects of gender-based attitudes and beliefs on HIV risk reduction constructs and intervention outcomes. Results of the proposed research will also provide critical information about the role of gender power differentials, attitudes toward women, and AIDS stigmas in HIV transmission risks in South Africa and will offer urgently needed strategies for improving HIV prevention interventions in South Africa.
Keywords: Africa, HIV infection, behavior therapy, disease /disorder proneness /risk, domestic violence, therapy design /development, attitude, communicable disease transmission, gender difference, human therapy evaluation, mental health epidemiology, psychopathology, spouse abuse, behavioral /social science research tag, clinical research, human subject, male, patient oriented research
Project start date: 2004-08-01
Project end date: 2008-07-31
5R01MH071160-03 (2006): $493546
5R01MH071160-02 (2005): $510146
1R01MH071160-01A1 (2004): $501181
Alcohol And HIV Risk Reduction In South Africa
Seth C Kalichman, Professor
University Of Connecticut Storrs 438 Whitney Road Extension, Unit 1133 Storrs-mansfield, Ct 06269
Grant 5R21AA014820-03 from National Institute On Alcohol Abuse And Alcoholism IRG: ZAA1
Abstract: This research proposal is in response to the Request for Applications "Alcohol Abuse and HIV/AIDS in Resource-Poor Societies" (RFA-03-009) and requests 3 years of support to conduct developmental research to design and field test a theory-based behavioral risk reduction intervention for men and women who use alcohol and are at-risk for HIV infection in the Western Cape of South Africa. As many as one in five South Africans is HIV positive and there are an estimated 1,500 new HIV infections in South Africa each day. Guided by the Information-Motivation-Behavioral Skills model of health promoting behaviors we will conduct 3 phases of intervention development research (1) Initial interviews, focus groups, and quantitative surveys with men and women who use alcohol and are at risk for HIV transmission in a Black township in Cape Town South Africa. Based on information gained from rapid formative studies, this first phase of research will develop a theory-based alcohol related risk reduction intervention tailored for use in HIV voluntary testing and counseling contexts in South Africa; (2) Test the feasibility of the newly developed alcohol related HIV risk reduction intervention with a small sample of men and women who use alcohol and engage in risky behavior; and (3) Conduct a randomized field test to determine the potential efficacy of the alcohol risk reduction intervention for South African men and women. Participants in the field test will be randomly assigned to either receive the newly developed intervention or assigned to a time matched attention comparison condition. Following a 6-month follow-up period, we will test for differences between groups on behavioral outcomes. We will also test the mediating effects of information, motivation, and behavioral skills constructs on intervention outcomes. Results of the proposed research will provide critical information about the role of alcohol in HIV transmission risks and will offer urgently needed strategies for improving HIV prevention interventions in South Africa.
Keywords: AIDS education /prevention, alcoholic beverage consumption, health behavior, sex behavior, field study, focus group, health survey, interview, Africa, behavioral /social science research tag, clinical research, human subject
Project start date: 2004-04-01
Project end date: 2007-12-31
5R21AA014820-03 (2006): $303132
5R21AA014820-02 (2005): $310427
1R21AA014820-01 (2004): $320987
MULTILEVEL ALCOHOL-HIV/AIDS PREVENTION IN SOUTH AFRICA
Seth C Kalichman
University Of Connecticut Storrs, 438 Whitney Road Extension, Unit 1133, Storrs-mansfield, Ct 06269
Grant 5R01AA017399-04 from National Institute On Alcohol Abuse And Alcoholism
Abstract: This project will conduct a randomized community-level trial of a theory-based and culturally tailored multilevel HIV/AIDS risk reduction intervention for men and women who drink alcohol in informal drinking establishments (shebeens) in Cape Town South Africa. As many as one in five South Africans is HIV positive and there are an estimated 1,500 new HIV infections in South Africa each day. The multilevel intervention we are testing is grounded in Social Action Theory and incorporates behavioral skills for HIV risk reduction, risk-related alcohol use, and social communication skills for community activation. The intervention consists of three weekly 3-hour group workshops with a community-level intervention component. We will recruit 75 men from shebeens in 12 impoverished neighborhoods (N=900). The neighborhoods will be matched on key characteristics and randomly assigned to either (a) the multilevel HIV/alcohol risk reduction intervention or (b) a time-matched HIV/alcohol information-only education control condition. Participants will be enrolled using chain recruitment to reach men who drink in shebeens and engage in high-risk sexual activities. Following community level randomization, participants will be baseline assessed, intervened with, and followed for 12 months post intervention. We will also monitor changes in alcohol expectancies, AIDS stigmas, social norms and other social environmental factors among men who did not participate in the intervention workshops and women recruited from the same shebeens. Multilevel modeling will test the associations of environmental and individual changes in alcohol use, social norms, alcohol expectancies, and sexual risk behaviors over time. This community level randomized trial will determine the efficacy of a risk reduction intervention for South Africans who drink and are at high-risk for HIV. The study will directly test the effects of alcohol-related social influences at the community level on behavior change and maintenance of change at the individual level. Alcohol is associated with sexual risks for HIV/AIDS in South Africa. Interventions aimed at reducing HIV transmission among individuals who drink alcohol have short-lived effects. Interventions that target both individual and social environmental level behavior change may result in greater and sustained HIV risk reduction. This study will test the effects of a multilevel alcohol and HIV risk reduction intervention for South African men who drink at informal alcohol serving establishments (e.g., shebeens). We will examine community-level intervention effects for men not attending the intervention sessions as well as women sampled from the shebeens. This research will determine social and alcohol contextual influences at the community level that predict individual behavior change over-time
Keywords: AIDS; AIDS Seroconversion; AIDS Seropositivity; AIDS Virus; AIDS prevention; AIDS test; AIDS/HIV; AIDS/HIV prevention; AIDS/HIV problem; AIDS/HIV test; AOD use; Acquired Immune Deficiency; Acquired Immune Deficiency Syndrome; Acquired Immune Deficiency Syndrome Virus; Acquired Immuno-Deficiency Syndrome; Acquired Immunodeficiency Syndrome; Acquired Immunodeficiency Syndrome Virus; Active Follow-up; Address; Advocacy; Affective; Africa; Africa South of the Sahara; African; Alcohol Drinking; Alcohol consumption; Alcohol or Other Drugs use; Alcohols; Anti-HIV Positivity; Applied Research; Applied Science; Basic Research; Basic Science; Behavioral; Cessation of life; Characteristics; Chemical Class, Alcohol; Clinic; Cognitive; Collaborations; Communication, Personal; Communities; Community Surveys; Condom; Condoms, Unspecified; Death; Development; Diagnosis; ETOH level; Education; Education for Intervention; Educational Intervention; Educational aspects; Educational workshop; Effectiveness of Interventions; Enrollment; Environment; Environmental Factor; Environmental Risk Factor; Epidemic; EtOH drinking; Expectancy; Experimental Designs; Female; Fostering; Funding; Gender; Gender Issues; Goals; HIV; HIV Antibody Positivity; HIV Infections; HIV Positive; HIV Positivity; HIV Prevention; HIV Seroconversion; HIV Seropositivity; HIV test; HIV/AIDS; HIV/AIDS prevention; HIV/AIDS problem; HTLV-III; HTLV-III Infections; HTLV-III Seroconversion; HTLV-III Seropositivity; HTLV-III-LAV Infections; High-Risk Sex; History; Home; Home environment; Hour; Human Immunodeficiency Viruses; Human T-Cell Leukemia Virus Type III; Human T-Cell Lymphotropic Virus Type III; Human T-Lymphotropic Virus Type III; Human immunodeficiency virus test; Immunologic Deficiency Syndrome, Acquired; Individual; Instruction Intervention; International; Interpersonal Communication; Intervention; Intervention Strategies; Intervention Studies; Intervention Trial; Investigation; Investigators; LAV-HTLV-III; Life; Link; Lymphadenopathy-Associated Virus; Maintenance; Maintenances; Measurement; Modeling; Monitor; NIAAA; NIH RFA; National Institute on Alcohol Abuse and Alcoholism; Neighborhoods; Outcome; Participant; Personal Communication; Persons; Pilot Projects; Population; Prevention Research; Preventive Intervention; Process; Randomized; Recording of previous events; Recruitment Activity; Reporting; Republic of South Africa; Request for Applications; Research; Research Personnel; Researchers; Risk; Risk Behaviors; Risk Reduction; Risk-Taking; Risky Behavior; STD; Sampling; Sex Behavior; Sexual Activity; Sexual Behavior; Sexual Transmission; Sexually Transmitted Diseases; Sexually Transmitted Disorder; Sexually Transmitted Infection; Social Change; Social Characteristics; Social Environment; Social Perception; Social modification; Social transformation; South Africa; Southern Africa; Specific qualifier value; Specified; Stigmata; Study Section; Sub-Saharan Africa; Subsaharan Africa; T-Lymphotropic Virus Type III Infections, Human; Testing; Time; Training; Training Intervention; Translational Research; Translational Research Enterprise; Translational Science; Transmission; Union of South Africa; Unprotected Sex; Unsafe Sex; Venereal Diseases; Venereal Disorders; Venereal Infections; Virus-HIV; WHO; Woman; Workshop; World Health Organization; adult youth; alcohol effect; alcohol expectancy; alcohol ingestion; alcohol intake; alcohol level; alcohol measurement; alcohol product use; alcohol risk reduction; alcohol use; alcoholic beverage consumption; alcoholic drink intake; antibody positive AIDS test; antigen positive AIDS test; at risk behavior; base; behavior change; condoms; drinking; effect of intervention; enroll; environmental change; environmental intervention; environmental risk; ethanol consumption; ethanol drinking; ethanol effect; ethanol ingestion; ethanol intake; ethanol measurement; ethanol product use; ethanol use; ethyl alcohol measurements; etoh use; follow-up; high risk; high risk sex activity; high risk sex behavior; high risk sexual activity; high risk sexual behavior; instructional intervention; intervention development; intervention effect; interventional strategy; male; meetings; men; men`s; methods to study multiple-level influences; multilevel analysis; multilevel model; multilevel modeling; peer influence; pilot study; post intervention; preventional intervention strategy; prospective; protective behavior; randomisation; randomization; randomized trial; randomly assigned; recruit; response; risky sexual behavior; seropositive (AIDS test); sex; sex activity; sex risk; sexual violence; skills; social; social climate; social communication; social context; social stigma; socioenvironment; stigma; substance use; theories; therapy development; translation research enterprise; transmission process; treatment development; uptake; young adult
Project start date: 2007-09-30
Project end date: 2012-08-31
Budget start date: 1-SEP-2010
Budget end date: 31-AUG-2011
PFA/PA: RFA-AA-07-020
5R01AA017399-04 (2010): $572392
5R01AA017399-03 (2009): $574789
5R01AA017399-02 (2008): $593746
Sponsored Links Excellgen http://Excellgen.com
1R01AA017399-01 (2007): $607729
ALCOHOL-RELATED HIV RISKS AMONG SOUTH AFRICAN WOMEN
Seth C Kalichman
University Of Connecticut Storrs, 438 Whitney Road Extension, Unit 1133, Storrs-mansfield, Ct 06269
Grant 5R01AA018074-03 from National Institute On Alcohol Abuse And Alcoholism
Abstract: This project will conduct a multilevel prospective analysis of alcohol-related HIV/AIDS risks among women who drink in alcohol serving establishments (shebeens, taverns and bottle stores) in Cape Town South Africa. As many as one in five South Africans is HIV positive and there are an estimated 1,500 new HIV infections in South Africa each day. Research consistently shows that alcohol is closely related to HIV transmission risks in southern Africa, although most research in drinking establishments has focused on men. Our proposed multilevel analysis is grounded in Social Action Theory and incorporates factors derived from three levels of analysis structural/environmental, social/interpersonal, and individual. We propose collecting environmental level data from two informal drinking places (shebeens), two larger drinking places (taverns), and businesses that sell and do not serve alcohol (bottle stores) in two racial/cultural communities (Black Africans of Xhosa heritage and mixed racial background Coloured), for a total of 12 drinking establishments. Data will be collected from key informants (n=20), alcohol serving business owners, managers and servers (n=60), interviews (n=240) and cross-sectional surveys (n= 900) of men and women drinkers, and a prospective cohort of women (n=300). Assessments at the structural/environmental, social/interpersonal, and individual levels will be collected at 4 time points baseline, 4-, 8-, and 12-months. We will test the associations of alcohol serving establishment characteristics, socioeconomic conditions, gender dynamics, social norms and collective efficacy, and individual risk characteristics including alcohol expectancies and risk reduction self-efficacy of women who drink in the target settings. We will use multilevel modeling to test whether contextual factors, including socioeconomic conditions and drinking setting characteristics, directly predict social interactions and social dynamics of women´s risks for HIV/AIDS. We will also examine characteristics of drinking settings, propensity for gender violence, and men´s gender attitudes in relation to women´s alcohol-related HIV risks. We also propose conducting a series of intervention development activities that will be informed by our multilevel study, providing a new intervention model as the study end-product available for subsequent testing. The proposed study will therefore directly meet the urgent need for new multilevel HIV prevention intervention models for women who drink in alcohol serving establishments in South Africa. Alcohol is associated with sexual risks for HIV/AIDS in South Africa. Research has shown that men who drink at alcohol serving establishments are at high risk for HIV transmission, but little research has focused on South African women who drink in these settings. Structural/environmental, social/interpersonal, and individual level factors influence alcohol use and risk behavior, although the complex interplay of these factors has not been examined among women who drink. This study will test a multilevel model of alcohol and HIV risks among African and Coloured women in South Africa using a prospective study design. Multilevel risk factors will be examined at small informal alcohol serving establishments (shebeens), larger more formal drinking places (taverns), and alcohol sales business (bottle stores). Guided by Social Action Theory, we will examine structural, social, and individual level influences on women´s drinking and HIV risks
Keywords: 8-Azabicyclo(3.2.1)octane-2-carboxylic acid, 3-(benzoyloxy)-8-methyl-, methyl ester, (1R-(exo, exo))-; AIDS; AIDS Seroconversion; AIDS Seropositivity; AIDS Virus; AIDS prevention; AIDS/HIV; AIDS/HIV prevention; AIDS/HIV problem; AOD use; Acquired Immune Deficiency; Acquired Immune Deficiency Syndrome; Acquired Immune Deficiency Syndrome Virus; Acquired Immuno-Deficiency Syndrome; Acquired Immunodeficiency Syndrome; Acquired Immunodeficiency Syndrome Virus; Address; Affective; Africa South of the Sahara; African; Alcohol Drinking; Alcohol consumption; Alcohol or Other Drugs use; Alcohols; Anti-HIV Positivity; Application Context; Attention; Attitude; Awareness; Awarenesses; Beer; Behavioral; Benzeneethanamine, N, alpha-dimethyl-, (S)-; Beverages; Businesses; Cannabis; Cessation of life; Characteristics; Chemical Class, Alcohol; Clinic; Cocaine; Cognitive; Collaborations; Color; Communities; Complex; Cross Sectional Analysis; Cross-Sectional Analyses; Cross-Sectional Studies; Cross-Sectional Survey; Crystal Meth; Dancing; Dancings; Data; Data Collection; Death; Deoxyephedrine; Desoxyephedrine; Diagnosis; Disease Frequency Surveys; Domestic Violence; Drugs; Economic Factors; Economical Factors; Educational workshop; Environment; Epidemic; EtOH drinking; Evaluation; Expectancy; Fostering; Frequencies (time pattern); Frequency; Funding; Gender; Gender Role; Goals; HIV; HIV Antibody Positivity; HIV Infections; HIV Positive; HIV Positivity; HIV Prevention; HIV Seroconversion; HIV Seropositivity; HIV/AIDS; HIV/AIDS prevention; HIV/AIDS problem; HTLV-III; HTLV-III Infections; HTLV-III Seroconversion; HTLV-III Seropositivity; HTLV-III-LAV Infections; Health; Hemp Plant; History; Home; Home environment; Hour; Human Immunodeficiency Viruses; Human T-Cell Leukemia Virus Type III; Human T-Cell Lymphotropic Virus Type III; Human T-Lymphotropic Virus Type III; Immunologic Deficiency Syndrome, Acquired; Indigenous; Individual; International; Intervention; Intervention Strategies; Intervention Studies; Interview; Investigation; Investigators; Kaffir Corn; Kafir; Knowledge; LAV-HTLV-III; Life; Lifestyle Risk Reduction; Link; Lymphadenopathy-Associated Virus; Malt Grain; Malts; Maps; Measurement; Medication; Methamphetamine; Methylamphetamine; Minority; Modeling; Motivation; N-Methylamphetamine; NIAAA; NIH RFA; National Institute on Alcohol Abuse and Alcoholism; Neighborhoods; Outcome; Pattern; Persons; Pharmaceutic Preparations; Pharmaceutical Preparations; Pilot Projects; Population; Pregnant Women; Prevalence; Prevention Research; Prevention of violence; Preventive Intervention; Problem Solving; Process; Prospective Studies; Race; Racial Group; Recording of previous events; Recreation; Reporting; Republic of South Africa; Request for Applications; Research; Research Design; Research Personnel; Research Resources; Researchers; Resources; Risk; Risk Behaviors; Risk Factors; Risk Reduction; Risk Reduction Behavior; Risk-Taking; Risky Behavior; STD; Sales; Sampling; Self Efficacy; Series; Sex Behavior; Sex Roles; Sexual Activity; Sexual Behavior; Sexually Transmitted Diseases; Sexually Transmitted Disorder; Sexually Transmitted Infection; Social Change; Social Environment; Social Interaction; Social modification; Social transformation; Sorghum; Sorghum (Plant); South Africa; Southern Africa; Specific qualifier value; Specified; Stigmata; Stocks, Racial; Structure; Study Section; Study Type; Sub-Saharan Africa; Subsaharan Africa; Substance abuse problem; T-Lymphotropic Virus Type III Infections, Human; Testing; Time; Transmission; Union of South Africa; Venereal Diseases; Venereal Disorders; Venereal Infections; Violence; Virus-HIV; WHO; Wine; Woman; Work; Workshop; World Health Organization; abuse of substances; alcohol expectancy; alcohol ingestion; alcohol intake; alcohol product use; alcohol risk; alcohol use; alcoholic beverage consumption; alcoholic drink intake; antibody positive AIDS test; antigen positive AIDS test; at risk behavior; at-risk drinking; base; behavior change; cohort; contextual factors; design; designing; drinking; drinking behavior; drug/agent; ethanol consumption; ethanol drinking; ethanol ingestion; ethanol intake; ethanol product use; ethanol use; etoh use; high risk; high risk drinking; high risk sex activity; high risk sex behavior; high risk sexual activity; high risk sexual behavior; informant; intervention development; intervention effect; interventional strategy; meetings; men; men`s; methods to study multiple-level influences; multilevel analysis; multilevel model; multilevel modeling; neglect; peer influence; pilot study; preventional intervention strategy; prospective; public health relevance; response; risky drinking; risky sexual behavior; seropositive (AIDS test); sex activity; sex risk; sexual violence; skills; social; social climate; social context; social stigma; socioeconomic; socioeconomically; socioeconomics; socioenvironment; stem; stigma; study design; substance abuse; substance use; theories; therapy development; transmission process; treatment development; violence prevention; violent; violent behavior
Relevance: Alcohol is associated with sexual risks for HIV/AIDS in South Africa. Research has shown that men who drink at alcohol serving establishments are at high risk for HIV transmission, but little research has focused on South African women who drink in these settings. Structural/environmental, social/interpersonal, and individual level factors influence alcohol use and risk behavior, although the complex interplay of these factors has not been examined among women who drink. This study will test a multilevel model of alcohol and HIV risks among African and Coloured women in South Africa using a prospective study design. Multilevel risk factors will be examined at small informal alcohol serving establishments (shebeens), larger more formal drinking places (taverns), and alcohol sales business (bottle stores). Guided by Social Action Theory, we will examine structural, social, and individual level influences on women´s drinking and HIV risks
Project start date: 2008-09-30
Project end date: 2013-08-31
Budget start date: 1-SEP-2010
Budget end date: 31-AUG-2011
PFA/PA: RFA-AA-08-011
5R01AA018074-03 (2010): $574696
5R01AA018074-02 (2009): $568748
1R01AA018074-01 (2008): $611232
Intervention To Close Digital Divide In AIDS Care
Seth C Kalichman, Professor
University Of Connecticut Storrs 438 Whitney Road Extension, Unit 1133 Storrs-mansfield, Ct 06269
Grant 5R01MH063666-04 from National Institute Of Mental Health IRG: ZMH1
Abstract: This application is in response to the RFA "Communications and HIV/STD Prevention" (RFA MH 01003) and requests 4 years of support to conduct a randomized trial of an intervention designed to improve health behaviors and quality of life among people living with HIV- AIDS. This secondary prevention study will determine whether a motivational-skills building intervention, guided by the Information- Motivation-Behavioral Skills (IMB) Model of health behavior change, increases personal capacity to access and effectively use information available on the Internet to empower the practice of health behaviors and improve health outcomes in people living with HIV-AIDS. The communications revolution has expanded the universal availability of information and created opportunities for millions of people with access to the Internet. Access to health communications and resources via the Internet has also demonstrated positive health outcomes for people with chronic illnesses. However, African-Americans, women, and the inner- city poor are at considerable disadvantage for using information technologies due to limited education, limited exposure to computers, and a sense of disconnection from advances in technology. The demography of AIDS suggests, and our preliminary studies confirm, that there is a significant information gap, or digital divide, between persons with HIV-AIDS who have and those who do not have sufficient information technology skills to use the Internet. The proposed research will test the efficacy of an information technology motivational-skills building intervention to improve information consumer skills and health benefits of information resources available via the Internet. The study will recruit, assess, and randomly assign 225 HIV positive men and 225 HIV positive women from community service agencies who possess at least a 6th grade reading level to receive either (a) 10-session motivational-skills building intervention designed to increase effective use of information technology; or (b) 10-session standard educational comparison group; or (c) 2-session minimal intervention control group. Participants will be followed for 12-months to assess the effects of the information technology motivational-skills building intervention on motivation to use the Internet, Internet use, health knowledge, internal health locus of control, social support, problem focused coping, health behaviors, health-related quality of life, and mental health outcomes. We will also test a mediation model based on the IMB model of health behavior adapted for Internet use and information consumer skills. In addition, we will examine the characteristics of HIV infected persons who utilize and benefit from increased access to information available on the Internet and identify personal and social factors that impede and facilitate use of information resources. If successful, the experimental intervention could be readily implemented as a community-based program by AIDS Service Organizations, health centers, and community-based Internet access providers.
Keywords: AIDS education /prevention, HIV infection, Internet, health behavior, information dissemination, information seeking behavior, motivation, quality of life, clinical research, human subject
Project start date: 2001-06-12
Project end date: 2006-05-31
5R01MH063666-04 (2004): $581527
5R01MH063666-03 (2003): $604012
1R01MH063666-01 (2001): $582452
ALCOHOL BELIEFS AND HIV ADHERENCE
Seth C Kalichman
University Of Connecticut Storrs, 438 Whitney Road Extension, Unit 1133, Storrs-mansfield, Ct 06269
Grant 5RC1AA018983-02 from National Institute On Alcohol Abuse And Alcoholism
Abstract: This application addresses the broad challenge area of (06) Enabling Technology and the specific challenge topic 06-OD(OBSSR)-101 Using new technologies to improve treatment adherence. Strict adherence to antiretroviral medications is necessary for people living with HIV/AIDS to achieve sufficient viral suppression to slow disease and alcohol use is a known barrier to medication adherence. Alcohol intoxication effects memory, attention, and other basic cognitive functions that are obviously linked to missing medications. In addition, drinking can affect adherence the day after intoxication due to hangover impairments. Less is known about how alcohol-related beliefs interrupt treatment, such as when individuals believe that they should stop taking their medications to avoid mixing them with alcohol. Believing that mixing alcohol with medications leads to adverse reactions (interactive toxicity beliefs) can result in patients deliberately stopping their HIV therapy. Thus, HIV positive individuals who drink may experience prolonged and dangerous treatment interruptions due to their beliefs about alcohol. There are few studies of alcohol expectancies, including interactive toxicity beliefs, in relation to medication adherence. We propose a 12- month prospective cohort study to examine interactive toxicity beliefs in relation to HIV treatment adherence. Our model predicts that quantity and frequency of alcohol intake will be associated with non- adherence to HIV treatments. We also predict that drinkers who believe that mixing alcohol and HIV medications is toxic will interrupt their therapy when drinking. We hypothesize that interactive toxicity beliefs will predict non-adherence to treatment over and above common factors associated with non- adherence, including quantity and frequency of alcohol consumption. The study will include an innovative combination of reliable and valid technologies for objectively monitoring HIV treatment adherence and alcohol consumption. A cohort of 200 men and women who are (a) taking HIV medications and (b) report drinking alcohol in the previous month will be enrolled in a 12-month prospective cohort. Participant´s alcohol and other drug use as well as HIV treatment adherence will be monitored using cell-phone-based assessment technologies. To monitor HIV treatment adherence, we will use unannounced pill counts conducted every 3 to 4 weeks. Alcohol and other drug use will be monitored using daily interactive voice response technology. Multilevel modeling will test a model of interactive toxicity beliefs in relation to alcohol use and medication adherence over a one year period. Our findings will inform interventions to address alcohol use and HIV treatment adherence in HIV/AIDS patients who drink. The benefits of HIV treatment are only realized with persistent strict adherence and alcohol is a known barrier to medication adherence. Alcohol intoxication effects memory, attention, and other basic cognitive functions that obviously lead to missing medication doses. In addition, beliefs that mixing alcohol with medications will result in adverse reactions (interactive toxicity beliefs) may cause particularly hazardous prolonged interruptions in HIV treatment. Beliefs about alcohol and HIV treatments may contribute to the development and spread of treatment resistant virus representing a significant threat to public health as well as personal health
Keywords: 18 year old; AIDS; AIDS Seroconversion; AIDS Seropositivity; AIDS Virus; AIDS/HIV; AIDS/HIV problem; AOD use; Acquired Immune Deficiency; Acquired Immune Deficiency Syndrome; Acquired Immune Deficiency Syndrome Virus; Acquired Immuno-Deficiency Syndrome; Acquired Immunodeficiency Syndrome; Acquired Immunodeficiency Syndrome Virus; Address; Adherence; Adherence (attribute); Adverse reactions; Affect; Alcohol Drinking; Alcohol Intoxication; Alcohol consumption; Alcohol or Other Drugs use; Alcoholic Intoxication; Alcohols; Anti-HIV Positivity; Anti-Retroviral Agents; Antiretroviral Agents; Area; Attention; Behavioral Research; Belief; Cell Phone; Cellular Phone; Chemical Class, Alcohol; Cohort Studies; Communities; Concurrent Studies; Development; Disease; Disorder; Dose; Drug usage; Drugs; Drunkenness; Drunkennesses; Educational workshop; Enrollment; EtOH drinking; EtOH intoxication; Expectancy; Frequencies (time pattern); Frequency; HIV; HIV Antibody Positivity; HIV Infections; HIV Positive; HIV Positivity; HIV Seroconversion; HIV Seropositivity; HIV therapy; HIV/AIDS; HIV/AIDS problem; HTLV-III; HTLV-III Infections; HTLV-III Seroconversion; HTLV-III Seropositivity; HTLV-III-LAV Infections; Health; Human Immunodeficiency Viruses; Human T-Cell Leukemia Virus Type III; Human T-Cell Lymphotropic Virus Type III; Human T-Lymphotropic Virus Type III; Immunologic Deficiency Syndrome, Acquired; Impairment; Individual; Interruption; Intervention; Intervention Strategies; Interview; Intoxication; LAV-HTLV-III; Lead; Life; Link; Lymphadenopathy-Associated Virus; Medication; Memory; Methods; Modeling; Monitor; Participant; Patients; Pattern; Pb element; Perception; Pharmaceutic Preparations; Pharmaceutical Preparations; Phone; Pill; Procedures; Programs (PT); Programs [Publication Type]; Public Health; Recruitment Activity; Regimen; Reporting; Research; Resistance; Series; Structure; T-Lymphotropic Virus Type III Infections, Human; Technology; Technology Assessment; Telephone; Telephone, Cellular; Testing; Time; Toxic effect; Toxicities; Variant; Variation; Viral; Virus; Virus-HIV; Viruses, General; Voice; Woman; Workshop; alcohol and other drug; alcohol expectancy; alcohol ingestion; alcohol intake; alcohol product use; alcohol response; alcohol use; alcoholic beverage consumption; alcoholic drink intake; anti-retroviral; antibody positive AIDS test; antigen positive AIDS test; antiretroviral; antiretroviral therapy; base; cognitive function; cohort; computerized; disease/disorder; drinking; drug use; drug/agent; eighteen year old; enroll; ethanol consumption; ethanol drinking; ethanol ingestion; ethanol intake; ethanol intoxication; ethanol product use; ethanol response; ethanol use; etoh use; experience; hangover; heavy metal Pb; heavy metal lead; improved; innovate; innovation; innovative; innovative technologies; intervention design; interventional strategy; medication adherence; medication compliance; meetings; men; men`s; methods to study multiple-level influences; multilevel analysis; multilevel model; multilevel modeling; new technology; pill (pharmacologic); programs; prospective; public health medicine (field); recruit; resistant; response; response to alcohol; response to ethanol; seropositive (AIDS test); skills; substance use; theories; therapy design; treatment adherence; treatment design
Relevance: The benefits of HIV treatment are only realized with persistent strict adherence and alcohol is a known barrier to medication adherence. Alcohol intoxication effects memory, attention, and other basic cognitive functions that obviously lead to missing medication doses. In addition, beliefs that mixing alcohol with medications will result in adverse reactions (interactive toxicity beliefs) may cause particularly hazardous prolonged interruptions in HIV treatment. Beliefs about alcohol and HIV treatments may contribute to the development and spread of treatment resistant virus representing a significant threat to public health as well as personal health
Project start date: 2009-09-30
Project end date: 2011-08-31
Budget start date: 1-SEP-2010
Budget end date: 31-AUG-2011
PFA/PA: RFA-OD-09-003
5RC1AA018983-02 (2010): $495063
1RC1AA018983-01 (2009): $461131
BRIEF HIV PREVENTION COUNSELING IN SOUTH AFRICA
Seth C Kalichman, Professor
University Of Connecticut Storrs, 438 Whitney Road Extension, Unit 1133, Storrs-mansfield, Ct 06269
Grant 5R01MH074371-05 from National Institute Of Mental Health
Abstract: This 5 year study will conduct a randomized clinical trial of a gender and culturally tailored theory-based behavioral risk reduction intervention for men and women who are receiving sexually transmitted infection (STI) diagnostic and treatment services from two different types of STI treatment providers in two provinces in South Africa. As many as one in five South Africans is HIV positive and there are an estimated 1,500 new HIV infections in South Africa each day. The experimental intervention in this study was developed by South African and US investigators and pilot tested in South Africa. The intervention is grounded in the experience of South African health service providers, Social Constructionist Theory of Gender, empirical research on AIDS-related stigmas, and elements of a social cognitive theory of health behavior change. The intervention consists of a single 60-minute risk reduction counseling session delivered within the context of STI services. The study will recruit 200 men and 200 women from four STI clinics (N = 1600), two dedicated STI clinics in urban centers and two primary care clinics in townships. Participants will be STI clinic patients over age 18 that have been treated for a previous STI. Participants will be baseline assessed and randomized to receive either (a) the 60 min theory-based and culturally tailored risk reduction intervention or (b) a time and contact matched standard of care HIV and health education session. Participants will be followed for 15 months post intervention. Assessments will be conducted using computer assisted interviews (ACASI). The randomized trial will determine the efficacy of the risk reduction intervention for South African men and women receiving STI clinic services. Outcome analyses will include differences between .conditions on new STI diagnoses over 15 months. We will also test the mediating effects of gender attitudes and beliefs, AIDS stigmas, information, motivation, and behavioral skills constructs on intervention outcomes. Results of this research will therefore test a clinic-based HIV prevention intervention model that is urgently needed in South Africa
Keywords: AIDS; AIDS Seroconversion; AIDS Seropositivity; AIDS Virus; AIDS education; AIDS education/prevention; AIDS prevention; AIDS test; AIDS/HIV; AIDS/HIV prevention; AIDS/HIV problem; AIDS/HIV test; Acquired Immune Deficiency; Acquired Immune Deficiency Syndrome; Acquired Immune Deficiency Syndrome Virus; Acquired Immuno-Deficiency Syndrome; Acquired Immunodeficiency Syndrome; Acquired Immunodeficiency Syndrome Virus; Active Follow-up; Address; Africa South of the Sahara; Africa, Southern; African; Age; Anti-HIV Positivity; Attention; Attitude; Behavioral; Belief; Cessation of life; Characteristics; Clinic; Cognitive; Collaborations; Community Services; Computer Assisted; Controlled Clinical Trials, Randomized; Counseling; Country; Data; Death; Development; Diagnosis; Diagnostic; Education; Educational aspects; Elements; Empirical Research; Epidemic; Exercise; Exercise, Physical; Female; Foundations; Funding; Gender; HIV; HIV Antibody Positivity; HIV Infections; HIV Positive; HIV Positivity; HIV Prevention; HIV Seroconversion; HIV Seropositivity; HIV test; HIV/AIDS; HIV/AIDS prevention; HIV/AIDS problem; HTLV-III; HTLV-III Infections; HTLV-III Seroconversion; HTLV-III Seropositivity; HTLV-III-LAV Infections; Health; Health Care Providers; Health Instruction; Health Personnel; Health Services; Health Training; Health Tutoring; Health behavior change; Health education; Healthcare Providers; Healthcare worker; History; Home; Home environment; Human Immunodeficiency Viruses; Human T-Cell Leukemia Virus Type III; Human T-Cell Lymphotropic Virus Type III; Human T-Lymphotropic Virus Type III; Human immunodeficiency virus test; Immunologic Deficiency Syndrome, Acquired; Individual; Intervention; Intervention Strategies; Intervention Trial; Interview; Investigation; Investigators; LAV-HTLV-III; Life; Lifestyle Risk Reduction; Lymphadenopathy-Associated Virus; Mediating; Mediation; Modeling; Motivation; NIH RFA; Negotiating; Negotiation; Outcome; PROV; Participant; Patients; Pilot Projects; Population; Prevention; Prevention program; Preventive Intervention; Primary Care; Primary Health Care; Primary Healthcare; Provider; Province; Randomized; Randomized Clinical Trials; Randomized Controlled Clinical Trials; Recording of previous events; Recruitment Activity; Reporting; Republic of South Africa; Request for Applications; Research; Research Personnel; Researchers; Risk; Risk Behaviors; Risk Reduction; Risk Reduction Behavior; Risky Behavior; STD; Self Efficacy; Services; Sex Behavior; Sexual Activity; Sexual Behavior; Sexual Partners; Sexual Transmission; Sexually Transmitted Diseases; Sexually Transmitted Disorder; Sexually Transmitted Infection; South Africa; Southern Africa; Stigmata; Study Section; Sub-Saharan Africa; Subsaharan Africa; T-Lymphotropic Virus Type III Infections, Human; Testing; Time; Transmission; Transmission, Sexual; Trials, Randomized Clinical; Union of South Africa; Venereal Diseases; Venereal Disorders; Venereal Infections; Virus-HIV; Woman; Work; antibody positive AIDS test; antigen positive AIDS test; at risk behavior; base; behavior change; computer aided; design; designing; effective intervention; experience; follow-up; health care personnel; health care service; health care worker; health provider; healthcare personnel; high risk; intervention design; interventional strategy; male; medical personnel; meetings; men; men`s; pilot study; post intervention; preventional intervention strategy; primary care setting; protective behavior; randomisation; randomization; randomized trial; randomly assigned; recruit; seropositive (AIDS test); sex; sex activity; sex partner; sex risk; skills; skills training; social; social cognitive theory; social stigma; standard of care; stigma; theories; therapy design; transmission process; treatment design; treatment provider
Project start date: 2005-09-05
Project end date: 2010-08-31
Budget start date: 1-SEP-2009
Budget end date: 31-AUG-2010
PFA/PA: PA-95-070
5R01MH074371-05 (2009): $535638
Sponsored Links Excellgen http://Excellgen.com
5R01MH074371-04 (2008): $510368
5R01MH074371-03 (2007): $514235
5R01MH074371-02 (2006): $536334
1R01MH074371-01A1 (2005): $568478
CORE--ASSESSMENT METHODOLOGIES
Seth C Kalichman, Professor
Medical College Of Wisconsin 8701 Watertown Plank Rd Milwaukee, Wi 532260509
Grant 5P30MH052776-059002 from National Institute Of Mental Health
Abstract: The quality of HIV intervention research is dependent upon the reliable and valid measurement of behavior change. To the extent that study outcomes are demonstrated with measures that meet high scientific standards for reliability, validity, and conceptual relevance, we can have confidence in the behavior change effects produced by interventions. This core will support and stimulate basic research on assessment methodology through four functions 1. Develop, pilot test, and evaluate existing data sets, and provide consultation of CAIR investigators in the areas of multidomain and multimethod assessment of sexual and substance use practices that confer risk for HIV infection, focusing particularly on measures to corroborate self-reports of behavior change and reliability and validity of these measures; 2. Develop, pilot test, and provide consultation to CAIR investigators on methods to tailor measure content and administration format to ensure cultural appropriateness for ethnic minority and low-reading level individuals; 3. Construct assessment measures related to intervention conceptual components in order to enrich opportunities to more precisely identify characteristics of interventions and mediators responsible for their behavior change effects; and 4. Establish a centralized system for efficient cohort tracking and followup location that can be used across multiple CAIR intervention outcome studies. This core will bring together a team of scientists experienced in behavioral, quantitative, and qualitative assessment research methods. The core will support the development, refinement, and adaptation of assessment methodologies and measures for use in existing and new CAIR investigators, will provide support and consultation to new investigators, and will conduct activities to stimulate improvements in research assessment methodologies.
Keywords: AIDS education /prevention, HIV infection, behavior modification, biomedical facility, data collection methodology /evaluation, disease /disorder proneness /risk, psychometrics, culture, sex behavior, substance abuse, behavioral /social science research tag, human data
Project start date: 1998-05-01
Project end date: 1999-03-31
RISK REDUCTION INTERVENTION FOR HIV POSITIVE MEN
Seth C Kalichman, Professor
Psychiatry And Behavioral Medmedical College Of Wisconsin
8701 Watertown Plank Rd
milwaukee, Wi 532260509
Grant 5R01MH057624-04 from National Institute Of Mental Health IRG: MHAI
Abstract: Research has show that continued high-risk sexual practices among people with HIV infection are related to psychological distress, maladaptive coping, difficulty disclosing HIV serostatus to sex partners, and problems coping with high-risk situations. Although HIV risk reduction interventions based on theories of behavior change have been successfully applied to populations vulnerable to becoming HIV infected, there have been no published studies reporting outcomes from theory- based sexual behavior change interventions for HIV seropositive men. This application requests support to develop and test the effects of an HIV risk reduction intervention designed for HIV seropositive men who continue to practice unsafe sex. The proposed research will begin with a 6-month period of formative study to interview 50 HIV seropositive men and women concerning factors that facilitate and interfere with maintenance of safer sex practices. We will also pilot test our assessment instruments and procedures during this period. Beginning in the second half of the first year of study, we will initiate recruitment of 300 HIV seropositive men who will be randomized to one of two experimental conditions 91) a 12 session with 3 booster sessions experimental HIV risk reduction intervention based on social cognitive theory of coping and behavior change. The intervention will include five major components; coping skills training, social support network development, communication and self-disclosure skills enhancement, sexual risk reduction skills enhancement, and relapse prevention; or (2) 12 sessions with 3 reunion sessions contact matched control condition which will be structured as a closed support group. The study will specifically test the effectiveness of an intensive, theory-based HIV coping and risk reduction intervention for men who already know they are HIV infected. An emphasis will also be placed on communication and self-disclosure skills enhancement, and relapse prevention. Assessments collected at baseline, immediately following the intervention, and again at 3-months, 6-months, 9-months, and 12-months following the intervention will be used to determine relative intervention effects on mental health, social support, sexual communication and sexual behavior change outcomes. It is hypothesized that the cognitive behavioral skills intervention will result in increased coping and social support compared to the social support group condition, and that the cognitive behavioral intervention will demonstrate increased self-efficacy, intentions, and acts of disclosing HIV serostatus to sex partners, as well as reduction in high-risk sexual practices and increased condom use, over a longer period of time than the support groups. This research will therefore test the effects of a cognitive behavioral coping and risk reduction skills intervention that, if effective, could be readily implemented by health care clinics and AIDS service organizations providing services to HIV seropositive men
Keywords: AIDS education /prevention, HIV infection, cognitive behavior therapy, disease /disorder proneness /risk, human therapy evaluation, male, sex behavior coping, group therapy, social support network behavioral /social science research tag, clinical research, human subject, interview
Project start date: 1997-09-30
Project end date: 2001-04-30
5R01MH057624-04 (2000): $146591
Sponsored Links Excellgen http://Excellgen.com
5R01MH057624-03 (1999): $595364
1R01MH057624-01 (1997): $298773
VIDEOTAPE-BASED HIV PREVENTION INTERVENTION
Seth C Kalichman, Professor
Georgia State University Po Box 3999 Atlanta, Ga 303023999
Grant 5R01MH053780-04 from National Institute Of Mental Health IRG: MHAI
Abstract: Rates of HIV infection continue to rise in U.S. inner-cities, particularly among young ethnic minority men and women. Research has consistently demonstrated that prevention programs derived from social learning theory and based on cognitive behavioral skills training principles can produce HIV-risk reduction behavior changes. Unfortunately, cognitive behavioral interventions tested to date have relied on professional interventionists for implementation in face-to-face formats, making them difficult to transfer to community-based organizations. This application requests four years of support to develop, implement, and evaluate a behavioral skills training HIV prevention intervention to be delivered by videotape and community group facilitators to inner-city African-American men. The proposed research will begin with a 6-month period of formative study to expand our preliminary studies of situations and circumstances related to HIV-risk among young African-American men and to identify culture and gender themes for use in developing videotape contexts. The second half of the first year will be used to develop and produce two sets of videotapes a five-session HIV prevention intervention using behavioral skills training techniques presented on videotape with subsequent group practice sessions facilitated by community group leaders; and a five-session videotape-based control condition focusing on social issues unrelated to AIDS and of relevance to inner-city men. Group sessions will be led by community-based organization staff who will be randomly assigned to intervention conditions and provided with group facilitation training. The intervention trial will be conducted at an inner-city neighborhood center, where 300 African-American men at recent risk for HIV infection will be randomly assigned to conditions. Assessments collected at baseline, post- intervention, 3-, 6-, 9-, and 12-month follow-ups will be used to determine relative intervention effects on AIDS-related knowledge, risk- related attitudes, intentions and self-efficacy to change behavior, and sexual risk behavior, as well as differences in communication skills and redemption of coupons to receive condoms. It is hypothesized that the HIV prevention intervention will result in increased behavioral skills relevant to HIV-risk reduction, decreases in unprotected sexual intercourse, and increases in condom use relative to the control condition. This research is intended to test the effects of a behavioral skills training intervention delivered by videotape that, if effecti5R01MH053780-03
Keywords: 1996
Project start date: 1994-09-30
Project end date: 1998-05-31
5R01MH053780-04 (1997): $389997
HIV TREATMENT ADHERENCE/RISK REDUCTION INTEGRATED
Seth C Kalichman
Department/ Educational Institution Type:
Grant 5R01MH071164-05 from National Institute Of Mental Health
Abstract: Non-adherence to antiretroviral medications can lead to the development of treatment resistant genetic variants of HIV, which can then be transmitted to sexual risk partners. This application proposes to test a theory-based behavioral intervention to simultaneously improve HIV treatment adherence and reduce HIV transmission risk behaviors in people living with HIV-AIDS. Grounded in the Information - Motivation - Behavioral Skills (1MB) model of health behavior change, the experimental intervention will be delivered in a mixed format model with four group sessions followed by two individual counseling sessions conducted by community-based group facilitators. The intervention will be conducted at an AIDS service organization in Atlanta. Men (n = 225) and women (n = 225) will be recruited from a variety of AIDS services and infectious disease clinics. Following informed consent and baseline assessments, participants will be randomly assigned to receive either the (a) integrated HIV treatment adherence - risk reduction intervention or (b) a time matched non-contaminating standard of care comparison intervention. Participants will be followed over the course of a 12-month observation period. Assessments will include measures of information, motivation, and behavioral skills pertaining to HIV treatment adherence and HIV transmission risks and risk reduction, self-report and objectively assessed medication adherence, sexual transmission risk behaviors, and viral load, and CD4 cell counts. The study will test the hypothesis that a unified, integrated theory-based HIV treatment and risk reduction intervention will improve HIV treatment adherence, reduce HIV transmission risk behaviors, and improve health. The study will also examine the influence of 1MB theoretical constructs on intervention outcomes. Changes in behavior that coincide with and predict maintenance of change and relapse to non-adherence and risk behaviors in relation to changes in viral load over the 12-month follow-up period will also be a focal point of the study. The intervention under investigation will be among the first to simultaneously address treatment adherence and sexual risk behavior in an integrated model derived from a single, unified theory of health behavior. If shown effective, the intervention model will have implications for community and clinical services for people living with HIV-AIDS
Keywords: 18 year old; Acquired Immune Deficiency; Acquired Immune Deficiency Syndrome; Acquired Immune Deficiency Syndrome Virus; Acquired Immuno-Deficiency Syndrome; Acquired Immunodeficiency Syndrome; Acquired Immunodeficiency Syndrome Virus; Active Follow-up; Address; Adherence; Adherence (attribute); AIDS; AIDS prevention; AIDS Seroconversion; AIDS Seropositivity; AIDS Virus; AIDS/HIV prevention; Alcohol or Other Drugs use; Anti-HIV Positivity; anti-retroviral; Anti-Retroviral Agents; anti-retroviral resistance; anti-retroviral resistant; antibody positive AIDS test; antigen positive AIDS test; antiretroviral; Antiretroviral Agents; Antiretroviral resistance; Antiretroviral resistant; antiretroviral therapy; AOD use; ARV resistance; ARV resistant; at risk behavior; Attention; base; Behavior; behavior change; Behavior Conditioning Therapy; behavior intervention; Behavior Modification; Behavior or Life Style Modifications; Behavior Therapy; Behavior Treatment; Behavioral; Behavioral Conditioning Therapy; behavioral intervention; Behavioral Modification; Behavioral Research; Behavioral Therapy; Behavioral Treatment; Caring; CD4 Lymphocyte Count; CD4+ Cell Counts; CD4+ Counts; CDC; Centers for Disease Control; Centers for Disease Control (U.S.); Centers for Disease Control and Prevention; Centers for Disease Control and Prevention (U.S.); Clinic; Clinical Services; Collaborations; Communicable Diseases; Communities; Community Services; Conditioning Therapy; Counseling; demographics; depressed; Depressed mood; Development; Disease; disease control; disease/disorder; Disorder; disorder control; Drug usage; drug use; drug/agent; Drugs; effective intervention; eighteen year old; Elements; Emotional; follow-up; Generations; genetic variant; Genital System, Female, Vagina; Hand; Health; Health behavior; Health behavior change; Health Status; heavy metal lead; heavy metal Pb; high risk; high risk behavior; HIV; HIV Antibody Positivity; HIV Infections; HIV Positive; HIV Positivity; HIV Prevention; HIV Seroconversion; HIV Seropositivity; HIV/AIDS prevention; Home; Home environment; HTLV-III; HTLV-III Infections; HTLV-III Seroconversion; HTLV-III Seropositivity; HTLV-III-LAV Infections; Human Immunodeficiency Viruses; Human T-Cell Leukemia Virus Type III; Human T-Cell Lymphotropic Virus Type III; Human T-Lymphotropic Virus Type III; Immunologic Deficiency Syndrome, Acquired; improved; Individual; Infectious Disease Pathway; Infectious Diseases; Infectious Diseases and Manifestations; Infectious Disorder; Informed Consent; Injection of therapeutic agent; Injections; Intervention; intervention design; intervention development; intervention effect; Intervention Strategies; Intervention Studies; Intervention Trial; interventional strategy; Investigation; Investigators; Knowledge; LAV-HTLV-III; Lead; Learning; Level of Health; Life; Life Style Modification; Lifestyle Risk Reduction; Lymphadenopathy-Associated Virus; Maintenance; Maintenances; Manuals; Measures; Mediation; Medication; medication adherence; medication compliance; meetings; men; men`s; Minority; Modeling; Motivation; Negotiating; Negotiation; NIH RFA; Outcome; pandemic; pandemic disease; Participant; Patient Self-Report; Pb element; Pharmaceutic Preparations; Pharmaceutical Preparations; post intervention; programs; Programs (PT); Programs [Publication Type]; prospective; prototype; PROV; Provider; Public Health; public health medicine (field); QOL; Quality of life; randomisation; randomization; Randomized; Randomized Clinical Trials; randomly assigned; recruit; Recruitment Activity; Relapse; Reporting; Request for Applications; Research; Research Personnel; Researchers; Resistance; resistance to anti-retroviral; resistance to antiretroviral; resistance to ARV; resistant; resistant strain; resistant to anti-retroviral; resistant to antiretroviral; resistant to ARV; Risk; Risk Behaviors; Risk Reduction; Risk Reduction Behavior; Risky Behavior; sadness; Self-Report; seropositive (AIDS test); Services; sex; sex risk; Sexual Transmission; skills; social; Social support; social support network; standard of care; substance use; T-Lymphotropic Virus Type III Infections, Human; T4 Lymphocyte Count; Testing; theories; therapy design; therapy development; Time; Training; Transmission; transmission process; treatment adherence; treatment design; treatment development; Treatment outcome; United States; United States Centers for Disease Control; United States Centers for Disease Control and Prevention; Vagina; Vaginal; Viral Burden; Viral Load; Viral Load result; Virus-HIV; Woman
Project start date: 2005-04-01
Project end date: 2011-03-31
Budget start date: 1-APR-2009
Budget end date: 31-MAR-2011
5R01MH071164-05 (2009): $508378
3R01MH071164-02S1 (2006): $122642
5R01MH071164-02 (2006): $569818
1R01MH071164-01A1 (2005): $566503
BRIEF HIV RISK REDUCTION COUNSELING
Seth C Kalichman, Professor
Psychiatry And Behavioral Medmedical College Of Wisconsin
8701 Watertown Plank Rd
milwaukee, Wi 532260509
Grant 5R01MH061672-02 from National Institute Of Mental Health IRG: ZRG1
Abstract: Applicant´s ) This application is in response to the Program Announcement BRIEF INTERVENTIONS TO PREVENT THE SPREAD OF AIDS (PA 95-070) and requests 3 years of support to test brief HIV risk reduction counseling intervention models for men and women at risk for HIV and other sexually transmitted infections. Based on Fisher and Fisher´s (1992) Information-Motivation-Behavioral Skills model (IMB), we will systematically manipulate two independent intervention components (motivational enhancement and risk reduction skills building) within the context of a single 60-minute face to face counseling session delivered to sexually transmitted disease (STD) clinic clients. We will recruit 400 women and 400 men from a city STD clinic who meet high-risk behavior criteria. Participants will be randomly assigned to 1 of 4 brief HIV risk reduction counseling experimental conditions (a) a single 60-minute counseling session that delivers information about HIV sexual transmission risks, motivational enhancement counseling, and cognitive-behavioral skills for HIV risk reduction; or (b) a single 60-minute counseling session that delivers HIV risk reduction information and motivational enhancement without any cognitive-behavioral skills building components; or (c) a single 60-minute counseling session delivering risk reduction information and risk reduction skills building without motivational enhancement components; or (d) a single 60-minute counseling session delivering only HIV risk reduction information without motivational enhancement and without skills building components. Using the proposed 2 (motivational enhancement / no motivational enhancement) X 2 (behavioral skills building / no behavioral skills building) X 2 gender (male/female) complete factorial design we will assess the effects of brief counseling on incident sexually transmitted diseases, sexual risk behaviors, and condom use over 1-, 3-, 6-, and 12-month follow-up periods. We hypothesize that motivational and behavioral skills components will reduce risk, but a significant interaction will show the complete IMB intervention model is most effective in reducing STD and risk behavior outcomes. In addition we will use mediation and cost-effectiveness analyses to further examine the change mechanisms and the utility of the brief interventions tested in the proposed research. Results of the proposed study will guide the allocation of HIV prevention resources in establishing brief and effective HIV risk reduction counseling services for populations vulnerable to HIV infection
Keywords: AIDS education /prevention, HIV infection, counseling, disease /disorder proneness /risk, sex behavior behavior prediction, cognitive behavior therapy, human therapy evaluation, motivation, safe sex, sexually transmitted disease, training behavioral /social science research tag, clinical research, human subject
Project start date: 2000-09-30
Project end date: 2002-06-03
5R01MH061672-02 (2001): $641912
1R01MH061672-01A1 (2000): $695905
TRAINING IN SOCIAL PROCESSES OF HIV/AIDS
Seth C Kalichman, Professor
University Of Connecticut Storrs, 438 Whitney Road Extension, Unit 1133, Storrs-mansfield, Ct 06269
Grant 5T32MH074387-05 from National Institute Of Mental Health
Abstract: AIDS behavioral research has benefited from the contributions of social psychology and there is a need for training social psychologists committed to AIDS research. The proposed training program will integrate three core areas of social psychological studies with state of the art AIDS behavioral research. During the proposed 5-year training program, we will recruit and train 14 predoctoral students in social processes of AIDS theories, research methods and applications. The Objectives of the 3-year training period are to (1) Train doctoral candidates in one of the three integrated models of HIV/AIDS and basic social behavioral research through a structured program and dual mentorship; (2) Provide trainees with community field research skills relevant to conducting community-based HIV/AIDS behavioral research; (3) Facilitate innovative research ideas in three core areas of HIV/AIDS behavioral research; (4) Have trainees complete an independent field research project in collaboration with an AIDS service provider; (5) Provide trainees with skills and experience in grant writing. All trainees in the program will be dually mentored in AIDS behavioral sciences by one of five Faculty dedicated to AIDS behavioral research and one Faculty member from one of three core-related areas (a) interpersonal relationships, couples, groups and other dyadic processes, (b) social inequality and social disparities, including psychological consequences and correlates of social disenfranchisement, marginalization, discrimination, and stereotyping, and (c) social psychological aspects of gender relations and stigmatizing beliefs and behaviors. Blending HIV/AIDS behavioral studies with core theoretical research on dyadic processes, social inequality, and gender and stigma will yield new and innovative approaches to addressing some of the most compelling contemporary challenges related to AIDS intervention and prevention. We will forge new avenues in dyadic processes of HIV risks and relationships, social aspects of poverty and disparities among people at risk as well as those living with HIV/AIDS, gender relations and gender power imbalances in relation to HIV risks, and social processes related to AIDS stigma. Trainees will be supported for 3 years and will complete extensive training in research design, quantitative methods, substantive courses from different general areas of social psychology, courses from other areas of psychology, and courses from related disciplines including public health, sociology, anthropology, etc. Program trainees will be expected to make research presentations at national or international conferences, publish original research, and will write a grant proposal. The program will also center around training in community-based field research that includes a service oriented research experience. Trainees will work with a community based AIDS service organization to conduct a field study that will serve as a rich training experience for them and will directly benefit the partner organization
Keywords: AIDS/HIV; AIDS/HIV problem; HIV/AIDS; HIV/AIDS problem; Process; Training; social
Project start date: 2006-07-01
Project end date: 2011-06-30
Budget start date: 1-JUL-2010
Budget end date: 30-JUN-2011
PFA/PA: PA-02-109
5T32MH074387-05 (2010): $181072
Sponsored Links Excellgen http://Excellgen.com
5T32MH074387-04 (2009): $191501
5T32MH074387-03 (2008): $196902
5T32MH074387-02 (2007): $135225
1T32MH074387-01A1 (2006): $67800
HIV TREATMENT ADHERENCE FOR PERSONS WITH LOW-LITERACY
Seth C Kalichman, Professor
Psychiatry And Behavioral Medmedical College Of Wisconsin
8701 Watertown Plank Rd
milwaukee, Wi 532260509
Grant 5R01MH062287-02 from National Institute Of Mental Health IRG: ZRG1
Abstract: adapted from ´s ) This application is in response to the Program Announcement "Coping with AIDS as a Chronic Long-Term Illness" (PA-99-026) and requests 3 years of support to develop and field-test an intervention to enhance HIV treatment adherence among persons with low-literacy skills. Guided by the Information-Motivation-Behavioral Skills model of health promoting behaviors and principles established for improving health behaviors in persons with low-literacy, we will conduct 3 phases of research (1) Perform initial interviews and focus groups with HIV positive persons with low-literacy and their health care providers to establish barriers to treatment adherence and strategies to improve adherence for persons with low-literacy. This first phase of research will also develop informed consent and adherence assessment procedures for low-literacy populations; (2) Test the feasibility of a pictograph-based information, motivation, and behavioral skills building treatment adherence intervention with a small sample of persons with HIV infection who demonstrate poor literacy skills, and test the acceptability of the new intervention model with health care providers; and (3) Conduct a randomized field test to determine the potential efficacy of the pictograph-based intervention with 80 HIV seropositive persons with low-literacy. Participants in the field test will be randomly assigned to either receive the newly developed intervention or assigned to a wait-list comparison group. Following a six-month follow-up period, we will test for differences between groups on self-reported HIV treatment adherence measures as well as variables relevant to testing the Information, Motivation, Behavioral Skills adherence intervention model. Results of the proposed research will provide critical information about improving HIV treatment adherence with low-literacy populations that is needed prior to conducting larger and more expensive clinical trials
Keywords: AIDS education /prevention, behavior modification, behavior therapy, educationally disadvantaged, experimental design, health behavior, human therapy evaluation, patient care management, therapy compliance clinical trial, health care service evaluation, health education, human population study, longitudinal human study behavioral /social science research tag, clinical research, human subject, interview
Project start date: 2000-09-01
Project end date: 2002-06-03
5R01MH062287-02 (2001): $373750
1R01MH062287-01 (2000): $373750
Seth C Kalichman
University Of Connecticut Storrs
Project start date: 2012-02-01
Project end date: 2017-01-31
HIV Treatment Adherence/Risk Reduction Integrated
Seth C Kalichman, Professor
University Of Connecticut Storrs 438 Whitney Road Extension, Unit 1133 Storrs-mansfield, Ct 06269
Grant 5R01MH071164-03 from National Institute Of Mental Health IRG: BSCH
Keywords: AIDS education /prevention, AIDS therapy, HIV infection, behavior modification, behavior therapy, motivation, therapy compliance, high risk behavior /lifestyle, human therapy evaluation, longitudinal human study, sex behavior, sex partner, behavioral /social science research tag, clinical research, data collection methodology /evaluation, human subject, patient oriented research, questionnaire
Project start date: 2005-04-01
Project end date: 2010-03-31
5R01MH071164-03 (2007): $705414
VIDEOTAPE-BASED HIV PREVENTION INTERVENTION
Seth C Kalichman, Professor
Georgia State University Po Box 3999 Atlanta, Ga 303023999
Grant 5R01MH053780-03 from National Institute Of Mental Health IRG: MHAI
Project start date: 1994-09-30
Project end date: 1998-05-31
5R01MH053780-03 (1996): $365587
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