Meade Christina S, Drabkin Anya S, Hansen Nathan B, Wilson Patrick A, Kochman Arlene, Sikkema Kathleen J
Department of Psychiatry and Behavioral Sciences, Division of Medical Psychology, Duke University School of Medicine, Durham, NC 27708, USA.
Addiction. 2010 Nov;105(11):1942-51. doi: 10.1111/j.1360-0443.2010.03075.x. Epub 2010 Sep 15.
Few interventions exist to reduce alcohol and non-injection drug use among people living with HIV/AIDS. This study tested the effects of a coping group intervention for HIV-positive adults with childhood sexual abuse histories on alcohol, cocaine and marijuana use.
Participants were assigned randomly to the experimental coping group or a time-matched comparison support group. Both interventions were delivered in a group format over 15 weekly 90-minute sessions.
A diverse sample of 247 HIV-positive men and women with childhood sexual abuse were recruited from AIDS service organizations and community health centers in New York City.
Substance use was assessed pre- and post-intervention and every 4 months during a 12-month follow-up period. Using an intent-to-treat analysis, longitudinal changes in substance use by condition were assessed using generalized estimating equations.
At baseline, 42% of participants drank alcohol, 26% used cocaine and 26% used marijuana. Relative to participants in the support group, those in the coping group had greater reductions in quantity of alcohol use (Wald χ²(₄)=10.77, P = 0.029) and any cocaine use (Wald χ²(₄) = 9.81, P = 0.044) overtime.
Many HIV patients, particularly those with childhood sexual abuse histories, continue to abuse substances. This group intervention that addressed coping with HIV and sexual trauma was effective in reducing alcohol and cocaine use, with effects sustained at 12-month follow-up. Integrating mental health treatment into HIV prevention may improve outcomes.
几乎没有干预措施可减少艾滋病毒/艾滋病感染者的酒精和非注射毒品使用。本研究测试了一种应对小组干预措施对有童年性虐待史的艾滋病毒呈阳性成年人在酒精、可卡因和大麻使用方面的效果。
参与者被随机分配到实验性应对小组或时间匹配的对照支持小组。两种干预措施均以小组形式进行，为期15周，每周一次，每次90分钟。
从纽约市的艾滋病服务组织和社区卫生中心招募了247名有童年性虐待史的艾滋病毒呈阳性的男性和女性，组成了一个多样化的样本。
在干预前和干预后以及12个月随访期内每4个月评估一次物质使用情况。采用意向性分析，使用广义估计方程评估不同条件下物质使用的纵向变化。
在基线时，42%的参与者饮酒，26%使用可卡因，26%使用大麻。与支持小组的参与者相比，应对小组的参与者随着时间的推移在酒精使用量（Wald χ²(₄)=10.77，P = 0.029）和任何可卡因使用（Wald χ²(₄) = 9.81，P = 0.044）方面有更大程度的减少。
许多艾滋病毒患者，特别是那些有童年性虐待史的患者，继续滥用物质。这种针对应对艾滋病毒和性创伤的小组干预在减少酒精和可卡因使用方面是有效的，且在12个月的随访中效果持续。将心理健康治疗纳入艾滋病毒预防可能会改善结果。
