Initiation of injection drug use and HIV risks among street-involved youth

街头青少年开始注射吸毒和艾滋病毒风险

• 批准号: 8056081
• 负责人: Evan Wood
• 金额: $ 39.95万
• 依托单位: UNIVERSITY OF BRITISH COLUMBIA
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-04-15 至 2015-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8056081
• 关键词: Address; Adult; Age-Years; American; Area; Biological; Canada; Characteristics; Chemicals; Cities; Cohort Studies; Communicable Diseases; Data; Drug usage; Drug user; Environment; Environmental Risk Factor; Epidemic; Epidemiologic Methods; Epidemiology; Evaluation; Event; Evidence based intervention; Exposure to; Face; Future; Growth; HIV; HIV Infections; Health; Home environment; Housing; Illicit Drugs; Incidence; Individual; Infection; Injecting drug user; Injection of therapeutic agent; Intervention; Laboratories; Lead; Location; Maps; Methamphetamine; Methods; North America; Pattern; Peer Review; Pharmaceutical Preparations; Police; Policies; Population; Prevention; Preventive Intervention; Prodrugs; Publications; Questionnaires; Research; Risk; Risk Behaviors; Risk Factors; Sexually Transmitted Diseases; Source; Specimen; Street Youths; Techniques; United States; United States Public Health Service; Update; Work; Youth; aged; base; cohort; drug market; experience; high risk; innovation; member; men who have sex with men; novel; prevent; prospective; public health relevance; response; sex risk; social; trend

DESCRIPTION (provided by applicant): The purpose of this application is to evaluate the impacts of methamphetamine and a range of social, structural, and environmental factors on initiation into injection drug use, HIV risk behavior and sexually transmitted infection (STI) incidence among street-involved youth. Globally, it is estimated that there are as many as 100 million street-involved youth, and illicit drug use and related harms (e.g., infectious diseases) have consistently been shown to be elevated among this population. Thus, there is an urgent need for data to inform interventions aimed at addressing the health needs of this growing population. In particular, given the challenges preventing harms (e.g., HIV infection) that occur after youth begin drug injecting, data to inform strategies to prevent initiation into injection drug use are urgently needed. We propose to undertake this work in a western Canadian setting where the explosive growth in methamphetamine use has mirrored a steady growth in the use of this drug in the western United States. While these trends are a source of growing concern due to methamphetamine's relationship with rising HIV risk behavior among men who have sex with men and adult IDU, the epidemiology of methamphetamine use and its relationship to sexual and injection-related HIV risk behavior remain poorly defined. Vancouver, Canada, is ideally suited for the proposed study for several reasons. First, the city is presently experiencing an explosive rise in the use of methamphetamine among street-involved youth, and past experience demonstrates that drug market trends in Vancouver are often reflected in other western US cities, and the city is known to be a North American port of entry for several illicit drugs and precursor chemicals which subsequently flow into the US. Thus, this research will provide valuable data to inform US drug trends and interventions. Vancouver is also home to a large and visible street-youth problem and street-based illicit drug market, and the risk environment in which street youth become involved in illicit drugs has not been well described. Herein, we propose to create an open prospective cohort study of 500 street-involved youth aged 14 to 25 who will complete a standardized questionnaire and provide biological specimens on a semi-annual basis. Given the local drug use and risk environment characteristics, as well as the local laboratory capacity, our proposed research plan offers an ideal opportunity to examine the impact of evolving drug use patterns and a range of social, structural, and environmental factors on the rates of initiation into injection drug use, sexual risk behavior and STI incidence. This research also presents a unique opportunity to create a cohort of street-involved non-injecting youth which will enable comparisons with an ongoing study of adult injection drug users. Together, this research will address several questions central to the urgent challenges facing street-involved youth in North America as a result of the growth of methamphetamine use and illicit drug injecting, and will allow for the evaluation of a range of individual and contextual determinants of HIV risk behavior and STI incidence among this population. PUBLIC HEALTH RELEVANCE: While increasing methamphetamine use among youth is a source of growing concern due to methampheta- mine's relationship with rising HIV risk behavior among men who have sex with men and adult injection drug users, the epidemiology of methamphetamine use and its relationship to initiation of injection drug use, HIV risk behaviour, and sexually transmitted infection incidence among high-risk youth remains poorly defined. This research will fill this void by evaluating patterns of methamphetamine use and other illicit drug patterns, as well as the risk environment in which drugs are used, to describe their effects on initiation of injection drug use, sexual risk behavior, and incidence of sexually transmitted infections among a cohort of 500 street-involved youth.

描述（由申请人提供）：本申请的目的是评估甲基苯丙胺以及一系列社会，结构和环境因素对入射药物使用，HIV风险行为和性传播感染（STI）的发生率（STI）发生率的一系列社会，结构和环境因素。在全球范围内，据估计，在该人群中，始终显示出多达1亿个涉及街头的青年，而非法的毒品使用及相关危害（例如传染病）始终被证明升高。因此，迫切需要数据为旨在满足这一不断增长的人群的健康需求的干预措施提供信息。特别是，鉴于预防青年开始注射药物后发生的危害的挑战（例如，艾滋病毒感染），迫切需要数据为防止注射药物使用的策略提供信息。我们建议在加拿大西部的环境中进行这项工作，在加拿大西部，使用甲基苯丙胺的爆炸性增长反映了美国西部这种药物使用的稳定增长。尽管这些趋势是由于甲基苯丙胺与与男性和成人IDU发生性关系的艾滋病毒风险行为的关系而引起的人们日益关注的来源，但甲基苯丙胺使用的流行病学及其与性和注射相关的HIV风险行为的关系仍然很差。加拿大温哥华非常适合拟议的研究，原因有几个。首先，该城市目前正在经历甲基苯丙胺在街头涉及的青年中的使用爆炸性上升，过去的经验表明，温哥华的药物市场趋势经常在美国西部的其他城市中反映出来，并且该城市是北美的几种非法药物和先前化学物质的北美港口，随后流入美国。因此，这项研究将提供有价值的数据，以告知美国药物趋势和干预措施。温哥华也是一个大型且可见的街头大街问题和街头非法药物市场的所在地，街头青年参与非法毒品的风险环境尚未得到很好的描述。在本文中，我们建议对14至25岁的500名街头参与的青年进行开放的前瞻性队列研究，该研究将完成标准化的问卷，并半年度提供生物标本。鉴于当地的药物使用和风险环境特征以及当地的实验室能力，我们提出的研究计划为研究不断发展的药物使用模式以及一系列社会，结构和环境因素对注射药物使用，性风险行为和性病发病率的启动率的影响提供了理想的机会。这项研究还提供了一个独特的机会，可以创建一系列街头参与的非注射年轻人，这将使与正在进行的成人注射吸毒者进行的研究可以进行比较。这项研究将解决北美街头涉及街道涉及的青年面临的紧急挑战的核心，这是由于甲基苯丙胺的使用和非法药物注射的增长，并可以评估该人群中艾滋病毒风险行为的一系列个人和上下文决定因素。 公共卫生相关性：在青年中增加甲基苯丙胺的使用虽然是由于甲基苯甲矿与与男性和成人注射吸毒者发生性关系的男性之间的增长，甲基苯丙胺使用及其与入射药物使用，HIV危险行为的启动，甲基苯丙胺的关系及其关系不足的男性，甲基苯丙胺的使用及其与甲基苯丙胺的流行相关的差异仍然不足。这项研究将通过评估甲基苯丙胺使用和其他非法药物模式的模式以及使用药物的风险环境来描述其对入射药物使用的启动，性风险行为以及500名街头影响侵害的年轻人的性传播感染的发生率。