Pilot Test of an Intervention to Change Syringes Used by Injecting Drug Users

注射吸毒者更换注射器干预措施的试点试验

基本信息

批准号：
8601366
负责人：
WILLIAM A ZULE
金额：
$ 18.78万
依托单位：
RESEARCH TRIANGLE INSTITUTE
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-08-15 至 2016-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8601366
关键词：
Acquired Immunodeficiency Syndrome Adoption Afghanistan Asians Aspirate substance Blood Central Asia China Client Cognitive Country Data Depressed mood Devices Diffusion Diffusion of Innovation Drug usage Epidemic Funding Funding Agency Goals HIV HIV Infections HIV risk Heroin Incidence Indonesia Injecting drug user Injection of therapeutic agent Intervention Kazakhstan Kyrgyzstan Laboratories Liquid substance Malaria Methods Modeling Needle Sharing Needles Opiates Opium Outcome Pharmaceutical Preparations Prevalence Prevention approach Public Health Randomized Controlled Trials Route Russia Simulate Surveys Syringes Tajikistan Testing Time Treatment Cost Tuberculosis Turkmenistan Ukraine Uzbekistan Vietnam Water Work World Health Organization biobehavior cost design experience fighting high risk mathematical model prevent programs public health relevance research study social theories trafficking transmission process

项目摘要

DESCRIPTION (provided by applicant): Tajikistan and the other Central Asian Republics are experiencing HIV epidemics that are driven by injecting drug use. The proposed 3-year R34 project will pilot test the feasibility of a structural intervention to switch needle and syringe program (NSP) clients in Tajikistan from high dead space to low dead space needles and syringes. Circumstantial evidence from laboratory experiments, biobehavioral surveys, ecological studies, and mathematical models suggests that such an intervention could substantially reduce HIV transmission among people who inject drugs (PWID). In mathematical models, such an intervention would prevent injection- related HIV epidemics among PWID from occurring in the first place and reverse injection-related epidemics that have occurred. However, no one knows whether such an intervention is feasible or whether it would actually reduce HIV incidence. The proposed project will use a combination prevention approach that works with NSP (structural intervention) to distribute low dead space needles and syringes (biomedical device/intervention). Our efforts to promote the adoption and diffusion of low dead space needles and syringes will be informed by Diffusion of Innovations Theory. Findings from the study will determine whether it makes sense to design and implement an expensive randomized controlled trial (RCT) with HIV incidence as an outcome to test such an intervention. The proposed pilot test will be conducted at two NSP that are located in Kulyob and Khorog, Tajikistan. These NSP distribute only high dead space needles and syringes. HIV prevalence among PWID is 24% in Kulyob and 14% in Khorog. The specific aims of the proposed study are as follows: Aim 1. To pilot test the feasibility of a structural intervention to switch NSP client in Tajikistan from high dead space to low dead space needles and syringes. Aim 2. To evaluate the potential impact of such an intervention by incorporating findings from the pilot test into ou predictive mathematical model of the effects of syringe type on HIV transmission among PWID. If we find that the intervention is feasible and the model suggests that it would have substantial impact, we will design a full RCT to test the intervention using HIV incidence as an outcome.

描述（由申请人提供）：塔吉克斯坦和其他中亚共和国正在经历由注射吸毒引起的艾滋病毒流行。拟议的为期 3 年的 R34 项目将试点测试结构干预的可行性，以将塔吉克斯坦的针头和注射器计划 (NSP) 客户从高死腔针头和注射器转换为低死腔针头和注射器。来自实验室实验、生物行为调查、生态研究和数学模型的间接证据表明，这种干预措施可以大大减少注射吸毒者 (PWID) 中的艾滋病毒传播。在数学模型中，这种干预措施将首先防止注射吸毒者中发生与注射有关的艾滋病毒流行，并扭转已经发生的与注射有关的流行病。然而，没有人知道这种干预措施是否可行，或者是否能真正降低艾滋病毒发病率。拟议项目将采用与 NSP（结构干预）结合的组合预防方法来分发低死腔针头和注射器（生物医学设备/干预）。我们将通过创新扩散理论来促进低死腔针头和注射器的采用和推广。该研究的结果将决定设计和实施一项昂贵的随机对照试验（RCT）是否有意义，以艾滋病毒发病率作为测试此类干预措施的结果。拟议的试点测试将在塔吉克斯坦库廖布和霍罗格的两个国家核电站进行。这些 NSP 仅分销高死腔针头和注射器。库廖布吸毒者的艾滋病毒感染率为 24%，霍罗格为 14%。本研究的具体目标如下：目标 1. 试点测试结构干预的可行性，将塔吉克斯坦的 NSP 客户从高死腔针头和注射器切换为低死腔针头和注射器。目标 2. 通过将试点测试的结果纳入注射器类型对吸毒者中艾滋病毒传播影响的预测数学模型中，评估此类干预措施的潜在影响。如果我们发现干预措施是可行的，并且模型表明它将产生重大影响，我们将设计一个完整的随机对照试验，以艾滋病毒发病率作为结果来测试干预措施。