Evaluating the natural history of injection drug use

评估注射吸毒的自然史

• 批准号: 8899303
• 负责人: Thomas Kerr
• 金额: $ 20万
• 依托单位: UNIVERSITY OF BRITISH COLUMBIA
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-08-01 至 2014-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8899303
• 关键词: AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; American; Area; Baltimore; Biological; British Columbia; Canada; Characteristics; Cities; Cohort Studies; Communicable Diseases; Crack Cocaine; Data; Databases; Development; District of Columbia; Drug usage; Environmental Risk Factor; Epidemic; Funding; Growth; HIV; HIV Seropositivity; HIV risk; Health; Health Services; Healthcare; Healthcare Systems; Heroin; Home environment; Hospitals; Illicit Drugs; Incidence; Individual; Injecting drug user; Injection of therapeutic agent; Intervention; Investigation; Link; Medical; Methamphetamine; Morbidity - disease rate; Natural History; Neighborhoods; North America; Participant; Pattern; Peer Review; Persons; Pharmaceutical Preparations; Policies; Preparation; Public Health; Publications; Questionnaires; Records; Research; Research Priority; Risk Behaviors; Risk Factors; San Francisco; Social Impacts; Specimen; Sum; Testing; Urban Renewal; Visit; Work; base; cohort; drug market; experience; follow-up; global health; hospital utilization; injection drug use; member; methicillin resistant Staphylococcus aureus; mortality; novel; programs; prospective; public health relevance; repository; social; trafficking; trend

DESCRIPTION (provided by applicant): The purpose of this competing renewal application is to evaluate the impact of evolving drug use patterns, as well as a range of social, structural, and environmental factors, on HIV incidence, morbidity, and mortality among a cohort of HIV-negative injection drug users (IDU) in Vancouver, Canada. We propose to undertake this work in a setting where a steady growth in methamphetamine injection has become an increasing concern. The proposed research involves the continuation of the Vancouver Injection Drug Users Study (VIDUS), which is among the longest-standing cohort studies in North America. Since 1997, this study has led to more than 120 peer-reviewed publications in the area of public health, HIV/AIDS, and injection drug use. Vancouver, Canada, is unique in North America and is ideally suited to the proposed research questions for several reasons. First, the city is home to one of the most explosive HIV epidemics ever documented among IDU in the developed world, with HIV incidence peaking at 18 per 100 person-years in 1997 and persistently elevated HIV rates continuing up to 2007. Second, like many West Coast cities, Vancouver is in the midst of a massive growth in the use of methamphetamine and is also seeing a dramatic increase in methamphetamine injection. Third, Vancouver is unique in having an exceptionally large and visible street-based drug market and a large network of single-room occupancy hotels (SROs). We seek to build upon our past work focused on individual risk factors and health service use by investigating the impact of various social, structural, and environmental factors on HIV risk behavior, HIV incidence, morbidity, mortality, and hospital utilization among IDU. Herein we propose to continue our cohort-based approach involving semi-annual follow-up of 1000 HIV-negative IDU. We also propose to continue taking advantage of the universal healthcare system and centralized health data in British Columbia by linking participant data to a range of healthcare databases. Our proposed continuation of cohort-based research offers an ideal opportunity to examine the impact of evolving drug use patterns, as well as the impact of various social, structural, and environmental factors on the natural history of injection drug use. Given that methamphetamine use emerged on the West Coast, our investigation of rising methamphetamine injection could provide important information and early warning to other North American settings. In sum, through the continuation of VIDUS, we aim to address several urgent global health challenges and inform the development of a range of policies and interventions.

描述（由申请人提供）：这种竞争性更新申请的目的是评估不断发展的药物使用模式的影响，以及一系列社会，结构和环境因素，对HIV-NIV负性入口药物使用者（IDU）在加拿大Vancouver的一系列HIV发病率，发病率和死亡率中。我们建议在甲基苯丙胺注射稳定增长已成为越来越关注的环境中进行这项工作。拟议的研究涉及温哥华注射吸毒者研究（Vidus）的继续，这是北美最长的队列研究之一。自1997年以来，这项研究已导致在公共卫生，艾滋病毒/艾滋病和注射药物使用的领域进行了120多个同行评审的出版物。加拿大温哥华在北美是独一无二的，非常适合拟议的研究问题，原因有几个。首先，这座城市是发达国家IDU中有史以来最爆炸性的HIV流行病之一的所在地，艾滋病毒的发病率在1997年达到每100人的18人，持续升高的艾滋病毒率持续到2007年。第二，就像许多西海岸城市一样，温哥华在甲基甲基甲基甲基甲基甲基甲基氨基甲基上也占据了巨大的增长。第三，温哥华在拥有一个非常大的街道毒品市场和大型单居室居住酒店（SRO）网络方面是独一无二的。我们试图基于我们过去的工作，重点是个人风险因素和卫生服务使用，通过调查各种社会，结构和环境因素对IDU中各种社会，结构和环境因素对HIV风险行为，HIV发病率，发病率，死亡率和医院利用的影响。本文中，我们建议继续我们的基于队列的方法，涉及1000个HIV阴性IDU的半年度随访。我们还建议通过将参与者数据与一系列医疗保健数据库联系起来，继续利用不列颠哥伦比亚省的通用医疗系统和集中的健康数据。我们提出的基于队列研究的延续为研究不断发展的药物使用模式的影响以及各种社会，结构和环境因素对注射药物使用自然历史的影响提供了理想的机会。鉴于西海岸出现了甲基苯丙胺的使用，我们对甲基苯丙胺注射升高的调查可以为其他北美其他环境提供重要的信息和预警。总而言之，通过Vidus的延续，我们旨在应对一些紧急的全球健康挑战，并为一系列政策和干预的制定提供信息。

项目成果

Phylogenetic clustering of hepatitis C virus among people who inject drugs in Vancouver, Canada.

加拿大温哥华注射吸毒者中丙型肝炎病毒的系统发育聚类。

• DOI: 10.1002/hep.27310
• 发表时间: 2014-11
• 期刊: HEPATOLOGY
• 影响因子: 13.5
• 作者: Jacka, Brendan;Applegate, Tanya;Krajden, Mel;Olmstead, Andrea;Harrigan, P. Richard;Marshall, Brandon D. L.;DeBeck, Kora;Milloy, M. -J.;Lamoury, Francois;Pybus, Oliver G.;Lima, Viviane D.;Magiorkinis, Gkikas;Montoya, Vincent;Montaner, Julio;Joy, Jeffrey;Woods, Conan;Dobrer, Sabina;Dore, Gregory J.;Poon, Art F. Y.;Grebely, Jason
• 通讯作者: Grebely, Jason

Needle exchange and the HIV epidemic in Vancouver: lessons learned from 15 years of research.

• DOI: 10.1016/j.drugpo.2012.03.006
• 发表时间: 2012-07
• 期刊: INTERNATIONAL JOURNAL OF DRUG POLICY
• 影响因子: 4.4
• 作者: Hyshka, Elaine;Strathdee, Steffanie;Wood, Evan;Kerr, Thomas
• 通讯作者: Kerr, Thomas

Survival sex work and increased HIV risk among sexual minority street-involved youth.

• DOI: 10.1097/qai.0b013e3181c300d7
• 发表时间: 2010-04
• 期刊: Journal of acquired immune deficiency syndromes (1999)
• 作者: Marshall BD;Shannon K;Kerr T;Zhang R;Wood E
• 通讯作者: Wood E

Hepatitis C virus treatment for prevention among people who inject drugs: Modeling treatment scale-up in the age of direct-acting antivirals.

• DOI: 10.1002/hep.26431
• 发表时间: 2013-11
• 期刊: HEPATOLOGY
• 影响因子: 13.5
• 作者: Martin, Natasha K.;Vickerman, Peter;Grebely, Jason;Hellard, Margaret;Hutchinson, Sharon J.;Lima, Viviane D.;Foster, Graham R.;Dillon, John F.;Goldberg, David J.;Dore, Gregory J.;Hickman, Matthew
• 通讯作者: Hickman, Matthew

Slower uptake of HIV antiretroviral therapy among Aboriginal injection drug users.

原住民注射吸毒者接受艾滋病毒抗逆转录病毒治疗的速度较慢。

• DOI: 10.1016/j.jinf.2005.07.008
• 发表时间: 2006
• 期刊: The Journal of infection
• 作者: Wood,Evan;Kerr,Thomas;Palepu,Anita;Zhang,Ruth;Strathdee,SteffanieA;Tyndall,MarkW;Montaner,JulioSG;Hogg,RobertS
• 通讯作者: Hogg,RobertS