Heroin Cessation and Hiv Risk: A Case-Control Study

海洛因戒断和艾滋病毒风险：病例对照研究

• 批准号: 8548720
• 负责人: DANIELLE C OMPAD
• 金额: $ 17.89万
• 依托单位: NEW YORK UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-20 至 2015-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8548720
• 关键词: Heroin; Cessation; Hiv; Risk; Case

DESCRIPTION (provided by applicant): The purpose of this case-control study is to characterize the prognostic indicators, including HIV infection, for the positive outcome of sustained heroin cessation among persons with a prior history of chronic heroin use within economically disadvantaged, predominantly racial/ethnic minority neighborhoods in New York City (NYC). With drug use as a major risk factor for HIV and a chronic relapsing condition, identifying factors that promote sustained cessation can be key to enhancing HIV prevention and treatment efforts. Also unknown is what happens with sexual risk after short and long term cessation; an important but understudied consideration. Previous studies that have described patterns of cessation have been limited for several reasons. First, while much work has been done on relapse and cessation, the literature is sparse on long- term effective cessation. Second, most studies have sampled from treatment settings which misses persons who cease use without treatment. Third, previous research has not investigated the possible impact of determinants at multiple levels, including initial circumstances of cessation (e.g., influence of incarceration, family, etc.), potential influences of individual-level factors (e.g., social support, network characteristics) and one's neighborhood context (e.g., availability of drugs, density of AIDS cases). Post treatment relapse is more common in disadvantaged communities where persons return to settings with cues for drug use, however a proportion sustains cessation; characterizing neighborhood factors that contribute to this remains understudied. To identify factors associated with sustained cessation, we will recruit 1800 heroin using individuals utilizing venue- and respondent-driven sampling in 36 NYC neighborhoods. Eligible individuals will be those aged >27 years with a history of heroin use at least five years before interview. Eligible and consenting participants will undergo structured interviews include a year by year recall for the prior 6 years as has been used successfully in earlier studies. For analyses, cases will be defined as former heroin users, i.e., non-use at interview (N=744). Two control groups are specified: (1) heroin users who used continuously through past six years, (N=527) and (2) relapsed heroin users who were abstinent sometime in the past 5 years but who subsequently relapsed to drug use (N=527). Cases (sustained cessation) and controls will be frequency matched on age and age at heroin initiation (¿2 years) during analysis. Determinants of sustained cessation will be assessed using conditional logistic regression and hierarchical modeling. Data from this study can be used to identify modifiable factors that can be subjected to individual, group or policy intervention to promote sustained cessation from opiate use. Additionally, we will consider heroin cessation as an "exposure" by examining the relation between cessation and high-risk sexual behavior.

描述（通过应用程序提供）：该病例对照研究的目的是表征包括艾滋病毒感染在内的预后指标，以表征有持续的海洛因戒烟在纽约市（NYC）（纽约市）经济上处于不利地位，主要种族/伦理少数民族社区（NYC）的持续海洛因戒烟的积极结果。由于药物用作艾滋病毒的主要危险因素和慢性复发状况，因此确定促进持续停止的因素是增强艾滋病毒预防和治疗工作的关键。短期和长期停止后，性风险会发生什么；一个重要但值得一提的考虑因素。以前描述了戒烟模式的研究受到限制。首先，尽管在退休和停止方面已经完成了许多工作，但文献在长期戒烟方面却很少。其次，大多数研究都从治疗环境中取样，这些治疗环境错过了未经治疗而停止使用的人。第三，先前的研究尚未研究确定词在多个层次上的可能影响，包括戒烟的初始情况（例如影响，家庭等的影响），个人级别因素的潜在影响（例如，社会支持，网络特征，网络特征）和邻里的环境（例如，毒品的可用性，药物的可用性，艾滋病的密度，艾滋病的密度）。治疗后接力赛在不利的社区中更为常见，在这些社区中，人们回到带有毒品使用线索的环境中，但比例的自杀停止；表征促成这一点的邻里因素仍然被理解。为了确定与持续停止相关的因素，我们将在36个纽约市社区中使用场地和响应驱动的采样招募1800个海洛因。符合条件的人将是至少在面试前五年使用海洛因史的27岁> 27岁的人。符合条件和同意的参与者将接受结构化的访谈，包括前6年的一年召回，并在早期的研究中成功使用。对于分析，案例将定义为前海洛因用户，即面试中不使用（n = 744）。指定了两个对照组：（1）在过去的六年中连续使用的海洛因用户，（n = 527）和（2）传递了过去5年中某个时候戒酒但随后将其转移到药物使用（n = 527）中的海洛因用户。在分析过程中，病例（持续停止）和控制措施将与海洛因启动时的年龄和年龄相匹配。持续停止的决定因素将使用条件逻辑回归和分层建模进行评估。这项研究的数据可用于识别可修改的因素，这些因素可能受到个人，团体或政策干预，以促进优化使用的持续停止。此外，我们将海洛因戒烟视为一种“暴露”，通过研究戒烟与高风险性行为之间的关系。

项目成果

Exploring and exploiting unique properties of the hippocampal dentate gyrus for post-stroke therapy: astrocytes link ischemic resistance with neurogenic potential.

• DOI: 10.4103/1673-5374.194714
• 发表时间: 2016-11
• 期刊: Neural regeneration research
• 影响因子: 6.1
• 作者: Stary CM

Understanding prolonged cessation from heroin use: findings from a community-based sample.

了解长期戒除海洛因使用：基于社区的样本的发现。

• DOI: 10.1080/02791072.2014.890765
• 发表时间: 2014
• 期刊: Journal of psychoactive drugs
• 影响因子: 2.8
• 作者: Weiss,Linda;Gass,Jonathon;Egan,JamesE;Ompad,DanielleC;Trezza,Claudia;Vlahov,David
• 通讯作者: Vlahov,David