Pearson C R, Huh D, Bedard-Gilligan M, Walker D, Marín R A, Saluskin K, Kaysen D
Indigenous Wellness Research Institute, School of Social Work, University of Washington, Box 354900, Seattle, WA, 98105-6299, USA.
Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, WA, USA.
AIDS Behav. 2025 Jun 17. doi: 10.1007/s10461-025-04777-w.
We compared two counseling approaches aimed at preventing HIV: Narrative Exposure Therapy (NET) targeting posttraumatic stress disorder (PTSD) and Motivational Interviewing with CBT-skills training (MIST), addressing substance misuse. We recruited 125 participants aged 16 + rural American Indians. Participants were screened for current sexual activity, probable PTSD, and substance misuse, then randomly assigned to either NET or MIST. Interventions were culturally adapted and up to 6 sessions delivered by local counselors. Primary outcomes included PTSD severity, number of sexual partners, frequency of sex, sex while using substances, and overall substance use. Both treatments reduced PTSD severity, risky sexual behavior, number of sexual partners, sexual encounters with unknown HIV serostatus partners, and substance use symptoms at follow-up. However, NET showed greater effectiveness than MIST, specifically in reducing risky sexual behaviors and substance use. Results suggest that interventions addressing either PTSD symptoms or substance misuse can effectively reduce HIV sexual risk behaviors.
我们比较了两种旨在预防艾滋病病毒（HIV）的咨询方法：针对创伤后应激障碍（PTSD）的叙事暴露疗法（NET）和针对药物滥用问题的结合认知行为疗法（CBT）技能培训的动机性访谈疗法（MIST）。我们招募了125名年龄在16岁及以上的美国农村印第安人参与者。对参与者进行了当前性活动、可能的创伤后应激障碍和药物滥用筛查，然后随机分配到叙事暴露疗法或动机性访谈疗法组。干预措施进行了文化适应性调整，由当地咨询师提供最多6次咨询。主要结果包括创伤后应激障碍严重程度、性伴侣数量、性行为频率、使用药物时的性行为以及总体药物使用情况。两种治疗方法在随访时均降低了创伤后应激障碍严重程度、危险性行为、性伴侣数量、与HIV血清学状态未知的伴侣发生性接触的情况以及药物使用症状。然而，叙事暴露疗法比动机性访谈疗法显示出更大的效果，特别是在减少危险性行为和药物使用方面。结果表明，针对创伤后应激障碍症状或药物滥用问题的干预措施可以有效降低HIV性传播风险行为。
