Environmental Factors in HIV Transmission among Suburban IDUs

郊区注射吸毒者中艾滋病毒传播的环境因素

• 批准号: 7822873
• 负责人: ROBERT HEIMER
• 金额: $ 65.1万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-07-01 至 2012-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7822873
• 关键词: AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Affect; Behavior; Behavioral; Biological; Categories; Cities; Collection; Communities; Community Services; Connecticut; County; Criminal Justice; Data; Data Analyses; Disease; Drug usage; Economics; Environment; Environmental Risk Factor; Epidemic; Exposure to; Goals; HIV; HIV Infections; Health Services Accessibility; Health Surveys; Hepatitis; Hepatitis B; Hepatitis B Virus; Hepatitis C; Hepatitis C virus; Home environment; Household; Housing; Imprisonment; Incidence; Income; Individual; Infection; Injecting drug user; Injection of therapeutic agent; Interdisciplinary Study; Interview; Investigation; Knowledge; Lead; Life; Link; Locales; Location; Longitudinal Studies; Low Prevalence; Medical; NIH Program Announcements; Occupations; Outcome; Participant; Pathway interactions; Pattern; Pharmaceutical Preparations; Policies; Population; Prevalence; Prevention program; Public Health; Recommendation; Recruitment Activity; Refractory; Research; Research Personnel; Resources; Respondent; Risk; Risk Behaviors; Sampling; Serologic tests; Serological; Services; Source; Stigmata; Structure; Suburban Population; Syringes; System; Testing; Time; Virus; Virus Diseases; base; cohort; design; disorder prevention; experience; life history; meetings; multidisciplinary; neglect; programs; response; social; social stigma; suburb; transmission process; treatment program; trend; urban area

DESCRIPTION (provided by applicant): Recent evidence suggests that injection drug use is increasing among suburban residents. Little research has focused on this trend, and the economic, social, and medical consequences have not been considered. To close this gap, we are proposing to identify, recruit, and study a valid sample of injectors who reside in Connecticut suburbs using respondent driven sampling (RDS). RDS was selected because of its strengths in identifying individuals from hidden populations and allowing statistical analysis of the sample. We are submitting this application in response to PAR-06-114, "Research on Pathways Linking Environments, Behaviors and HIV/AIDS". Not only will be focusing on an environment - the suburbs - that has been neglected, but we will further focus on suburban injectors who inject in two distinct environments. Preliminary studies revealed that there are those who inject predominantly in the suburban town in which they reside and those who inject in urban areas where they obtain their drugs. We are building our study around the hypothesis that the two environments result in differences in (1) injection drug use patterns; (2) knowledge of, risk for, and prevalence of HIV, hepatitis B, and hepatitis C infections; (3) sociodemographic stability; and (4) the use of and barriers to services that reduce the negative consequences of injection. Our study will recruit a sample of 600 active injection drug users who reside in the suburbs. The sample will be studied through structured interviews, serology, and in-depth life histories. The sample will be followed longitudinally to ascertain whether the pattern of suburban or urban injection is stable and to identify factors associated with changes in injection environments and in risk for syringe-borne viral infection. Our study is designed able to answer questions including (1) how representative the sample is of the underlying population, (2) whether two groups of suburban injectors who differ based on where they inject differ in terms of disease knowledge, risk, and prevalences, (3) how much of the prevalence of HIV, HBV, and HCV can be predicted by individual, group, and environmental level variables, (4) how suburban injectors are geographically clustered and whether this affects disease prevalence, (5) how interaction with the criminal justice system influences drug use and risky injection practices, (6) which factors are associated with arrest and incarceration and (7) how injectors use drug treatment and disease prevention programs and what they perceive as the barriers to larger use of these services. To meet the objectives of this study, we have assembled an experienced, multidisciplinary team that can collect and analyze the quantitative, qualitative, and serological data and disseminate research findings to the scientific community through scholarly and public health channels and to the service community through our Center for Interdisciplinary Research on AIDS.

描述（由申请人提供）：最近的证据表明，郊区居民的注射药物使用正在增加。很少有研究重点关注这一趋势，并且尚未考虑经济，社会和医疗后果。为了缩小这一差距，我们建议使用受访者驱动的采样（RDS）来识别，招募和研究居住在康涅狄格州郊区的有效注射器样本。之所以选择RDS，是因为它在识别隐藏人群中的个体并允许对样本的统计分析中具有优势。我们正在根据PAR-06-114提交此申请，“有关连接环境，行为和艾滋病毒/艾滋病的途径的研究”。不仅将专注于被忽视的郊区环境，而且我们还将进一步专注于在两个不同环境中注射的郊区注射器。初步研究表明，有些人主要在居住在郊区的城镇中注射，而在获得毒品的城市地区注入的人。我们正在围绕这两个环境导致（1）注射药物使用模式的差异的假设进行研究； （2）了解HIV，乙型肝炎和丙型肝炎感染的知识，风险和患病率； （3）社会人口统计学稳定； （4）使用和障碍的服务减少了注射的负面后果。我们的研究将招募居住在郊区的600名活跃注入药物使用者的样本。样本将通过结构化访谈，血清学和深入的生活史进行研究。该样本将纵向遵循，以确定郊区或城市注射的模式是否稳定，并确定与注射环境变化以及注射传播病毒感染风险相关的因素。我们的研究旨在回答问题，包括（1）样本的潜在人群的代表性，（2）基于疾病知识，风险，风险和流行的两组郊区注射器，它们是否在疾病知识，风险和普遍性方面有所不同，（3）艾滋病毒，HBV和HCV的普遍性在个人，组和环境层面的clipertiate（4）中（4）的流行情况（4）。这会影响疾病的患病率，（5）与刑事司法系统的相互作用如何影响毒品使用和风险注射习惯，（6）哪些因素与逮捕和监禁有关，以及（7）注射器如何使用药物治疗和预防疾病预防计划，以及他们认为这些服务的障碍。为了实现这项研究的目标，我们组建了一个经验丰富的多学科团队，可以通过学术和公共卫生渠道通过我们的艾滋病跨学科研究中心通过学术和公共卫生渠道来收集和分析定量，定性和血清学数据，并通过学术和公共卫生渠道向科学界以及服务社区传播研究结果。