UCLA Integrated Substance Abuse Programs, David Geffen School of Medicine, Los Angeles, USA; UCLA School of Nursing, Los Angeles, USA.
University of California at San Diego, San Diego, USA.
Drug Alcohol Depend. 2022 Feb 1;231:109229. doi: 10.1016/j.drugalcdep.2021.109229. Epub 2021 Dec 25.
To date, no studies have reported the use of text messaging to deliver cognitive behavioral therapy (CBT) to people living with HIV and substance use disorders.
We developed and evaluated a 12-week, CBT-based text-messaging intervention (TXT-CBT) targeting drug use and adherence to antiretroviral therapy (ART) for adults with HIV and comorbid opioid and stimulant use disorders.
Participants were randomly assigned to receive either TXT-CBT (n = 25) or an informational pamphlet (INFO) discussing substance use and medication adherence (n = 25). ART adherence, drug use, and HIV-risk behaviors were assessed at baseline, monthly during treatment, and treatment-end, and were compared between groups using a mixed-model repeated-measures analysis. Injection drug use was examined as a moderator of outcomes.
Relative to the INFO group, TXT-CBT participants evidenced increased ART adherence, measured by phone-based unannounced pill counts and biochemically by viral load and CD4 count. TXT-CBT participation was also associated with reductions in opioid use and HIV risk behaviors. While reductions in cocaine use were observed in the TXT-CBT group, relative to the INFO group, other stimulant use did not change. Among people who inject drugs, TXT-CBT produced increases in ART adherence and corresponding changes in viral load, relative to injection drug users in the control condition.
Findings demonstrated promising preliminary evidence for the efficacy of TXT-CBT in improving ART adherence and reducing drug use and HIV-risk behaviors among people with HIV infection and comorbid opioid and stimulant use disorders.
迄今为止，尚无研究报告使用短信传递认知行为疗法（CBT）给感染艾滋病毒和伴有物质使用障碍的人群。
我们开发并评估了一种基于 CBT 的为期 12 周的短信干预（TXT-CBT），旨在针对同时患有 HIV 和阿片类药物及兴奋剂使用障碍的成年人改善药物使用和抗逆转录病毒治疗（ART）的依从性。
参与者被随机分配接受 TXT-CBT（n=25）或包含有关物质使用和药物依从性的信息小册子（INFO）（n=25）。在基线、治疗期间每月和治疗结束时评估 ART 依从性、药物使用和 HIV 风险行为，并使用混合模型重复测量分析比较组间差异。将注射毒品使用作为结果的调节因素进行了检验。
与 INFO 组相比，TXT-CBT 组的参与者在电话非通知药物计数和通过病毒载量和 CD4 计数测量的药物依从性方面显示出更大的改善。TXT-CBT 的参与还与阿片类药物使用和 HIV 风险行为的减少有关。虽然在 TXT-CBT 组中观察到可卡因使用减少，但与 INFO 组相比，其他兴奋剂使用没有变化。在注射毒品使用者中，与对照条件下的注射毒品使用者相比，TXT-CBT 增加了 ART 的依从性，并相应地改变了病毒载量。
研究结果初步证明了 TXT-CBT 在改善 HIV 感染和伴有阿片类药物及兴奋剂使用障碍的人群的 ART 依从性和减少药物使用及 HIV 风险行为方面具有潜力。
