Interventions with HIV+ and HIV- IDUs in Ukraine

乌克兰对艾滋病毒和艾滋病毒吸毒者的干预措施

• 批准号: 6805932
• 负责人: ROBERT Edwin BOOTH
• 金额: $ 35.94万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-09-30 至 2008-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6805932
• 关键词: AIDS education /prevention; Commonwealth of Independent States; HIV infections; behavioral /social science research tag; clinical research; counseling; health behavior; high risk behavior /lifestyle; human subject; intravenous drug abuse; motivation; sex behavior

DESCRIPTION (provided by applicant): Background: Ukraine is the epicenter of HIV/AIDS in Eastern and Western Europe, with an estimated 230,000 infected, most of whom are injection drug users (IDUs). The goal of this project is to compare the effectiveness of two interventions in reducing the spread of HIV infection in three Ukrainian locations noted for their high HIV seroprevalence: Kiev, Odessa and Makeevka/Donetsk. The interventions include the HIV Counseling and Education (C & E) intervention model developed during NIDA's Cooperative Agreement and the Indigenous Leader Outreach Model (ILOM). Aims: To compare the relative effectiveness of the two approaches in: 1) increasing knowledge about HIV and AIDS transmission; 2) increasing self-efficacy to practice safer drug and sex HIVor related behaviors and motivation to quit drug use; and 3) decreasing or eliminating injection drug use and reducing HIV-related drug and sex risk behaviors. Other aims are: 4) to evaluate differences between individuals who are HIV positive and those who are HIV negative in decreasing or eliminating injection drug use and reducing HIV-related drug and sex risk behaviors within each intervention (ILOM and ILOM+C & E) and across interventions as appropriate; and 5) to assess factors associated with reduced injection drug use and reduced HIV-related drug and sex risk behaviors. Based on the success of this effort, it is our long-term goal that at least one of these interventions will be sustained by the government of Ukraine following the conclusion of the research. Methods: In collaboration with Dr. Sergiy Dvoryak and the Directors of three nongovernmental organizations, 600 IDUs from each of the three cities will receive the C & E intervention or the C & E plus the ILOM, using a crossover experimental design. Subjects will be recruited through street outreach, interviewed, intervened with and followed at six and 12 months. Subjects in both arms will be offered HIV testing and counseling (using the C & E model) following the baseline interview and at both follow-up assessments. Using mixed model analysis of variance and logistic regressions accounting for the relatedness of repeated measures on each subject, analyses will assess the extent to which the C & E alone and the C & E plus the ILOM, as well as other factors, are effective in increasing knowledge, self-efficacy, motivation and reducing risk behaviors associated with HIV. Analyses will also evaluate differences between IDUs who are HIV infected (estimated at 42%) and those who are not infected.

描述（由申请人提供）： 背景：乌克兰是东欧和西欧艾滋病毒/艾滋病的重灾区，估计有 230,000 名感染者，其中大多数是注射吸毒者 (IDU)。该项目的目标是比较两种干预措施在减少艾滋病毒感染传播方面的有效性，这三个乌克兰艾滋病毒血清流行率较高的地区是：基辅、敖德萨和马克耶夫卡/顿涅茨克。这些干预措施包括 NIDA 合作协议期间开发的艾滋病毒咨询和教育 (C & E) 干预模型和土著领袖外展模型 (ILOM)。目的：比较两种方法在以下方面的相对有效性：1）增加有关艾滋病毒和艾滋病传播的知识； 2) 提高采取更安全的药物和性行为的自我效能或艾滋病毒相关行为和戒毒动机； 3) 减少或消除注射吸毒，并减少与艾滋病毒相关的吸毒和性危险行为。其他目标是： 4) 评估 HIV 阳性个体和 HIV 阴性个体在每次干预中减少或消除注射吸毒以及减少 HIV 相关吸毒和性风险行为方面的差异（ILOM 和 ILOM+C & E）并酌情采取跨干预措施； 5) 评估与减少注射吸毒以及减少艾滋病毒相关吸毒和性风险行为相关的因素。基于这项努力的成功，我们的长期目标是，在研究结束后，乌克兰政府将至少维持其中一项干预措施。方法：与 Sergiy Dvoryak 博士和三个非政府组织的主任合作，使用交叉实验设计，来自三个城市各 600 名注射吸毒者将接受 C&E 干预或 C&E 加 ILOM。受试者将通过街头外展招募，并在 6 个月和 12 个月时进行访谈、干预和跟踪。在基线访谈和后续评估后，双臂受试者将接受 HIV 检测和咨询（使用 C&E 模式）。使用方差和逻辑回归的混合模型分析来说明每个受试者重复测量的相关性，分析将评估单独的 C & E 和 C & E 加上 ILOM 以及其他因素在以下方面的有效程度：增加知识、自我效能、积极性并减少与艾滋病毒相关的危险行为。分析还将评估感染 HIV 的注射吸毒者（估计为 42%）和未感染的注射吸毒者之间的差异。