Interventions Delivered in Clinical Settings are Effective in Reducing Risk of HIV Transmission Among People Living with HIV: Results from the Health Resources and Services Administration (HRSA)’s Special Projects of National Significance Initiative

To support expanded prevention services for people living with HIV, the US Health Resources and Services Administration (HRSA) sponsored a 5-year initiative to test whether interventions delivered in clinical settings were effective in reducing HIV transmission risk among HIV-infected patients. Across 13 demonstration sites, patients were randomized to one of four conditions. All interventions were associated with reduced unprotected vaginal and/or anal intercourse with persons of HIV-uninfected or unknown status among the 3,556 participating patients. Compared to the standard of care, patients assigned to receive interventions from medical care providers reported a significant decrease in risk after 12 months of participation. Patients receiving prevention services from health educators, social workers or paraprofessional HIV-infected peers reported significant reduction in risk at 6 months, but not at 12 months. While clinics have a choice of effective models for implementing prevention programs for their HIV-infected patients, medical provider-delivered methods are comparatively robust

Relapse prevention for addictive behaviors

The Relapse Prevention (RP) model has been a mainstay of addictions theory and treatment since its introduction three decades ago. This paper provides an overview and update of RP for addictive behaviors with a focus on developments over the last decade (2000-2010). Major treatment outcome studies and meta-analyses are summarized, as are selected empirical findings relevant to the tenets of the RP model. Notable advances in RP in the last decade include the introduction of a reformulated cognitive-behavioral model of relapse, the application of advanced statistical methods to model relapse in large randomized trials, and the development of mindfulness-based relapse prevention. We also review the emergent literature on genetic correlates of relapse following pharmacological and behavioral treatments. The continued influence of RP is evidenced by its integration in most cognitive-behavioral substance use interventions. However, the tendency to subsume RP within other treatment modalities has posed a barrier to systematic evaluation of the RP model. Overall, RP remains an influential cognitive-behavioral framework that can inform both theoretical and clinical approaches to understanding and facilitating behavior change

Clinical guidelines for implementing relapse prevention therapy.

A guideline outlining this cognitive behaviour therapy approach. Focuses on identification of individual high-risk situations and the person's ability to cope with them without relapsing, as well as learning new coping skills and enhancing self-efficacy

Expectancy Models of Alcohol Use

The primary goal of the present article is to compare expectancy models with competing attitude models of alcohol use. First, several methodological issues in expectancy research were addressed, to more adequately compare the theoretical models. Study 1 examined the effect of possible self-report biases on associations among expectancy constructs and alcohol use. In Studies 2 and 3, the basic distinction between general factors of positive and negative alcohol expectancies was investigated in both cross-sectional and prospective models. Alternative predictions that were based on competing expectancy and attitude theories were evaluated primarily in Study 3. Results from these studies supported the validity of the expectancy constructs and the proposed distinctions among expectancy and attitude constructs in terms of strong discriminant validity, absence of self-report bias, and differential prediction of alcohol use. Furthermore, the findings favored certain expectancy models over alternative attitude models of alcohol use, reaffirming the usefulness of the expectancy framework