NATIONAL STUDY OF SYRINGE EXCHANGE PROGRAMS

全国注射器交换计划研究

• 批准号: 6174863
• 负责人: DON C DES JARLAIS
• 金额: $ 67.56万
• 依托单位: BETH ISRAEL MEDICAL CTR (NEW YORK)
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-09-15 至 2004-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6174863
• 关键词: AIDS education /prevention; United States; behavioral /social science research tag; clinical research; data collection methodology /evaluation; health /scientific organization; health behavior; health care policy; health services research tag; health surveys; high risk behavior /lifestyle; human subject; hypodermic needle; interview; needle sharing; sex behavior; substance abuse epidemiology; substance abuse related behavior; telecommunications

Many if not most of the new HIV infections in the US are occurring among intravenous drug users (IDUs) and their sexual partners. Three types of programs have been shown to be effective in reducing HIV risk behaviors in this population: community outreach, drug abuse treatment, and syringe exchange programs (SEPs). National assessments of community outreach and drug abuse treatment programs have been conducted, but notably absent is a similar assessment of the state of SEPs in the US. The proposed research seeks to fill that gap. The proposed research addresses the following specific aims: (1) a description of the organizational characteristics of SEPs operating in the U.S. with a description of change in these programs over time; (2) an assessment of the demographic characteristics and risk behaviors of SEP participants; (3) the identification of individual-level factors associated with continued or persistent risk behaviors; (4) the identification of SEP organizational characteristics associated with risk among participants; (5) an examination of the relationships between SEP characteristics and change in risk behaviors among participants; and (6) an estimation of HIV incidence among participants in large SEPs. To achieve these aims, we will conduct annual telephone surveys of the directors of currently operating SEP in the US. This will provide current information on SEP implementation, organizational characteristics of SEPs, and services offered at SEPs. We will also conduct a stratified random sample of 25,920 interviews of participants in 6 large and 18 medium SEPs. The sampled programs will represent approximately half of all SE activity in the US. The sampling will be constricted to provide geographic representation and high versus low HIV seroprevalence rates among the IDUs served by the programs. Potential subjects will be randomly selected from persons visiting the SEPs. Data on demographic characteristics, drug use patterns and injection and sexual risk behaviors will be obtained. Audio-computer assisted structured interviewing, an innovative technique for increasing respondent privacy, will be used for SEP participant data collection. Our pilot study (grant R01 DA 09536) showed that this method can substantially reduce underreporting of HIV risk behavior. The proposed research will be the first national assessment of the state of syringe exchange programming in the US, and will use innovative data collection method to provide more complete reporting of HIV risk behaviors among SEP participants. The information obtained in the research should be useful for both HIV prevention planning in the US as well as understanding persistent risk behavior among persons already participating in prevention programs.

美国的许多新的艾滋病毒感染者（IDU）及其性伴侣都发生在美国。 三种类型的计划已被证明可以有效减少该人群的艾滋病毒危险行为：社区外展、药物滥用治疗和注射器交换计划 (SEP)。 已经对社区外展和药物滥用治疗计划进行了国家评估，但值得注意的是，美国缺乏对标准必要专利状况的类似评估。拟议的研究旨在填补这一空白。拟议的研究旨在实现以下具体目标：(1) 描述在美国运营的标准必要专利的组织特征，并描述这些项目随时间的变化； (2) SEP参与者的人口特征和风险行为评估； (3) 识别与持续或持续风险行为相关的个人层面因素； (4) 识别与参与者风险相关的SEP组织特征； （5）检验SEP特征与参与者风险行为变化之间的关系； (6) 大型 SEP 参与者中 HIV 发病率的估计。为了实现这些目标，我们将对目前在美国运营的 SEP 的董事进行年度电话调查。 这将提供有关标准必要专利实施、标准必要专利的组织特征以及标准必要专利提供的服务的最新信息。 我们还将对 6 个大型和 18 个中型 SEP 的参与者进行分层随机抽样，采访 25,920 名参与者。 抽样项目将约占美国所有 SE 活动的一半。抽样将受到限制，以提供该项目所服务的注射吸毒者中的地理代表性以及艾滋病毒血清阳性率的高低对比。 潜在的受试者将从访问 SEP 的人员中随机选择。 将获得有关人口特征、吸毒模式以及注射和性危险行为的数据。 音频计算机辅助结构化访谈是一种增强受访者隐私的创新技术，将用于 SEP 参与者数据收集。 我们的试点研究（R01 DA 09536）表明，这种方法可以大大减少艾滋病毒风险行为的漏报。拟议的研究将是对美国注射器交换规划状况的首次全国性评估，并将使用创新的数据收集方法来提供 SEP 参与者中 HIV 风险行为的更完整报告。 研究中获得的信息对于美国的艾滋病毒预防规划以及了解已经参与预防计划的人中持续存在的危险行为应该有用。