HIV RISK BEHAVIORS AMONG URBAN NOMAD DRUG INJECTORS

城市游牧吸毒者的艾滋病毒风险行为

• 批准号: 6379083
• 负责人: DON C DES JARLAIS
• 金额: $ 60.3万
• 依托单位: NATIONAL DEVELOPMENT AND RESEARCH INSTITUTES, INC.
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-09-05 至 2004-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6379083
• 关键词: AIDS; AIDS /HIV diagnosis; HIV infections; behavioral /social science research tag; clinical research; communicable disease diagnosis; communicable disease transmission; computer assisted diagnosis; counseling; data collection methodology /evaluation; disease /disorder proneness /risk; hepatitis B; hepatitis C; high risk behavior /lifestyle; human migration; human subject; interview; intravenous drug abuse; longitudinal human study; questionnaires; residential mobility; substance abuse related behavior; urban area; young adult human (21-34)

The global diffusion of HIV, hepatitis B and hepatitis C among injecting drug users (IDUs) shows both that they engage in substantial travel and that research is needed on their travel patterns. Previous research makes it clear that IDUs travel regionally, nationally, and internationally, but has not adequately described travel patterns nor the factors that influence IDUs' HIV risk behavior when they travel. Through our street-based research with IDUs in New York City, we have developed considerable familiarity with a large group of highly mobile, young IDUs, self-defined as "urban nomads", who travel frequently and widely throughout the U.S. These urban nomads are often homeless, but are conceptually and behaviorally distinct from "locally homeless" drug injectors who are not geographically mobile. The specific aims include both methodological and substantive objectives: (Aim 1) Analytically describe a large sample (n = 800) of "urban nomad" young IDUs, including their demographics, drug use histories, travel histories, HIV risk behaviors and serostatus. Identify factors associated with (a) HIV risk behaviors and (b) frequency of intercity travel. (Aim 2) Identify patterns of drug use and HIV risk behavior during travel by urban nomad IDUs, including numbers of "person-trips" (a trip by a person to another metropolitan area), the geographic distribution of person- trips where HIV risk behaviors do and do not occur, and factors that differentiate person-trips with and without HIV risk behavior. Aims 1 and 2 will be achieved through interviews with 600 urban nomad IDUs recruited in New York City and 200 urban nomad IDUs recruited at collaborating research sites across the country. (Aim 3) Implement and assess a long-distance telephone follow-up interview system for collecting data from urban nomad IDUs in their travels. Subjects will be intensively prepared to maintain telephone contact with researchers. Long-distance telephone interviewing will be supplemented by referrals to local research studies for HIV counseling and testing, by referrals to syringe exchange programs, and by e-mail and web site communication. (Aim 4) Determine potential biases in loss to follow-up in using these techniques. Estimated biases can then be used to adjust estimates of continuing drug use and risk behaviors. Aims 3 and 4 will be achieved through a cohort study of 300 subjects recruited in New York. Drug use and HIV risk behavior among IDUs are often viewed as local phenomena, with drug practices, risk behaviors and HIV epidemics occurring within defined geographic areas. The proposed research will provide data and research technologies for a complementary perspective that sees drug use practices and blood-borne pathogens diffusing within a loosely integrated nation-wide "system" of illicit drug use.

艾滋病毒、乙型肝炎和丙型肝炎在注射吸毒者 (IDU) 中的全球传播表明，他们进行大量旅行，因此需要对其旅行模式进行研究。先前的研究明确表明注射吸毒者在地区、国家和国际范围内旅行，但没有充分描述旅行模式或影响注射吸毒者旅行时艾滋病毒危险行为的因素。通过我们对纽约市注射吸毒者的街道研究，我们对一大群流动性强的年轻注射吸毒者有了相当的了解，他们自称为“城市游牧者”，他们经常在美国各地旅行。这些城市游牧者是往往无家可归，但在概念和行为上与不具有地理流动性的“当地无家可归”吸毒者不同。具体目标包括方法论和实质性目标：（目标 1）分析描述大量“城市游牧”年轻注射吸毒者样本（n = 800），包括他们的人口统计数据、吸毒史、旅行史、艾滋病毒危险行为和血清状况。确定与 (a) HIV 危险行为和 (b) 城际旅行频率相关的因素。 （目标 2）确定城市游牧注射吸毒者旅行期间的吸毒模式和艾滋病毒风险行为，包括“个人旅行”（一个人前往另一个大都市区的旅行）数量、存在艾滋病毒风险的个人旅行的地理分布发生和不发生的行为，以及区分有和没有 HIV 危险行为的人员旅行的因素。目标 1 和 2 将通过采访在纽约市招募的 600 名城市游牧注射吸毒者以及在全国合作研究地点招募的 200 名城市游牧注射吸毒者来实现。 （目标 3）实施并评估远程电话跟踪访谈系统，收集城市游牧注射吸毒者的旅行数据。受试者将做好充分准备，与研究人员保持电话联系。远程电话访谈还将通过转介当地艾滋病毒咨询和检测研究、转介注射器交换计划以及电子邮件和网站沟通来补充。 （目标 4）确定使用这些技术时失访的潜在偏差。然后可以使用估计偏差来调整对持续吸毒和危险行为的估计。目标 3 和 4 将通过在纽约招募 300 名受试者的队列研究来实现。注射吸毒者中的吸毒和艾滋病毒危险行为通常被视为当地现象，吸毒行为、危险行为和艾滋病毒流行发生在特定的地理区域内。拟议的研究将为补充视角提供数据和研究技术，即药物使用实践和血源性病原体在松散整合的全国范围非法药物使用“系统”中扩散。