Exploratory Research on Late Initiation of Drug Injection

延迟启动药物注射的探索性研究

基本信息

批准号：
8142142
负责人：
Ricky N Bluthenthal
金额：
$ 56.07万
依托单位：
UNIVERSITY OF SOUTHERN CALIFORNIA
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-09-30 至 2013-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8142142
关键词：
AIDS prevention AIDS/HIV problem Abscess Adherence Adolescent Adult Affect Age Age-Years California Characteristics Cities Cocaine Communicable Diseases Communities Counseling Data Development Drug Prescriptions Drug usage Drug user Elderly Environment Event Family Foundations Friends Gender Goals HIV HIV Seropositivity Health Health Services Accessibility Hepatitis B Hepatitis B Virus Hepatitis C virus Heroin Illicit Drugs Imprisonment Incidence Individual Infection Influentials Injecting drug user Injection of therapeutic agent Intervention Knowledge Lead Life Life Cycle Stages Los Angeles Methamphetamine Methods Motivation Occupations Older Population Outcome Overdose Paper Participant Pattern Perception Pharmaceutical Preparations Physical environment Population Poverty Prevalence Prevention Public Health Publishing RQ2 Race Recording of previous events Recruitment Activity Research Respondent Risk Risk Factors Route Sampling San Francisco Sex Behavior Sexual Partners Social Environment Social Health Services Soft Tissue Infections Testing Thick Time Trauma U-Series Cooperative Agreements Wound botulism base community setting critical period demographics design experience intergenerational preference prevent psychosocial racial and ethnic social substance abuse prevention theories young adult

项目摘要

We propose a 3-year, qualitative exploratory study of 'late initiates' {individuals who began injecting drugs at age 30 or later) and 'typical initiates' {those who initiate injection prior to 30) in order to better understand the circumstances, motivations, social environments and HIV, HCV, and HBV risk associated with injection initiation later in life. There are an estimated 3 million injection drug users {IDUs) in the US. Many of the detrimental health consequences of illicit drug use, including HIV, HCV, and HBV, as well as soft-tissue infections, and overdose, are related to the act of injection. Between 15% and 19% of IDUs initiated drug injection after turning 30 years old. Little is known about how late initiates differ from "typical" initiates {initiating before age 30). We propose to examine how aspects of drugs, individual characteristics, and social environments affect transition to drug injection among adults 30 years of age and older. While there are more than a dozen published papers on initiation of drug injection, most studies have focused on young injectors and the specific circumstances of the first injection episode, and do not systematically consider how route of administration might intersect with drug use trajectories, life events, and accumulated health, social, and psychosocial vulnerabilities {e.g., HIV/AIDS and other conditions, multiple incarcerations, traumatic events, intergenerational poverty). This gap in knowledge is significant since late initiates are likely to need different approaches to HIV and substance abuse prevention and treatment than adolescents and young adults. The primary goals of the proposed qualitative study are to understand and compare late initiates to typical initiates and to provide a "thick description" of the intersections amongst drug use, life events, HIV risk and infection, social and physical environments, and initiation of drug injection. Our proposal uses Zinberg's classic framework of Drug, Set, and Setting {DSS) and lifcourse theory {LCT) to guide the aims, research questions, and analyses of this exploratory study. We have established the following aims. Aim 1: To explore attributes of drugs and drug injection (DRUG) among late initiates using LCT constructs. Aim 2: To describe individual characteristics, including HIV status and perceptions of HIV/AIDS risks, drug use histories, and key life events (SET) of late initiates as compared to typical initiates using LCT constructs. Aim 3: To explore the interpersonal, social, and structural environments (including the prevalence of HIV/AIDS and other infectious diseases in the community- SETTING) of late initiates compared to typical initiates using LCT constructs. To accomplish these aims, we propose to conduct a qualitative, exploratory study comparing 80 late initiates and 80 typical initiates. Participants will be HIV negative and HIV positive, active IDUs recruited from community settings using targeted sampling methods. We will use the grounded theory method and life event approaches to explore in-depth the concepts related to DRUG, SET, and SETTING that influence late initiation to injection drug use. To capture a diversity of IDUs and settings, we will recruit IDUs in Los Angeles and San Francisco, two cities that have important differences in IOU demographics, drug use preferences, the incidence and prevalence of HIV/AIDS among IDUs, and other community and environmental influences. Exploring DSS among late initiates will help to identify influential factors for the prevention of injection drug use, injection-related risks for HIV/AIDS, and other health and social consequences.

我们提出了一项为期3年的定性探索性研究，对“晚期开始”（在30岁或更晚于30岁开始注射药物的人）和“典型启动”（30岁以前启动注射的人）（以便更好地了解情况，动机，社交环境和艾滋病毒，艾滋病毒，艾滋病毒，HCV和HBV风险与以后的注射率相关。美国估计有300万注射吸毒者（IDU）。非法药物使用的许多有害健康后果，包括HIV，HCV和HBV，以及软组织感染和过量服用与注射行为有关。 IDU的15％至19％在30岁后开始注射药物。关于启动与“典型”启动的不同之后{启动30岁之前的启动）知之甚少。我们建议研究药物，个人特征和社会环境的各个方面如何影响30岁及以上成年人的药物注射过渡。 While there are more than a dozen published papers on initiation of drug injection, most studies have focused on young injectors and the specific circumstances of the first injection episode, and do not systematically consider how route of administration might intersect with drug use trajectories, life events, and accumulated health, social, and psychosocial vulnerabilities {e.g., HIV/AIDS and other conditions, multiple incarcerations, traumatic events, intergenerational poverty).知识的差距很大，因为迟到的发起者可能需要与青少年和年轻人相比，需要不同的艾滋病毒和滥用药物预防和治疗方法。拟议的定性研究的主要目标是了解并比较典型的发起，并对药物使用，生命事件，艾滋病毒风险和感染，社会和身体环境以及药物注射的启动之间的相互作用进行“厚实的描述”。我们的建议使用Zinberg的典型药物，设定和设置（DSS）和Lifcourse理论（LCT）的经典框架来指导这项探索性研究的目的，研究问题和分析。我们已经建立了以下目标。目的1：使用LCT构建体探索药物和药物注射（药物）的属性（药物）。目的2：与使用LCT构造相比，与近期初期的艾滋病毒/艾滋病风险，药物使用历史和关键的生活事件（集合）相比，包括艾滋病毒/艾滋病风险，药物使用历史和关键的生活事件（集合）的个人特征。目标3：与使用LCT结构的典型启动相比，探索人际，社会和结构环境（包括社区环境中的艾滋病毒/艾滋病患病率以及社区环境中的其他传染病）。为了实现这些目标，我们建议进行一项定性的探索性研究，以比较80个较晚启动和80个典型启动。参与者将使用有针对性的抽样方法从社区环境中招募艾滋病毒和艾滋病毒阳性，主动IDU。我们将使用扎根的理论方法和生活事件方法来深入探讨与药物，设定和设置有关注射药物使用的较晚起始的概念。为了捕捉多样化的IDU和环境，我们将在洛杉矶和旧金山招募IDU，这是两个在IOU人口统计学上具有重要差异的城市，毒品使用偏好，IDUS中艾滋病毒/艾滋病的发生率和流行率以及其他社区和其他社区和环境影响。在晚期启动中探索DSS将有助于确定预防注射药物使用，艾滋病毒/艾滋病的注射风险以及其他健康和社会后果的影响因素。