Efficacy of Drug-HIV counseling among IDU at Methadone clinics in Jakarta

雅加达美沙酮诊所注射吸毒者药物艾滋病毒咨询的效果

基本信息

批准号：
7835556
负责人：
DAVID S METZGER
金额：
$ 31.44万
依托单位：
UNIVERSITY OF PENNSYLVANIA
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-05-15 至 2013-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7835556
关键词：
AIDS/HIV problem Acquired Immunodeficiency Syndrome Asia Asians Behavior Behavior Therapy Behavioral China Clinic Cognitive Collaborations Cost-Benefit Analysis Costs and Benefits Counseling Country Data Development Doctor of Philosophy Drug Addiction Drug Costs Drug abuse Drug usage Drug user Economics Enrollment Environment Epidemic Equipment Fellowship HIV HIV Infections Heroin Heroin Users Hospitals Individual Indonesia Informed Consent Injecting drug user Injection of therapeutic agent Intervention Laboratories Malaysia Manuals Measures Methadone National Institute of Drug Abuse Opiate Addiction Opiates Participant Patients Pennsylvania Pharmaceutical Preparations Population Prevalence Procedures Randomized Recruitment Activity Relative (related person)Research Research Personnel Risk Risk Assessment Risk Behaviors Risk Reduction Structure System Testing Time Universities Urinalysis Work arm cost cost effective design drug efficacy evidence base experience follow-up group intervention methadone clinic/center methadone maintenance programs prospective public health relevance randomized trial response scale up sex risk standard care tool treatment as usual

项目摘要

DESCRIPTION (provided by applicant): According to UNAIDS, Indonesia is experiencing one of the most rapidly expanding HIV/AIDS epidemics in Asia. The epidemic in Indonesia has been fueled by injection drug use among heroin users and the national response includes the scale-up of methadone maintenance treatment. Drug counseling is considered to be an integral part of methadone treatment, but few studies have been designed to assess its benefits and costs. In settings such as Jakarta, data regarding the costs and benefits of drug counseling have critical public heath relevance. We propose to conduct a prospective randomized trial to evaluate the efficacy of integrated drug and HIV counseling among injecting drug users. This study will be conducted at six methadone clinics in Jakarta, Indonesia where the HIV prevalence among injecting drug users ranges between 50- 86%, with collaborators from the Drug Dependence Hospital in Jakarta, the University of Pennsylvania and Yale University. The specific aims of this four year study are to evaluate the impact of Behavioral Drug and Risk Counseling (BDRC)-a low intensity, cognitive behavioral approach that integrates drug counseling and risk reduction intervention. Those assigned to the BDRC arm will be compared to those who receive treatment as usual which includes an initial risk reduction intervention and counseling as needed. We hypothesize that the structured, low intensity BDRC approach will be more cost effective and result in higher rates of retention in treatment, lower rates of drug use and lower rates of HIV risk. To test these hypotheses, the research team in Jakarta will recruit 300 injecting drug users as they enter treatment at the Drug Dependence Hospital and its five satellite programs. Following informed consent procedures, research staff will randomize participants to either the BDRC intervention or to treatment as usual. All subjects will be fuly assessed at baseline and months 3, 6, 9, and 12. The proposed work will be build on collaborations that have been established with the Indonesian Investigator Adhi Nurhidayat,MD during his NIDA INVEST Fellowship at University of Pennsylvania when he spent time with David Metzger, PhD and George Woody, MD. It will also extend findings from a WHO study on substitution therapy of opiates and HIV/AIDS that was completed by Riza Sarasvita, MS,MHS (former NIDA Humphrey Fellow at Johns Hopkins University) and her colleagues at The Drug Dependence Hospital Jakarta-Indonesia. PUBLIC HEALTH RELEVANCE: The AIDS epidemic in Indonesia has been fueled by injection drug use among heroin users and the National response includes the scale-up of methadone maintenance treatment. Drug counseling is considered to be an integral part of methadone treatment, but few studies have been designed to assess its benefits and costs. In settings such as Jakarta, data regarding the costs and benefits of integrated drug and risk counseling have critical public heath relevance.