Exploratory Research on Late Initiation of Drug Injection

延迟启动药物注射的探索性研究

• 批准号: 8300980
• 负责人: Ricky N Bluthenthal
• 金额: $ 51.3万
• 依托单位: UNIVERSITY OF SOUTHERN CALIFORNIA
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-30 至 2015-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8300980
• 关键词: AIDS prevention; AIDS/HIV problem; Abscess; Adherence; Adolescent; Adult; Affect; Age; Age-Years; California; Characteristics; Cities; Cocaine; Communicable Diseases; Communities; Counseling; Data; Development; Drug Prescriptions; Drug usage; Drug user; Elderly; Environment; Event; Family; Foundations; Friends; Gender; Goals; HIV; HIV Seropositivity; Health; Health Services Accessibility; Hepatitis B; Hepatitis B Virus; Hepatitis C virus; Heroin; Illicit Drugs; Imprisonment; Incidence; Individual; Infection; Influentials; Injecting drug user; Injection of therapeutic agent; Intervention; Knowledge; Lead; Life; Life Cycle Stages; Los Angeles; Methamphetamine; Methods; Motivation; Occupations; Older Population; Outcome; Overdose; Paper; Participant; Pattern; Perception; Pharmaceutical Preparations; Physical environment; Population; Poverty; Prevalence; Prevention; Public Health; Publishing; RQ2; Race; Recording of previous events; Recruitment Activity; Research; Respondent; Risk; Risk Factors; Route; Sampling; San Francisco; Sex Behavior; Sexual Partners; Social Environment; Social Health Services; Soft Tissue Infections; Testing; Thick; Time; Trauma; U-Series Cooperative Agreements; Wound botulism; base; community setting; critical period; demographics; design; experience; intergenerational; preference; prevent; psychosocial; racial and ethnic; social; substance abuse prevention; theories; young adult

We propose a 3-year, qualitative exploratory study of 'late initiates' {individuals who began injecting drugs at age 30 or later) and 'typical initiates' {those who initiate injection prior to 30) in order to better understand the circumstances, motivations, social environments and HIV, HCV, and HBV risk associated with injection initiation later in life. There are an estimated 3 million injection drug users {IDUs) in the US. Many of the detrimental health consequences of illicit drug use, including HIV, HCV, and HBV, as well as soft-tissue infections, and overdose, are related to the act of injection. Between 15% and 19% of IDUs initiated drug injection after turning 30 years old. Little is known about how late initiates differ from "typical" initiates {initiating before age 30). We propose to examine how aspects of drugs, individual characteristics, and social environments affect transition to drug injection among adults 30 years of age and older. While there are more than a dozen published papers on initiation of drug injection, most studies have focused on young injectors and the specific circumstances of the first injection episode, and do not systematically consider how route of administration might intersect with drug use trajectories, life events, and accumulated health, social, and psychosocial vulnerabilities {e.g., HIV/AIDS and other conditions, multiple incarcerations, traumatic events, intergenerational poverty). This gap in knowledge is significant since late initiates are likely to need different approaches to HIV and substance abuse prevention and treatment than adolescents and young adults. The primary goals of the proposed qualitative study are to understand and compare late initiates to typical initiates and to provide a "thick description" of the intersections amongst drug use, life events, HIV risk and infection, social and physical environments, and initiation of drug injection. Our proposal uses Zinberg's classic framework of Drug, Set, and Setting {DSS) and lifcourse theory {LCT) to guide the aims, research questions, and analyses of this exploratory study. We have established the following aims. Aim 1: To explore attributes of drugs and drug injection (DRUG) among late initiates using LCT constructs. Aim 2: To describe individual characteristics, including HIV status and perceptions of HIV/AIDS risks, drug use histories, and key life events (SET) of late initiates as compared to typical initiates using LCT constructs. Aim 3: To explore the interpersonal, social, and structural environments (including the prevalence of HIV/AIDS and other infectious diseases in the community- SETTING) of late initiates compared to typical initiates using LCT constructs. To accomplish these aims, we propose to conduct a qualitative, exploratory study comparing 80 late initiates and 80 typical initiates. Participants will be HIV negative and HIV positive, active IDUs recruited from community settings using targeted sampling methods. We will use the grounded theory method and life event approaches to explore in-depth the concepts related to DRUG, SET, and SETTING that influence late initiation to injection drug use. To capture a diversity of IDUs and settings, we will recruit IDUs in Los Angeles and San Francisco, two cities that have important differences in IOU demographics, drug use preferences, the incidence and prevalence of HIV/AIDS among IDUs, and other community and environmental influences. Exploring DSS among late initiates will help to identify influential factors for the prevention of injection drug use, injection-related risks for HIV/AIDS, and other health and social consequences.

我们提议对“晚期注射者”（30 岁或以上开始注射毒品的个人）和“典型注射者”（30 岁之前开始注射的人）进行为期 3 年的定性探索性研究，以便更好地了解情况和动机、社会环境以及与晚年开始注射相关的 HIV、HCV 和 HBV 风险。据估计，美国有 300 万注射吸毒者 (IDU)。非法药物使用造成的许多有害健康后果，包括艾滋病毒、丙型肝炎病毒和乙型肝炎病毒，以及软组织感染和药物过量，都与注射行为有关。 15% 至 19% 的注射吸毒者在 30 岁后开始注射毒品。人们对于晚入会与“典型”入会（30 岁之前开始）有何不同知之甚少。我们建议研究毒品、个人特征和社会环境等方面如何影响 30 岁及以上成年人向注射毒品的过渡。虽然已有十几篇关于开始注射毒品的论文发表，但大多数研究都集中在年轻注射者和第一次注射的具体情况，并没有系统地考虑给药途径如何与吸毒轨迹、生活事件相交叉，以及累积的健康、社会和社会心理脆弱性（例如，艾滋病毒/艾滋病和其他状况、多次监禁、创伤事件、代际贫困）。这种知识差距很大，因为较晚的入门者可能需要与青少年和年轻人不同的方法来预防和治疗艾滋病毒和药物滥用。拟议的定性研究的主要目标是了解和比较晚期吸毒者与典型吸毒者，并提供吸毒、生活事件、艾滋病毒风险和感染、社会和物理环境以及吸毒开始之间交叉点的“详细描述”注射。我们的提案使用 Zinberg 的经典药物、设定和设置 (DSS) 框架和生命历程理论 (LCT) 来指导这项探索性研究的目标、研究问题和分析。我们制定了以下目标。目标 1：探索使用 LCT 构建体的晚期初学者的药物和药物注射 (DRUG) 属性。目标 2：与使用 LCT 构建的典型入门者相比，描述晚期入门者的个人特征，包括 HIV 状况和对 HIV/AIDS 风险的认知、吸毒史和关键生活事件 (SET)。目标 3：使用 LCT 构建，探索晚期入会者与典型入会者的人际、社会和结构环境（包括社区环境中艾滋病毒/艾滋病和其他传染病的流行情况）。为了实现这些目标，我们建议进行一项定性的探索性研究，比较 80 名晚期入门者和 80 名典型入门者。参与者将是使用有针对性的抽样方法从社区环境中招募的艾滋病毒阴性和艾滋病毒阳性、活跃的注射吸毒者。我们将运用扎根理论方法和生活事件方法，深入探讨影响晚期注射吸毒的 DRUG、SET 和 SETTING 相关概念。为了了解注射吸毒者和环境的多样性，我们将在洛杉矶和旧金山招募注射吸毒者，这两个城市在 IOU 人口统计、吸毒偏好、注射吸毒者中艾滋病毒/艾滋病的发病率和流行率以及其他社区和环境方面存在显着差异。影响。在较晚的发起者中探索 DSS 将有助于确定预防注射吸毒、与注射有关的艾滋病毒/艾滋病风险以及其他健康和社会后果的影响因素。

项目成果

Is cannabis use associated with less opioid use among people who inject drugs?

• DOI: 10.1016/j.drugalcdep.2015.05.014
• 发表时间: 2015-08-01
• 期刊: Drug and alcohol dependence
• 影响因子: 4.2
• 作者: Kral AH;Wenger L;Novak SP;Chu D;Corsi KF;Coffa D;Shapiro B;Bluthenthal RN
• 通讯作者: Bluthenthal RN

Characteristics Associated with Nonmedical Methadone Use among People Who Inject Drugs in California.

加州注射毒品者非医疗美沙酮使用的相关特征。

• DOI: 10.1080/10826084.2019.1673420
• 发表时间: 2020
• 期刊: Substance use & misuse
• 影响因子: 2
• 作者: Zhao,JohnathanK;Kral,AlexH;Wenger,LynnD;Bluthenthal,RickyN
• 通讯作者: Bluthenthal,RickyN

Correlates of Sexual Coercion among People Who Inject Drugs (PWID) in Los Angeles and San Francisco, CA.

加利福尼亚州洛杉矶和旧金山注射毒品者 (PWID) 中性强迫的相关性。

• DOI: 10.1007/s11524-018-0238-6
• 发表时间: 2019
• 期刊: Journal of urban health : bulletin of the New York Academy of Medicine
• 作者: Williams,JefferyE;Dangerfield2nd,DerekT;Kral,AlexH;Wenger,LynnD;Bluthenthal,RickyN
• 通讯作者: Bluthenthal,RickyN