Reducing HCV/HIV Risk Behaviors among Injection Drug Users in China

减少中国注射吸毒者的 HCV/HIV 危险行为

• 批准号: 8145339
• 负责人: Jiang Du
• 金额: $ 10.4万
• 依托单位: SHANGHAI MENTAL HEALTH CENTER
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-07-01 至 2015-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8145339
• 关键词: AIDS prevention; Address; Adverse effects; Affect; Asians; Attitude; Caring; Case Management; Characteristics; China; Chinese People; Chronic Hepatitis; Cirrhosis; Client; Clinic; Clinical; Complication; Counseling; Country; Data; Doctor of Medicine; Drug abuse; Drug usage; Drug user; Education; Educational Materials; Ensure; Epidemic; Evidence based intervention; Frequencies; Future; Goals; Government; HIV; HIV Infections; HIV Seropositivity; Health; Hepatitis C; Hepatitis C Transmission; Hepatitis C Vaccine; Hepatitis C virus; Hepatotoxicity; Incidence; Individual; Infection; Injecting drug user; Injection of therapeutic agent; Interferons; Intervention; Knowledge; Medical; Medicine; Modeling; Outcome; Patients; Perception; Persons; Pharmaceutical Preparations; Population; Prevalence; Prevention strategy; Preventive Intervention; Primary carcinoma of the liver cells; Provider; Province; Public Health; Recommendation; Research; Risk; Risk Behaviors; Route; Services; Testing; United States; Virus; Work; World Health Organization; adverse outcome; base; burden of illness; effective intervention; high risk; intervention program; methadone maintenance; opioid abuse; peer; prevent; programs; service intervention; statistics; success; treatment site

DESCRIPTION (provided by applicant): The incidence of hepatitis C virus (HCV) infection increases year by year in China according to Ministry of Health statistics of China. The World Health Organization (WHO) has estimated that at least 2.5-4.9% of China's population is HCV positive. Injection drug use is a main route of HCV transmission. The HCV infection among Chinese injection drug users (IDUs) is high, particularly among those in methadone maintenance treatment (MMT) (e.g., more than 80% in many provinces). Due to share many characteristics, co-infection with HIV and HCV is common. Considering the enormous number of drug users in China, rapid transmission of HCV/HIV among and beyond this population, long duration of clinical progression of the virus, and limited access of infected addicts to routine treatment, HCV/HIV is one of China's major health burdens. Despite the high rate of HCV/HIV infection among IDUs in China, limited HCV/HIV intervention/prevention strategies are available. MMT can provide an efficient platform to address HCV/HIV-related issues among patients, but there is generally a lack of knowledge in HCV/HIV-related issues among both patients and service providers in China. Many materials regarding HCVHIV have been developed in the United States and other countries, but research efforts are needed to integrate and adapt them in Chinese settings and to empirically test the educational program to ensure that it is effective to reduce HCV/HIV risk behaviors and increase HCV/HIV-related services among Chinese addicts. We propose to investigate HCV/HIV knowledge, attitudes, and perceptions among injection drug users and service providers in MMT clinics, and further explore the barriers that impact HCV/HIV-related services and medical care. Based on these findings and HCV/HIV-related materials that have been developed in the United States and other countries, we plan to develop and deliver HCV/HIV education programs to IDUs and MMT staff in MMT clinics, with the long-term goal of developing interventions and services that will be effective preventing and reducing HCV/HIV infection and related risk behaviors among IDUs in China. The proposed project, to be conducted in Shanghai, has the following primary aims: 1) To assess HCV/HIV knowledge, attitudes, perceptions, risk behaviors, and HCV/HIV infection among IDUs in methadone maintenance treatment (MMT), 2) To assess HCV/HIV knowledge, attitudes, and perceptions among MMT staff, and 3) To adapt, develop, and deliver HCV/HIV education programs for clients and MMT staff. Secondary aims are: 4) To explore the barriers that impact IDUs receiving HCV/HIV-related intervention and medical service; 5) To explore ways to facilitate service providers to provide HCV/HIV-related services to IDUs in MMT. The program to be developed and the data collected in the proposed study will establish a basis for developing recommendations of a comprehensive HCV/HIV intervention program to be tested in a future, formal experimental trial. If proven effective, the intervention program can be widely used in China and other countries to reduce HCV/HIV risk behaviors and adverse consequences. PUBLIC HEALTH RELEVANCE: The study is unique and important because HCV/HIV infection and co-infection are major problems, especially among injection drug users, but there is little known about HCV or HCV/HIV co-infection, including HCV/HIV knowledge level among injection drug users (IDUs) and current barriers and intervention strategies for IDUs in China. If HCV/HIV infection and related consequences cannot be treated efficiently, it will result in a much greater disease burden. The proposed study will investigate the knowledge level, attitudes, and perceptions among MMT staff and IDUs who attending MMT clinics, which is the most reachable population for HCV/HIV intervention in China. This study will also explore the barriers that prevent IDUs from getting HCV/HIV intervention/prevention and medical care services. This study will help to understand and address this important problem in China and other Asian countries.

描述（由申请人提供）：根据中国卫生部统计数据，在中国，丙型肝炎病毒（HCV）感染的发生率每年增加。世界卫生组织（WHO）估计，中国人口的至少2.5-4.9％为HCV阳性。注射药物使用是HCV传播的主要途径。中国注射吸毒者（IDU）中的HCV感染很高，尤其是在美沙酮维护治疗（MMT）（例如，在许多省份中超过80％）中的HCV感染。由于具有许多特征，因此与HIV和HCV共同感染很常见。考虑到中国有大量吸毒者，HCV/HIV在该人群之间的迅速传播，病毒的临床临床进展持续时间以及受感染成瘾者对常规治疗有限的机会，HCV/HIV是中国的主要健康负担之一。 尽管中国IDU之间的HCV/HIV感染率很高，但HCV/HIV干预/预防策略仍有限。 MMT可以提供一个有效的平台来解决患者中与HCV/HIV相关的问题，但是通常在中国患者和服务提供者中缺乏与HCV/HIV相关问题的知识。在美国和其他国家已经开发了许多有关HCVHIV的材料，但是需要进行研究工作，以将其整合并适应中国的环境，并在经验上测试教育计划，以确保在中国成瘾者中降低HCV/HIV风险行为并增加HCV/HIV相关的服务是有效的。我们建议在MMT诊所调查注射吸毒者和服务提供商中的HCV/HIV知识，态度和看法，并进一步探索影响HCV/HIV相关的服务和医疗服务的障碍。根据这些发现以及在美国和其他国家开发的HCV/HIV相关材料，我们计划在MMT诊所开发和提供HCV/HIV教育计划，并为IDUS和MMT诊所的员工提供长期目标，其长期目标是开发干预措施和服务，这些干预措施将有效预防和减少HCV/HIV/HIV感染和相关风险的行为。拟议的项目将在上海进行，具有以下主要目的：1）评估HCV/HIV知识，态度，感知，风险行为和HCV/HIV感染在白沙酮维持治疗（MMT）中的IDU之间的HCV/HIV感染，2），2），评估HCV/HIV/HIV知识，attip and attiT and tostip and toction和MMMM MMT和3）。针对客户和MMT员工的计划。次要目的是：4）探索影响接收HCV/HIV相关的干预和医疗服务的IDU的障碍； 5）探索方法来促进服务提供商向MMT中的IDU提供与HCV/HIV相关的服务。该计划将要制定，并在拟议的研究中收集的数据将建立一个基础，以开发将在未来的正式实验试验中测试的全面HCV/HIV干预计划的建议。如果证明有效，则可以在中国和其他国家广泛使用干预计划来减少HCV/HIV风险行为和不利后果。 公共卫生相关性：这项研究是独特而重要的，因为HCV/HIV感染和共同感染是主要问题，尤其是在注射吸毒者中，但对HCV或HCV/HIV共同感染鲜为人知，包括注射药物使用者中的HCV/HIV知识水平（IDUS）以及中国IDU的当前障碍和干预策略。如果无法有效治疗HCV/HIV感染和相关后果，则会导致疾病负担更大。拟议的研究将调查参加MMT诊所的MMT员工和IDU的知识水平，态度和看法，这是中国HCV/HIV干预措施最受欢迎的人群。这项研究还将探索防止IDU获得HCV/HIV干预/预防和医疗服务的障碍。这项研究将有助于理解和解决中国和其他亚洲国家的这一重要问题。