{"id":6495,"date":"2010-12-10T10:21:33","date_gmt":"2010-12-10T15:21:33","guid":{"rendered":"http:\/\/www.bumc.bu.edu\/busm-news\/?p=1070"},"modified":"2015-07-09T09:59:35","modified_gmt":"2015-07-09T13:59:35","slug":"mental-health-counseling-and-behavioral-medicine-program-team-receives-2-8-million-federal-grant-to-study-mentally-ill-at-high-risk-for-hiv-infection","status":"publish","type":"post","link":"https:\/\/www.bumc.bu.edu\/camed\/2010\/12\/10\/mental-health-counseling-and-behavioral-medicine-program-team-receives-2-8-million-federal-grant-to-study-mentally-ill-at-high-risk-for-hiv-infection\/","title":{"rendered":"Mental Health Counseling and Behavioral Medicine program team receives $2.8 million federal grant to study mentally ill at high risk for HIV infection"},"content":{"rendered":"

Armed with a five-year, $2.8 million federal grant, School of Medicine researchers are hoping to stem HIV infection and transmission among mentally ill people engaged in risky behaviors such as needle sharing and unprotected sex.<\/p>\n

\"BUSM's
BUSM’s Stephen Brady says MI counselors will give mentally ill people unsparing information about the potential price of risky sexual or drug use behavior and help them build skills to change that behavior.<\/figcaption><\/figure>\n

Applying a technique called motivational interviewing<\/a> (MI), the BU team, from the Mental Health Counseling and Behavioral Medicine Program<\/a> (MHCBM), will recruit and counsel severely mentally ill adults who want to protect themselves from HIV or who are already infected but don\u2019t want to pass the disease to others. Sometimes homeless, these people lack the confidence, self-control, and communication skills to change their behavior. By tailoring sessions to the individual, MI counselors give people unsparing information about the potential price of their risky behavior and help them build skills to change that behavior, says Stephen Brady, a MED associate professor of psychiatry and graduate medical sciences and MHCBM director. The study, funded by the National Institute of Mental Health<\/a>,\u00a0 will include 308 volunteers and will compare brief MI-based prevention treatment with what clinicians call \u201ccare as usual.\u201d<\/p>\n

Participants will be recruited through advertisements posted at homeless shelters, emergency rooms, housing for the mentally ill, and other care centers, and will represent people living with a range of mental illnesses, including schizophrenia, major depression, bipolar disorder, and severe anxiety disorders like post-traumatic stress disorder. What they have in common, along with intravenous drug users in the study, is their greatly increased risk of acquiring or passing along HIV.<\/p>\n

Brady and his colleagues will measure MI\u2019s effects in sessions 3, 6, and 12 months after the interventions. If results are as promising as those of a much smaller pilot study completed by the BU team in 2009, says Brady, the model could be adapted to a range of settings and providers.<\/p>\n

Although MI was first described in 1983, the method has sparked a lot of interest recently, according to Brady. More goal-oriented than many talk therapies, MI seeks to change behavior by helping people explore and resolve their ambivalence, rather than trying directly to persuade them to stop doing things that can harm them. \u201cWe give them feedback about their risk behavior, tell them what the odds are they will contract HIV; we have them pick areas that are most difficult to change, and we work on skills such as condom or barrier use, or de-linking the use of alcohol or drugs with having sex,\u201d says Brady, whose clinic also offers HIV testing and care referrals for research subjects who want them.<\/p>\n

Why target the seriously mentally ill in an HIV\/AIDS study? In a review of 52 studies, Brady found that the majority of adults with serious mental illness are sexually active. Of these, many engage in high-risk behavior, which is most prevalent among the homeless. The review found that nearly half of the people in the studies had multiple partners and never used condoms, while a quarter had a history of prostitution or sex trading, and 30 percent had had at least one sexually transmitted disease. And 20 percent of the seriously mentally ill in the studies had histories of IV drug use.<\/p>\n

\u201cWhat we do is primary prevention,\u201d Brady says, \u201cto prevent people who don\u2019t have HIV from getting it, and secondary, preventing those who are HIV-positive from spreading it.\u201d<\/p>\n

\u201cMost people with mental illness are aware of HIV testing,\u201d he says. \u201cThey want to know their HIV status, and testing has become very common among this population, but we also know that instead of reducing risk, they just keep getting tested. They assume they\u2019ll continue to test negative, not understanding that they\u2019ve just been lucky so far.\u201d Brady believes high-risk behavior among the mentally ill is a motivation problem. \u201cMost behavioral science research<\/a> is very static,\u201d its strategy applied across the board, he says. \u201cBut the package we offer is very focused on the individual patient and what he or she wants to do. We can help people with their thinking and planning, from saying no to negotiating safer sex<\/a>.\u201d For example, he says, female condoms are expensive, but the women who begin using them soon feel empowered.<\/p>\n

When Brady first began his research, people in the field told him that his approach would never work. \u201cPredictions were that the clients would all wind up with HIV,\u201d he says. \u201cBut my experience is, these people don\u2019t want to get HIV and they don\u2019t want to give it to people. They just face so many obstacles \u2014 where to sleep, drug addictions, using their bodies to get what they want. But this doesn\u2019t mean people can\u2019t be motivated to use condoms, have periodic visits with an ob-gyn,\u201d or stop sharing needles.<\/p>\n

This BU Today<\/em> story was written by Susan Seligson. She can be reached at sueselig@bu.edu<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"

Armed with a five-year, $2.8 million federal grant, School of Medicine researchers are hoping to stem HIV infection and transmission among mentally ill people engaged in risky behaviors such as needle sharing and unprotected sex.<\/p>\n

Applying a technique called motivational interviewing (MI), the BU team, from the Mental Health Counseling and Behavioral Medicine Program (MHCBM), will recruit and counsel severely mentally ill adults who want to protect themselves from HIV or who are already infected but don\u2019t want to pass the disease to others. Sometimes homeless, these people lack the confidence, self-control, and communication skills to change their behavior. By tailoring sessions to the individual, MI counselors give people unsparing information about the potential price of their risky behavior and help them build skills to change that behavior, says Stephen Brady, a MED associate professor of psychiatry and graduate medical sciences and MHCBM director. The study, funded by the National Institute of Mental Health, will include 308 volunteers and will compare brief MI-based prevention treatment with what clinicians call \u201ccare as usual.\u201d<\/p>\n","protected":false},"author":903,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[91],"tags":[],"_links":{"self":[{"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/posts\/6495"}],"collection":[{"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/users\/903"}],"replies":[{"embeddable":true,"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/comments?post=6495"}],"version-history":[{"count":1,"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/posts\/6495\/revisions"}],"predecessor-version":[{"id":20577,"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/posts\/6495\/revisions\/20577"}],"wp:attachment":[{"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/media?parent=6495"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/categories?post=6495"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/tags?post=6495"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}