Using standardized methods for research on HIV and injecting drug use in developing/transitional countries: case study from the WHO Drug Injection Study Phase II.
Using standardized methods for research on HIV and injecting drug use in developing/transitional countries: case study from the WHO Drug Injection Study Phase II.
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DOI：
10.1186/1471-2458-6-54
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发表时间：
2006-03-02
影响因子：
4.5
通讯作者：
WHO Phase II Drug Injection Collaborative Study Group
中科院分区：
文献类型：
--
作者：
Des Jarlais DC;Perlis TE;Stimson GV;Poznyak V;WHO Phase II Drug Injection Collaborative Study Group
成功的跨国研究需要在不同地点标准化并适应当地条件的方法。我们报告了WHO药物注射研究第二阶段调查部分的方法学的发展和实施情况，该研究是一项关于注射吸毒者（IDUs）风险行为和HIV血清阳性率的多地点研究。调查协调中心与世卫组织项目官员和参与的现场调查员合作制定了标准化操作指南。在整个研究期间，协调中心监测地方一级的调查执行情况。在12个不同的城市进行了调查。此前在10个城市进行的快速评估提供了对当地情况的深入了解，并指导了调查的实施。在可能的情况下，受试者从药物滥用治疗中心和通过街道外展招募。虽然重点是注射吸毒者，但在大量非注射使用注射药物的城市也招募了非注射者。进行了结构化面谈和艾滋病毒咨询/检测。招募了5 000多名受试者。受试者从10个城市的药物治疗和街头外展招募。在9个城市招募了非注射者。事先的快速评估确定了合适的招聘领域，减少了吸毒者对调查人员的不信任，并揭示了特定地点的风险行为。集中的调查协调促进了在核心结构内修改当地调查表、标准化数据收集程序、统一数据库结构和跨地点分析。具体地点的主要问题包括：调查表翻译困难;寻找负担得起的艾滋病毒检测设施;由于治疗基础设施有限/有选择性，从戒毒治疗中招募人员;接触社区中特定的吸毒者亚群体，特别是女性或高收入群体;吸毒者和调查人员的安全问题，当地毒贩的敌意;以及当地服务提供者的干扰。事实证明，快速评估在为调查铺平道路方面非常宝贵。数据收集的中央协调至关重要。虽然完全标准化的方法可能是一个研究的理想，当地的情况可能需要大量的适应方法，以实现有意义的地方代表性。考虑到对当地情况的理解，可能会增加而不是减少数据的普遍性。
Successful cross-national research requires methods that are both standardized across sites and adaptable to local conditions. We report on the development and implementation of the methodology underlying the survey component of the WHO Drug Injection Study Phase II – a multi-site study of risk behavior and HIV seroprevalence among Injecting Drug Users (IDUs). Standardized operational guidelines were developed by the Survey Coordinating Center in collaboration with the WHO Project Officer and participating site Investigators. Throughout the duration of the study, survey implementation at the local level was monitored by the Coordinating Center. Surveys were conducted in 12 different cities. Prior rapid assessment conducted in 10 cities provided insight into local context and guided survey implementation. Where possible, subjects were recruited both from drug abuse treatment centers and via street outreach. While emphasis was on IDUs, non-injectors were also recruited in cities with substantial non-injecting use of injectable drugs. A structured interview and HIV counseling/testing were administered. Over 5,000 subjects were recruited. Subjects were recruited from both drug treatment and street outreach in 10 cities. Non-injectors were recruited in nine cities. Prior rapid assessment identified suitable recruitment areas, reduced drug users' distrust of survey staff, and revealed site-specific risk behaviors. Centralized survey coordination facilitated local questionnaire modification within a core structure, standardized data collection protocols, uniform database structure, and cross-site analyses. Major site-specific problems included: questionnaire translation difficulties; locating affordable HIV-testing facilities; recruitment from drug treatment due to limited/selective treatment infrastructure; access to specific sub-groups of drug users in the community, particularly females or higher income groups; security problems for users and interviewers, hostility from local drug dealers; and interference by local service providers. Rapid assessment proved invaluable in paving the way for the survey. Central coordination of data collection is crucial. While fully standardized methods may be a research ideal, local circumstances may require substantial adaptation of the methods to achieve meaningful local representation. Allowance for understanding of local context may increase rather than decrease the generalizability of the data.
影响因子：
120.7
作者：
DESJARLAIS, DC;HAGAN, H;MYERS, T
通讯作者：
MYERS, T
影响因子：
3.8
作者：
Aceijas, C;Stimson, GV;Rhodes, T
通讯作者：
Rhodes, T
影响因子：
12.7
作者：
DesJarlais, DC;Friedmann, P;Friedman, SR
通讯作者：
Friedman, SR