Long Term Injection Cessation among Injection Drug Users (IDUs)

注射吸毒者 (IDU) 长期戒断注射

• 批准号: 7548091
• 负责人: Becky Lynn Genberg
• 金额: $ 5.17万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-07-01 至 2010-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7548091
• 关键词: AIDS prevention; Abstinence; Accounting; Acquired Immunodeficiency Syndrome; African American; Age; Alcohol or Other Drugs use; Baltimore; Behavior; Censuses; Characteristics; Cities; Code; Cohort Studies; Communities; Computer software; Data; Data Collection; Depth; Disadvantaged; Drug usage; Economic Conditions; Economic Factors; Economics; Employment; Enrollment; Environment; Frequencies; Geographic Information Systems; Goals; HIV; HIV Infections; Home environment; Imprisonment; Income; Individual; Injecting drug user; Injection of therapeutic agent; Intervention; Interview; Intravenous; Lead; Link; Longitudinal Studies; Maryland; Methodology; Natural History; Neighborhoods; Pattern; Pharmaceutical Preparations; Population; Prevention strategy; Purpose; Rate; Recording of previous events; Recovery; Relapse; Research; Research Infrastructure; Sampling; Societies; Time; addiction; base; case control; cohort; design; experience; indexing; interest; prevent; social; success; transmission process

DESCRIPTION (provided by applicant): The main objective of this study is to increase understanding of the natural history of injection drug use, with a specific focus on long-term injection cessation, using data from the AIDS Link to the IntraVenous Experience (ALIVE) study, a community-based cohort of injection drug users (IDUs) in Baltimore, Maryland. The majority of HIV prevention strategies directed at IDUs focus on reducing the frequency and harms associated with injection drug use. While these efforts are important, the ultimate goal of HIV prevention for IDUs is long-term injection cessation. Previous research on injection cessation has focused primarily on individual-level factors that predict short periods of cessation (i.e. 6 months to one year). Studies of individual factors associated with short-term cessation do not take into account the factors that maintain longer periods of cessation or the broader social factors that create environments that encourage and sustain cessation. Since addiction is often characterized by periods of abstinence and relapsed use within relatively short time spans, predictors of short-term cessation may differ from predictors of long-term cessation and short-term cessation may not lead to long term recovery for all IDUs. The current study will be nested within the ALIVE study, which has enrolled and followed nearly 4,000 predominantly African-American IDUs since 1988 in Baltimore City. The specific aims of this study are: 1) To characterize the longitudinal patterns of injection and non-injection drug use, including long term injection cessation, among IDUs; 2) To identify individual-level predictors of long-term injection cessation among IDUs; and 3) To determine neighborhood- level predictors of long-term cessation of injection among IDUs. We propose a combination of qualitative, longitudinal, and multilevel analyses to investigate long-term injection cessation. Each aim will be explored qualitatively with iterative in-depth interviews with IDUs who have achieved long-term cessation. The quantitative analysis will begin by using the rich longitudinal data collected in the ALIVE study to determine the frequency of long-term cessation, defined as no injection for at least 3 years, as well as other injection and non-injection drug use patterns from 1988 to 2007. We will employ a nested case-control design to determine the longitudinal predictors of long-term cessation, as well as factors that maintain cessation, at the individual- level. Finally we will conduct multilevel analyses using Geographic Information System (GIS) software to link individual residential data to US Census and other administrative neighborhood-level data to examine the neighborhood characteristics (e.g. socio-economic disadvantage) in Baltimore City that promote and maintain long-term injection cessation. The proposed study will inform HIV and substance use interventions aimed at promoting and maintaining long-term injection cessation among IDUs. Project Narrative. The main objective of this study is to increase understanding of the natural history of injection drug use, with a specific focus on long-term injection cessation. We propose a combination of qualitative, longitudinal, and multilevel analyses to investigate the individual and neighborhood-level predictors of long-term injection cessation among injection drug users (IDUs). The proposed study will inform HIV prevention and substance use interventions aimed at promoting and maintaining long-term injection cessation among IDUs.

描述（由申请人提供）：这项研究的主要目的是通过使用与静脉内体验（Alive）研究的艾滋病链接的数据来提高对注射药物使用的自然历史的了解，并特别关注长期注射式停止，这是马里兰州巴尔的摩的基于社区的注射药物使用者（IDUS）。针对IDU的大多数艾滋病毒预防策略都集中在减少与注射药物使用相关的频率和危害。尽管这些努力很重要，但预防IDU的HIV的最终目标是长期注射停止。先前关于戒烟的研究主要集中在预测短期停止时的个人级别因素上（即6个月至一年）。对与短期停止相关的个体因素的研究并未考虑到维持较长时期的因素，也可以考虑更广泛的社会因素，从而创造出鼓励和维持停止的环境。由于成瘾通常是在相对较短的时间内的禁欲和复发使用时期的特征，因此短期停止的预测因素可能与长期停止和短期停止的预测因素有所不同，可能不会导致所有IDU的长期恢复。当前的研究将嵌套在Alive研究中，自1988年以来，该研究已入学并遵循了近4,000名主要是非裔美国人的IDU。这项研究的具体目的是：1）表征注射和非注射药物使用的纵向模式，包括长期注入的IDU； 2）确定IDU之间长期注射的个人级别预测指标； 3）确定IDU中长期停止注射的邻里水平预测指标。我们提出了定性，纵向和多层次分析的结合，以研究长期的注射停止。每个目标都将通过与长期停止的IDU进行深入的迭代访谈，在定性上进行定性探索。定量分析将首先使用活着研究中收集的丰富的纵向数据来确定长期停止的频率，定义为至少3年，以及1988年至2007年的其他注入和非注射药物使用模式。我们将采用嵌套的病例对照设计来确定长期持续的长期预测指标，并保持cessestation的长期预测。最后，我们将使用地理信息系统（GIS）软件进行多层次分析，以将单个住宅数据与美国人口普查和其他行政邻里级别的数据联系起来，以检查巴尔的摩市的邻里特征（例如社会经济劣势），以促进和维持长期的长期入射暂停。拟议的研究将为旨在促进和维持IDU之间长期注射的艾滋病毒和药物使用干预措施提供信息。项目叙述。这项研究的主要目的是提高对注​​射药物使用的自然史的了解，并特别关注长期注射停止。我们提出了定性，纵向和多层次分析的结合，以调查注射吸毒者（IDU）长期注射停止的个体和邻里级别的预测指标。拟议的研究将为旨在促进和维持IDU中长期注射的旨在预防和毒品使用干预措施提供信息。