Integrated Treatment for Smoking Cessation & Anxiety in People With HIV (Project Quit)

Primary Outcome Measures:

• Treatment Acceptability (Formative Phase of R34) [ Time Frame: 6 months ]
  The investigators will use the Treatment CEQ, a 6-item measure, to assess treatment credibility and expectancy for participants between their baseline assessment and 6-month follow-up assessment. The investigators will administer the scale after the first treatment session. Acceptability will also be evaluated on the basis of participant retention, and participant self report. Participants' self-report of their reactions to the intervention and study participation will be assessed through a qualitative exit interview.
  
  
• Short and long-term point prevalence abstinence (PPA; pilot RCT phase) [ Time Frame: 6 months ]
  Smoking outcomes are assessed post treatment and at follow up by comparing the reported 7 day abstinence (assessed through self-report and independent verification) across the randomized conditions controlling for pre-randomization levels.
  
  
• Treatment related changes in psychological distress (pilot RCT phase) [ Time Frame: 6 months ]
  These changes are assessed through anxiety, depression, and/or distress tolerance checklists assessed post-treatment and at follow-up by comparing the total scale scores across the randomized conditions controlling for pre-randomization levels.
  
  

This study represents an important step in treating nicotine dependence in HIV-positive individuals. This study addresses an important public health issue by assessing an intervention that may lead to a more effective application for the treatment of at-risk HIV+ smokers. The 1-year formative phase of the study will develop an integrated treatment for quitting smoking for anxiety-vulnerable HIV+ smokers. The proposed treatment will include cognitive-behavioral talk therapy for quitting smoking, a nicotine patch, and cognitive-behavioral talk therapy for anxiety. The pilot of the proposed treatment will be conducted with a small group of individuals (N = up to 12). This phase will be used to establish feasibility of treatment delivery, and participant acceptability before conducting a pilot randomized trial of the treatment. Additionally, this phase will monitor smoking cessation history through Point Prevalence Abstinence (PPA), as well as anxiety symptoms through the Anxiety Sensitivity Index (ASI) at the baseline and follow-up assessments. This study represents an important step in treating nicotine dependence in HIV-positive individuals. This study addresses an important public health issue by assessing an intervention that may lead to a more effective application for the treatment of at-risk HIV+ smokers. The pilot RCT phase of the study (years 2 and 3), will test the developed cognitive-behavioral intervention in a pilot randomized-controlled trial format. The outcomes for this trial will be to determine the acceptability and feasibility of the intervention and the potential for an effect on increasing point prevalence abstinence and deceasing psychological distress.