This application proposes to investigate the family mechanisms by which Structural Ecosystems Therapy (SET; Mitrani et al, 2000) has its impact on HIV+ women in drug recovery. This proposed study is a companion to NIDA Grant DA15004 (SETA Protocol), which investigates the efficacy of SET in a clinical trial with HIV+ women who are in drug recovery. In the SETA Protocol, 176 women are randomly assigned to either SET or an HIV health group. The interventions last 4 months. SET works to transform the family system to reinforce sobriety, increase adherence with HIV medical care, and decrease sexual transmission risk behaviors in the target woman. The SETA Protocol only assesses the effect of SET on the recovering woman, not her family. Because SET targets changing the whole family as a means of helping the woman, we hypothesize that effects on the family as a whole (family functioning) and on individual family members will help to explain the woman's outcomes. The proposed study will enroll the women in the SETA Protocol and their families. A total of 528 family members are anticipated. Families are assessed at 4-month intervals for a period of 12 months. SET is hypothesized to affect family functioning (measured by self-report and observational methods). Changes in family functioning are hypothesized to affect the woman's drug abuse, HIV medication adherence, and HIV risk behaviors as well as the individual functioning of her family members (psychological distress, drug use and parent report of problem behaviors in children). The hypotheses will be tested using Latent Growth Curve Modeling. Understanding these mechanisms will facilitate the development of the next generation of family-based interventions for HIV+ women in drug recovery. This will be the first R01 award for this investigator. ? ?

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
5R01DA016543-05
Application #
7254187
Study Section
Behavioral and Social Consequences of HIV/AIDS Study Section (BSCH)
Program Officer
Riddle, Melissa
Project Start
2003-09-30
Project End
2010-06-30
Budget Start
2007-07-01
Budget End
2010-06-30
Support Year
5
Fiscal Year
2007
Total Cost
$371,594
Indirect Cost
Name
University of Miami School of Medicine
Department
Psychiatry
Type
Schools of Medicine
DUNS #
052780918
City
Coral Gables
State
FL
Country
United States
Zip Code
33146
McCabe, Brian E; Feaster, Daniel J; Mitrani, Victoria B (2014) Health correlates of co-occurring substance use for women with HIV in cocaine use recovery. Addict Behav 39:725-8
Mitrani, Victoria B; McCabe, Brian E; Burns, Myron J et al. (2012) Family mechanisms of structural ecosystems therapy for HIV-seropositive women in drug recovery. Health Psychol 31:591-600
Mitrani, Victoria B; Feaster, Daniel J; Weiss-Laxer, Nomi S et al. (2011) Malaise, motivation and motherhood: predictors of engagement in behavioral interventions from a randomized controlled trial for HIV+ women in drug abuse recovery. AIDS Behav 15:396-406
Feaster, Daniel J; Mitrani, Victoria B; Burns, Myron J et al. (2010) A randomized controlled trial of Structural Ecosystems Therapy for HIV medication adherence and substance abuse relapse prevention. Drug Alcohol Depend 111:227-34
Feaster, Daniel J; Burns, Myron J; Brincks, Ahnalee M et al. (2010) Structural Ecosystems Therapy for HIV+ African-American women and drug abuse relapse. Fam Process 49:204-19
Mitrani, Victoria B; McCabe, Brian E; Robinson, Carleen et al. (2010) Structural Ecosystems Therapy for recovering HIV-positive women: child, mother, and parenting outcomes. J Fam Psychol 24:746-55
Feaster, Daniel J; Brincks, Ahnalee M; Mitrani, Victoria B et al. (2010) The efficacy of Structural Ecosystems Therapy for HIV medication adherence with African American women. J Fam Psychol 24:51-9
Brincks, Ahnalee M; Feaster, Daniel J; Burns, Myron J et al. (2010) The influence of health locus of control on the patient-provider relationship. Psychol Health Med 15:720-8
Mitrani, Victoria B; Weiss-Laxer, Nomi S; Feaster, Daniel J (2009) Factors related to loss of child custody in HIV+ women in drug abuse recovery. Am J Drug Alcohol Abuse 35:320-4
Mitrani, Victoria B; Weiss-Laxer, Nomi S; Ow, Christina E et al. (2009) Examining family networks of HIV+ women in drug recovery: challenges and opportunities. Fam Syst Health 27:267-83

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