RISK FACTORS FOR AIDS AMONG INTRAVENOUS DRUG USERS

静脉吸毒者患艾滋病的危险因素

• 批准号: 3208057
• 负责人: DON C DES JARLAIS
• 金额: $ 91.5万
• 依托单位: BETH ISRAEL MEDICAL CTR (NEW YORK)
• 依托单位国家: 美国
• 财政年份: 1990
• 资助国家: 美国
• 起止时间: 1990-09-30 至 1994-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3208057
• 关键词: AIDS; AIDS /HIV test; AIDS education /prevention; American; CD4 molecule; World Health Organization; antiviral antibody; behavior; biomarker; communicable disease transmission; disease /disorder proneness /risk; epidemiology; gender difference; habits; human immunodeficiency virus 1; human subject; interview; intravenous drug abuse; lifestyle; longitudinal human study; medical outreach /case finding; opportunistic infections; questionnaires; serology /serodiagnosis; sex behavior; sexually transmitted diseases; social psychology; statistics /biometry

Reducing the spread of HIV among intravenous drug users, and from intravenous drug users through heterosexual and perinatal transmission, is one of the most urgent public health problems in the United States and many other countries. Unfortunately, immediate success, in terms of a vaccine, a cure for HIV infection, or an infallible behavior change program is extremely unlikely. AIDS prevention programming must be done on a long term basis, and will require understanding the long term dynamics of HIV transmission among and from IV drugs users. The proposed research will provide data on long term dynamics by extending our studies of AIDS among IV drug users in Manhattan, New York City, for an additional five years. This research will also be part of a world Health Organization collaborative study that will use standardized methods to compare seroprevalence and risk behavior trends among 11 different cities. Specific aims are to determine levels of and trends in AIDS risk behavior and HIV seroprevalence among IV drug users in southern Manhattan, to study levels of and trends in immunologic status that may influence infectivity and thus the extent of viral transmission; to understand differences in HIV seroprevalence and AIDS risk behavior to ongoing AIDS prevention activities; and to compare trends in seroprevalence and risk behavior among IV drug users in southern Manhattan to those in the other cities participating in the World Health Organization study. Southern Manhattan will be the location for the study because, for this location, seroprevalence data exist since the beginning of the epidemic in the 1970s; data on relevant behavioral and immunologic parameters have been collected since 1984; the epidemic is highly advanced among IV drug users so it provides a model for possible future developments in other cities; and the ethnic mix of IV drug users in the area allows interracial comparisons. 1000 IV drug users entering treatment or recruited in street settings will be interviewed each year using a standardized sampling design and standardized questionnaire developed for the WHO study (and supplemented to capture important aspects of New York City drug culture). HIV antibody status and immunologic markers will be measured for subjects who consent to have phlebotomy performed. Analyses will examine cross-sectional differences in demographic groups; change over time in risk behavior, relationships between specific behaviors and the probability of being infected, seroprevalence, and immunologic status; and compare risk behavior and seroprevalence in New York City to those in other cities in the WHO study (in the context of differences in AIDS. and drug-related policies and prevention programs in these cities).

减少艾滋病毒在静脉吸毒者中的传播，以及 静脉吸毒者通过异性性行为和围产期传播， 是美国最紧迫的公共卫生问题之一 许多其他国家。不幸的是，就立即成功而言 疫苗、艾滋病毒感染的治疗方法或绝对正确的行为改变 计划的可能性极小。必须完成艾滋病预防规划 长期的基础上，并且需要了解长期 静脉注射吸毒者之间以及来自静脉吸毒者的艾滋病毒传播动态。拟议的 研究将通过扩展我们的研究来提供长期动态的数据 纽约市曼哈顿静脉注射吸毒者中艾滋病的发病率 额外五年。这项研究也将成为世界卫生研究的一部分 组织协作研究将使用标准化方法 比较 11 种不同人群的血清流行率和风险行为趋势 城市。 具体目标是确定艾滋病危险行为的水平和趋势 曼哈顿南部静脉注射吸毒者中的艾滋病毒血清流行率 研究可能影响的免疫状态水平和趋势 传染性以及病毒传播的程度；去理解 HIV 血清流行率和艾滋病风险行为与持续艾滋病的差异 预防活动；并比较血清流行率和风险的趋势 曼哈顿南部静脉吸毒者与其他地区的静脉注射吸毒者的行为 参与世界卫生组织研究的城市。 曼哈顿南部将成为这项研究的地点，因为 自疫情开始以来就存在地点、血清流行率数据 20世纪70年代；相关行为和免疫学参数的数据 自1984年起收集；静脉注射药物疫情严重 用户，因此它为其他领域未来可能的发展提供了模型 城市；该地区静脉注射吸毒者的种族混合使得 种族间的比较。 1000 名静脉注射吸毒者正在接受治疗或 每年都会使用街头招募的人员进行访谈 标准化抽样设计和标准化问卷开发 世界卫生组织的研究（并补充以捕捉纽约的重要方面 城市毒品文化）。 HIV 抗体状态和免疫标记物将 对同意进行静脉切开术的受试者进行测量。分析 将检查人口群体的横截面差异；改变 随着时间的推移，风险行为、特定行为之间的关系和 被感染的概率、血清流行率和免疫学 地位;并比较纽约市的风险行为和血清流行率 世界卫生组织研究中其他城市的情况（在差异的背景下） 艾滋病。以及这些城市的毒品相关政策和预防计划）。