Conflict, Substance Use and HIV and Related Diseases

冲突、药物滥用和艾滋病毒及相关疾病

• 批准号: 8602999
• 负责人: Bradley Townsend Kerridge
• 金额: $ 5.16万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-08-01 至 2016-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8602999
• 关键词: Accounting; Acquired Immunodeficiency Syndrome; Address; Affect; Africa South of the Sahara; African; Alcohol consumption; Alcohol or Other Drugs use; Applications Grants; Attention; Behavioral; Biometry; Communicable Diseases; Conflict (Psychology); Consensus; Country; Data; Disease; Drug usage; Economics; Epidemic; Epidemiology; Equation; Evidence based intervention; Federal Government; Geographic Locations; Goals; Government Agencies; HIV; Health Expenditures; Hepatitis B Virus; Hepatitis C virus; Illicit Drugs; Immigration; Infection; Intervention; Knowledge; Learning; Life; Link; Manuscripts; Mediating; Mediator of activation protein; Mentors; Mission; Modeling; Morbidity - disease rate; National Institute of Drug Abuse; Outcome Measure; Persons; Population; Populations at Risk; Predisposition; Preparation; Prevalence; Prevention; Process; Public Health; Research; Research Priority; Research Training; Resistance; Risk Factors; Role; Sexually Transmitted Diseases; Subgroup; Testing; Theoretical model; Training; Tuberculosis; Virus Diseases; World Health Organization; Writing; arm; disease transmission; experience; global health; health training; injection drug use; interest; member; migration; model development; mortality; peace; public health relevance; responsible research conduct; skills; social; transmission process

DESCRIPTION (provided by applicant): The objective of the proposed project is to develop and test a theoretical model of the relationship between conflict and human immunodeficiency virus (HIV) and related diseases (e.g. tuberculosis) among World Health Organization Member States. The model defines the direct effects of conflict on HIV, and the indirect effects of conflit on HIV spread operating through two sets of indicators; background susceptibility factors (e.g. baseline prevalence of HIV) and vulnerability factors (e.g. substance use) that reflect changes induced by conflict. In this explanatory model, susceptibility and vulnerability factors are hypothesized to serve as moderators and mediators of the conflict-HIV relationship. One vulnerability factor of central interest is substance use including alcohol use, non-injection illiit drug use and especially injection drug use (IDU). Consideration of IDU in explaining the conflict-HIV relationship is important given that IDU accounts for about 10% of the estimated 27 million new HIV infections that occur each year and for 30% of these new infections occurring outside Sub-Saharan Africa. Research attention has focused on the relationship between IDU and HIV, Hepatitis B virus, Hepatitis C virus, and sexually transmitted infections (STIs), tending to overshadow the importance of these diseases associated with non-injection drug use and alcohol use. The proposed project also aims to: (1) identify new and refine existing indicators of susceptibility and vulnerability; (2) examine hypothesized direct and indirect effects of conflict n HIV among relevant subgroups in which the relationship may differ (e.g. Sub-Saharan African vs. Non-Sub-Saharan African countries); and (3) test alternative explanatory models using structural equation modeling. These objectives and aims will be supported by a research training plan that involves learning/enhancing knowledge of advanced epidemiology, biostatistics and HIV and related infectious diseases and global health and training in presentation skills, conduct of research, manuscript writing and preparation of fundable grant proposals, mentoring and receiving training in the responsible conduct of research. This project is of substantial relevance to the research priorities of the National Institute on Drug Abuse, tha is, its focus on prevention and treatment of HIV, including developing intervention strategies, addressing HIV/AIDS, understanding IDU epidemics in different geographic areas, assessing the role of immigration/migration on HIV transmission and research addressing the epidemiology of HIV/AIDS and related co-infections and other STIs and tuberculosis, epidemiology, and behavioral, social and economic determinants of HIV/AIDS.

描述（由申请人提供）：拟议项目的目标是开发和测试世界卫生组织成员国之间冲突与人类免疫缺陷病毒（HIV）及相关疾病（例如结核病）之间关系的理论模型。该模型通过两组指标定义了冲突对艾滋病毒的直接影响，以及冲突对艾滋病毒传播的间接影响；反映冲突引起的变化的背景易感性因素（例如艾滋病毒的基线流行率）和脆弱性因素（例如药物使用）。在这个解释模型中，假设易感性和脆弱性因素充当冲突与艾滋病毒关系的缓和者和调解者。核心利益之一的脆弱性因素是物质使用，包括酒精使用、非注射非法药物使用，特别是注射药物使用（IDU）。在解释冲突与艾滋病毒关系时考虑注射吸毒者非常重要，因为注射吸毒者约占每年发生的 2,700 万新发艾滋病毒感染者的 10%，并且占撒哈拉以南非洲以外地区发生的新发感染者的 30%。研究注意力集中在注射吸毒者与艾滋病毒、乙型肝炎病毒、丙型肝炎病毒和性传播感染（STI）之间的关系上，往往掩盖了这些与非注射吸毒和饮酒相关的疾病的重要性。拟议项目还旨在：（1）确定新的并完善现有的易感性和脆弱性指标； (2) 检查假设的艾滋病毒冲突对相关亚组之间的直接和间接影响，其中关系可能不同（例如撒哈拉以南非洲国家与非撒哈拉以南非洲国家）； (3) 使用结构方程模型测试替代解释模型。这些目标和目的将得到研究培训计划的支持，该计划涉及学习/增强高级流行病学、生物统计学、艾滋病毒和相关传染病以及全球健康的知识，以及演讲技巧、研究开展、手稿写作和可资助拨款提案准备方面的培训、指导并接受负责任的研究行为的培训。该项目与国家药物滥用研究所的研究重点密切相关，即重点关注艾滋病毒的预防和治疗，包括制定干预战略、解决艾滋病毒/艾滋病问题、了解不同地理区域的注射吸毒者流行情况、评估移民/移徙对艾滋病毒传播的作用，以及研究艾滋病毒/艾滋病和相关合并感染以及其他性传播感染和结核病的流行病学、流行病学以及艾滋病毒/艾滋病的行为、社会和经济决定因素。