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首页> 外文期刊>Frontiers in Immunology >Developing an Integrated, Brief Biobehavioral HIV Prevention Intervention for High-Risk Drug Users in Treatment: The Process and Outcome of Formative Research
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Developing an Integrated, Brief Biobehavioral HIV Prevention Intervention for High-Risk Drug Users in Treatment: The Process and Outcome of Formative Research

机译：为治疗中高风险药物使用者开发综合，简短的生物行为艾滋病毒预防干预措施：形成性研究的过程和结果

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To date, HIV prevention efforts have largely relied on singular strategies (e.g., behavioral or biomedical approaches alone) with modest HIV risk-reduction outcomes for people who use drugs (PWUD), many of whom experience a wide range of neurocognitive impairments (NCI). We report on the process and outcome of our formative research aimed at developing an integrated biobehavioral approach that incorporates innovative strategies to address the HIV prevention and cognitive needs of high-risk PWUD in drug treatment. Our formative work involved first adapting an evidence-based behavioral intervention—guided by the Assessment–Decision–Administration–Production–Topical experts–Integration–Training–Testing model—and then combining the behavioral intervention with an evidence-based biomedical intervention for implementation among the target population. This process involved eliciting data through structured focus groups (FGs) with key stakeholders—members of the target population ( n ?=?20) and treatment providers ( n ?=?10). Analysis of FG data followed a thematic analysis approach utilizing several qualitative data analysis techniques, including inductive analysis and cross-case analysis. Based on all information, we integrated the adapted community-friendly health recovery program—a brief evidence-based HIV prevention behavioral intervention—with the evidence-based biomedical component [i.e., preexposure prophylaxis (PrEP)], an approach that incorporates innovative strategies to accommodate individuals with NCI. This combination approach—now called the biobehavioral community-friendly health recovery program—is designed to address HIV-related risk behaviors and PrEP uptake and adherence as experienced by many PWUD in treatment. This study provides a complete example of the process of selecting, adapting, and integrating the evidence-based interventions—taking into account both empirical evidence and input from target population members and target organization stakeholders. The resultant brief evidence-based biobehavioral approach could significantly advance primary prevention science by cost-effectively optimizing PrEP adherence and HIV risk reduction within common drug treatment settings.
机译：迄今为止，艾滋病毒的预防工作主要依靠单一的策略（例如，仅是行为或生物医学方法），对于使用毒品的人（PWUD），其艾滋病毒的风险降低效果不明显，其中许多人经历了广泛的神经认知障碍（NCI） 。我们报告了形成性研究的过程和结果，旨在开发一种综合的生物行为学方法，该方法结合了创新策略来解决药物治疗中的HIV预防和高风险PWUD的认知需求。我们的形成工作包括首先根据评估，决策，管理，生产，主题专家，整合，培训，测试模型对基于证据的行为干预进行调整，然后将行为干预与基于证据的生物医学干预相结合，以在目标人群。该过程涉及通过与主要利益相关者（目标人群（n = 20）和治疗提供者（n = 10）的成员）的结构化焦点小组（FG）来获取数据。 FG数据的分析采用了主题分析方法，该方法采用了几种定性数据分析技术，包括归纳分析和跨案例分析。基于所有信息，我们将经过调整的社区友好型健康恢复计划（基于证据的简短HIV预防行为干预措施）与基于证据的生物医学成分[即，暴露前预防（PrEP）]相结合，该方法结合了创新策略，容纳患有NCI的个人。这种组合方法（现称为生物行为社区友好型健康恢复计划）旨在解决许多PWUD在治疗中遇到的与HIV相关的风险行为以及PrEP摄取和依从性。这项研究提供了选择，调整和整合基于证据的干预措施的完整示例，同时考虑了经验证据以及目标人群和目标组织利益相关者的投入。由此产生的简短的循证生物行为方法可以通过在普通药物治疗环境中经济高效地优化PrEP依从性和降低HIV风险来大大提高一级预防科学水平。

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