HIGH VOLUME NEEDLE EXCHANGE TO AVERT NEW INFECTIONS

大量换针以避免新的感染

• 批准号: 2122827
• 负责人: DAVID R GIBSON
• 金额: $ 30.05万
• 依托单位: HEALTHRIGHT 360
• 依托单位国家: 美国
• 财政年份: 1994
• 资助国家: 美国
• 起止时间: 1994-09-30 至 1998-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2122827
• 关键词: AIDS; AIDS education /prevention; HIV infections; communicable disease control; counseling; disease /disorder proneness /risk; health care referral /consultation; health care service evaluation; health economics; high risk behavior /lifestyle; human immunodeficiency virus 1; human subject; hypodermic needle; interview; intravenous drug abuse; longitudinal human study; mathematical model; medical outreach /case finding; needle sharing; public health; serotyping; statistics /biometry

This project will evaluate the effectiveness of a high-penetration, high- volume needle exchange program 1) in reaching out-of-treatment drug injectors, 2) in reducing HIV risk behavior, 3) in averting new HIV infections, and 4) in referring drug injectors to drug treatment and HIV testing and counseling. The proposed evaluation of the high volume exchange will take advantage of a natural experiment in that we will gather baseline data both before and after implementation of the high volume exchange. The evaluation attempts to redress the shortcomings of previous evaluations of needle exchange, specifically, the difficulty of correcting for self-selection to the exchange in estimating the impact of needle exchange on HIV risk behavior. In addition to assessing penetration of the exchange of a population of out-of-treatment drug injectors, we will investigate the extent to which attendance at the exchange mediates risk reduction and decreased seroincidence. We will conduct both serial cross-sectional surveys, and a prospective cohort study that will enable us to compare the behavior of attenders and nonattenders, holding constant behavior prior to initiation of the exchange. The data gathered in interviews with community drug injectors will also be used to estimate mathematical models of the number of HIV infections averted by the exchange, and the cost-effectiveness of the exchange in terms of its cost per averted infection. Finally, we will evaluate the success of the needle exchange program in referring exchange clients to drug treatment and HIV testing and counseling. The approach to needle exchange is based on the principles of penetration (reach) and volume. Volume will be attained by daily exchanges, which will greatly increase opportunities for exchanging. Penetration will be achieved by making the exchange convenient to attend and by having outreach workers make referrals to the exchange. To maximize convenience, the route of a mobile van housing the exchange will be informed by detailed information the outreach team has about the location of pockets of injection drug use in the community. This project is a collaboration of the Santa Clara County AIDS Program, the HIV Prevention Center of Haight Ashbury Free Clinics, and the Center for AIDS Prevention Studies and Institute of Health Policy Studies at the University of California, San Francisco.

该项目将评估一个高渗透率，高- 大量针头交换计划1）获取治疗结束的药物 注射者，2）减少艾滋病毒风险行为，3）避免新的艾滋病毒 感染，以及4）将药物注射者转介给药物治疗和艾滋病毒 测试和咨询。拟议的高容量评价 交易所将利用一个自然的实验，我们将 在执行高级别方案前后收集基线数据， 体积交换评价试图纠正以下方面的缺点： 以前对针头交换的评价，特别是， 在估计交易所的影响时， 针具交换对艾滋病风险行为的影响。除了评估渗透率之外， 一群失去治疗的注射毒品者的交换， 我将调查在多大程度上出席交流调解 风险降低和血清发生率降低。我们将进行两个系列 横断面调查和前瞻性队列研究， 我们比较出席者和非出席者的行为，保持不变 交换开始前的行为。中收集的数据 与社区毒品注射者的访谈也将用于估计 艾滋病毒感染的数量的数学模型， 交换，以及交换成本的成本效益 避免感染。最后，我们将评估针的成功 介绍交换客户接受药物治疗和艾滋病毒治疗的交换计划 测试和咨询。针具交换的方法是基于 渗透（到达）和体积的原则。将通过以下方式获得体积： 日常交流，这将大大增加交流的机会。 通过使交流方便参加来实现渗透 并让外展工作人员向交易所推荐。最大化 为了方便起见，容纳交换机的移动的货车的路线将 根据外展团队掌握的有关该地点的详细信息 注射毒品的小块区域。这个项目是一个 圣克拉拉县艾滋病计划，艾滋病毒预防 海特中心阿什伯里免费诊所和艾滋病预防中心 研究和卫生政策研究所在大学 加州，旧金山弗朗西斯科。