Couples-Based HIV/STI Prevention for Injecting Drug Users in Kazakhstan

哈萨克斯坦注射吸毒者以夫妻为基础的艾滋病毒/性传播感染预防

• 批准号: 8265718
• 负责人: Nabila El-Bassel
• 金额: $ 60.98万
• 依托单位: COLUMBIA UNIV NEW YORK MORNINGSIDE
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-07-15 至 2013-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8265718
• 关键词: AIDS prevention; AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; Afghanistan; Age; Asians; Behavior; Behavior Therapy; Behavioral; Biological; Centers for Disease Control and Prevention (U.S.); Central Asia; Child Sexual Abuse; China; Chlamydia; Coitus; Collaborations; Communication; Couples; Criminal Justice; Drug Addiction; Drug abuse; Drug usage; Eligibility Determination; Epidemic; Epidemiology; Ethics; Expectancy; Gender; Gonorrhea; HIV; HIV/STD; Health; Hepatitis C; Hepatitis C Incidence; Hepatitis C virus; Heterosexuals; Incidence; Infection; Infection prevention; Injecting drug user; Injection of therapeutic agent; Institutes; Interdisciplinary Study; International; International AIDS; Intervention; Kazakhstan; Knowledge; Length; Link; Maps; Measures; Mediating; Mediator of activation protein; Needle Sharing; Needle-Exchange Programs; Needles; Outcome; Participant; Patient Self-Report; Pharmaceutical Preparations; Population; Population Study; Prevention Protocols; Prevention Research; Prevention approach; Preventive Intervention; Principal Investigator; Protocols documentation; Public Health; Race; Randomized; Randomized Controlled Trials; Recording of previous events; Recruitment Activity; Reporting; Research; Research Infrastructure; Research Institute; Research Personnel; Research Training; Risk Behaviors; Risk Reduction; Route; Russia; Schools; Self Efficacy; Sexual Partners; Sexually Transmitted Diseases; Site; Social Work; Social support; Study Section; Substance abuse problem; Syphilis; Syringes; Testing; Universities; Vagina; Venipunctures; base; condoms; efficacy testing; experience; follow-up; global health; group intervention; high risk; innovation; intimate partner violence; meetings; outreach; peer; pilot trial; post intervention; prevention service; programs; psychological distress; public health relevance; research and development; satisfaction; sex; skills; skin disorder; social; stem; trafficking; treatment effect

DESCRIPTION (provided by applicant): The proposed study will rigorously test the efficacy of an innovative, couples-based HIV/STI risk reduction intervention (CHSR) to decrease new cases of HIV and Hepatitis C (HCV) and incidence of sexually transmitted infections (STIs), as well as to reduce unsafe injection practices and increase condom use among injecting drug users (IDUs) and their heterosexual, intimate partners in Shu, Kazakhstan. Central Asia has experienced one of the fastest growing HIV/AIDS epidemics due to a sharp increase in injection drug use. This investigative team from the Social Intervention Group at Columbia University and the Shu Policlinic Needle Exchange Program in Kazakhstan completed a pilot randomized controlled trial of the proposed CHSR among 40 IDUs and their primary, heterosexual partners (N=80) in Shu, Kazakhstan. Compared to participants assigned to the wellness promotion comparison condition (WP) (n=40), CHSR participants (n=40) reported significantly fewer unsafe injection behaviors and greater condom use from baseline to the 3-month follow-up. For the proposed study, the participants will be 400 IDUs and their heterosexual, intimate partners, who meet eligibility criteria (e.g., at least one partner reports unsafe injection and unprotected sexual intercourse in the past 30 days). Participants will be recruited from the Shu Policlinic needle exchange program and through street outreach in Shu. Shu is located along a major drug trafficking route and has an estimated 4,500 IDUs out of a population of 35,000. In the proposed study, 400 couples will be randomized to one of two interventions: a 5-session couples-based HIV/STI risk reduction intervention or a 5- session couples-based wellness promotion intervention, which will serve as a comparison condition. Participants will be assessed with repeated measures at baseline, 3-, 6- and 12-months post-intervention. The primary behavioral outcomes are self- reported proportion of injection acts in which needles or syringes are shared in the past 30 days and proportion of condom-protected acts of sexual intercourse in the past 30 days. The primary biological outcomes are the rate of new HIV cases and new HCV cases, as well as the incidence of Chlamydia, gonorrhea, and syphilis over the 12-month post-intervention period. The proposed study will advance the understanding of HIV/HCV/STI risk reduction among a population of IDUs and their heterosexual partners, and thereby help to stem the rising epidemic of HIV, HCV, and STIs in Kazakhstan and Central Asia. PUBLIC HEALTH RELEVANCE The proposed study addresses a significant public health threat of HIV, HCV and other STIs among a very high risk population of active IDUs and their sexual partners in Kazakhstan - a region that is experiencing one of the fastest rising HIV epidemics in the world. There is a race to develop and implement effective HIV preventive interventions for IDUs and their sexual partners to stem the spread of HIV, HCV and other STIs in Shu and other Central Asian towns along drug trafficking routes.

描述（由申请人提供）：拟议的研究将严格测试创新的，基于夫妻的HIV/STI降低风险降低干预措施（CHSR），以减少新的HIV和乙型肝炎和丙型肝炎（HCV）的新病例（HCV）和性交感染的发生率（STIS），以及减少不安全的注射习惯，以及减少内部注射型的HINTICE HETRISE HERICES HOD（降低）（降低了内部的药物（降低）（降低）（降低了内部的药物）（以内部的孔内使用）（降低了内部的疾病（降低）（降低）（降低了内部的药物）（降低了内部的孔（Intecte hot）（降低）哈萨克斯坦舒的亲密伙伴。由于注射药物的使用急剧增加，中亚经历了增长最快的艾滋病毒/艾滋病流行病之一。来自哥伦比亚大学社会干预小组的调查小组和哈萨克斯坦的SHU POLICLINIC NEADENCE交换计划完成了一项对拟议CHSR的飞行员随机对照试验，其中40个IDU及其主要的异性恋伙伴（n = 80）在哈萨克斯坦Shu，哈萨克斯坦。与分配给健康促进比较条件（WP）（n = 40）的参与者相比，CHSR参与者（n = 40）报告说，从基线到3个月的随访，不安全的注射行为和避孕套的使用量明显较少。在拟议的研究中，参与者将是400名IDU及其异性恋，亲密的伴侣，他们符合资格标准（例如，至少有一个伴侣报告了过去30天内不安全的注射和不受保护的性交）。参与者将从SHU Policlinic针头交换计划和SHU的街头外展招募。 SHU位于一条主要的毒品贩运路线沿线，估计有35,000人口中有4,500名IDU。在拟议的研究中，将有400对夫妇随机分为两种干预措施之一：基于5条夫妇的HIV/STI风险降低干预措施或基于5-会议夫妇的基于5-会议的健康促进干预措施，这将是一种比较条件。干预后的基线，3，6个月和12个月，将通过重复措施对参与者进行评估。主要的行为结果是自我报道的注射行为的比例，在过去的30天中，针头或注射器分享了，并且在过去30天中，由避孕套保护的性交的比例。主要的生物学结果是新的HIV病例和新的HCV病例的发生率，以及在干预后12个月内的衣原体，淋病和梅毒的发生率。 拟议的研究将提高对IDU及其异性伴侣群体中HIV/HCV/STI风险降低的理解，从而有助于阻止哈萨克斯坦和中亚的HIV，HCV和STIS的越来越多。 公共卫生相关性拟议的研究涉及在哈萨克斯坦的活跃IDU及其性伴侣的高风险人群中，对艾滋病毒，HCV和其他性传播感染的重大公共卫生威胁 - 这个地区正在经历世界上最快的HIV艾滋病毒艾滋病毒率。为IDU及其性伴侣开发和实施有效的艾滋病毒预防干预措施，以阻止HIV，HCV和其他性传播疾病在SHU和其他中亚城镇沿毒品贩运路线的传播。

项目成果

HIV among injection drug users and their intimate partners in Almaty, Kazakhstan.

• DOI: 10.1007/s10461-013-0484-2
• 发表时间: 2013-09
• 期刊: AIDS and behavior
• 影响因子: 4.4
• 作者: El-Bassel N;Gilbert L;Terlikbayeva A;Wu E;Beyrer C;Shaw S;Hunt T;Ma X;Chang M;Ismayilova L;Tukeyev M;Zhussupov B;Rozental Y
• 通讯作者: Rozental Y

Depression Among People Who Inject Drugs and Their Intimate Partners in Kazakhstan.

哈萨克斯坦注射毒品者及其亲密伴侣的抑郁症。

• DOI: 10.1007/s10597-015-9883-3
• 发表时间: 2016
• 期刊: Community mental health journal
• 影响因子: 2.7
• 作者: Shaw,StaceyA;El-Bassel,Nabila;Gilbert,Louisa;Terlikbayeva,Assel;Hunt,Tim;Primbetova,Sholpan;Rozental,Yelena;Chang,Mingway
• 通讯作者: Chang,Mingway

Intimate relationships and patterns of drug and sexual risk behaviors among people who inject drugs in Kazakhstan: A latent class analysis.

哈萨克斯坦注射吸毒者的亲密关系以及毒品和性危险行为模式：潜在阶级分析。

• DOI: 10.1016/j.drugalcdep.2018.07.046
• 发表时间: 2018
• 期刊: Drug and alcohol dependence
• 影响因子: 4.2
• 作者: Marotta,PhillipL;Terlikbayeva,Assel;Gilbert,Louisa;Hunt,Tim;Mandavia,Amar;Wu,Elwin;El-Bassel,Nabila
• 通讯作者: El-Bassel,Nabila

State of the science of adherence in pre-exposure prophylaxis and microbicide trials.

• DOI: 10.1097/qai.0b013e31826f9962
• 发表时间: 2012-12-01
• 期刊: Journal of acquired immune deficiency syndromes (1999)
• 作者: Muchomba FM;Gearing RE;Simoni JM;El-Bassel N
• 通讯作者: El-Bassel N

HIV testing and access to HIV medical care among people who inject drugs and their intimate partners in Kazakhstan.

哈萨克斯坦注射吸毒者及其亲密伴侣的艾滋病毒检测和艾滋病毒医疗服务。

• DOI: 10.3109/14659891.2016.1143046
• 发表时间: 2017
• 期刊: Journal of substance use
• 影响因子: 0.8
• 作者: Shaw,StaceyA;Terlikbayeva,Assel;Famouri,Leila;Hunt,Tim;Gilbert,Louisa;Rozental,Yelena;Primbetova,Shopan;Chang,Mingway;Ma,Xin;El-Bassel,Nabila
• 通讯作者: El-Bassel,Nabila