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.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH071164-02
Application #
7046113
Study Section
Behavioral and Social Consequences of HIV/AIDS Study Section (BSCH)
Program Officer
Grossman, Cynthia I
Project Start
2005-04-01
Project End
2010-03-31
Budget Start
2006-04-01
Budget End
2007-03-31
Support Year
2
Fiscal Year
2006
Total Cost
$569,818
Indirect Cost
Name
University of Connecticut
Department
Psychology
Type
Schools of Arts and Sciences
DUNS #
614209054
City
Storrs-Mansfield
State
CT
Country
United States
Zip Code
06269
Overstreet, Nicole M; Earnshaw, Valerie A; Kalichman, Seth C et al. (2013) Internalized stigma and HIV status disclosure among HIV-positive black men who have sex with men. AIDS Care 25:466-71
Pellowski, Jennifer A; Kalichman, Seth C (2013) Mixing it Up: Integrating Men and Women Living with HIV/AIDS in Prevention Groups. J HIV AIDS Soc Serv 12:190-204
Cruess, Dean G; Kalichman, Seth C; Amaral, Christine et al. (2012) Benefits of adherence to psychotropic medications on depressive symptoms and antiretroviral medication adherence among men and women living with HIV/AIDS. Ann Behav Med 43:189-97
Kalichman, Seth C; Cherry, Charsey; White, Denise et al. (2012) Falling through the cracks: unmet health service needs among people living with HIV in Atlanta, Georgia. J Assoc Nurses AIDS Care 23:244-54
Kalichman, Seth C; Pellowski, Jennifer; Turner, Christina (2011) Prevalence of sexually transmitted co-infections in people living with HIV/AIDS: systematic review with implications for using HIV treatments for prevention. Sex Transm Infect 87:183-90
Kalichman, Seth C; Cherry, Chauncey; Kalichman, Moira O et al. (2011) Integrated behavioral intervention to improve HIV/AIDS treatment adherence and reduce HIV transmission. Am J Public Health 101:531-8
Kalichman, Seth C; Cherry, Chauncey; White, Denise et al. (2011) Sexual HIV transmission and antiretroviral therapy: a prospective cohort study of behavioral risk factors among men and women living with HIV/AIDS. Ann Behav Med 42:111-9
Kalichman, Seth C; Eaton, Lisa; Cherry, Chauncey et al. (2010) HIV super-infection beliefs and sexual practices of people living with HIV/AIDS. Sex Health 7:420-4
Kalichman, Seth C; Amaral, Christina; Swetsze, Connie et al. (2010) Monthly unannounced pill counts for monitoring HIV treatment adherence: tests for self-monitoring and reactivity effects. HIV Clin Trials 11:325-31
Kalichman, Seth C; Eaton, Lisa; Cherry, Chauncey (2010) ""There is no proof that HIV causes AIDS"": AIDS denialism beliefs among people living with HIV/AIDS. J Behav Med 33:432-40

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