SYRINGE ACCESS AND RISK FACTORS ON HIV TRANSMISSION

注射器的使用和艾滋病毒传播的风险因素

• 批准号: 2898223
• 负责人: MARTIN SCHECHTER
• 金额: $ 70.66万
• 依托单位: UNIVERSITY OF BRITISH COLUMBIA
• 依托单位国家: 美国
• 财政年份: 1998
• 资助国家: 美国
• 起止时间: 1998-06-05 至 2001-05-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2898223
• 关键词: HIV infections; behavioral /social science research tag; clinical research; communicable disease transmission; disease /disorder proneness /risk; health care service utilization; health services research tag; human population study; human subject; injection /infusion; interview; needle sharing; social group process; social problems; social psychology

DESCRIPTION: (Applicant's Abstract) Injection drug use accounts for nearly one third of AIDS cases in the United States through direct or indirect transmission to other injection drug users, their sexual partners and offspring. In 1996, in states with confidential HIV testing, injection drug use or sexual contact with an injection drug user accounted for 35% and 86% respectively, of new HIV-positive tests in men and women whose risk category was reported. In response, the National Academy of Sciences recommended in 1995, that HIV prevention strategies among injection drug users in the United States should include both needle exchange programs and deregulation of prescription and paraphernalia laws. Some U.S. states (e.g. Connecticut) have already implemented both these recommendations, and more are on the way to doing so. Despite widespread access to sterile syringes through established needle exchange programs and pharmacy access, there is recent evidence of high HIV infection rates among injection drug users in Montreal (5% per year) and Vancouver (19% per year). The purpose of this study is to follow well established cohorts for trends in seroincidence and to identify factors and processes which explain these elevated HIV infection rates among populations of injection drug users who have access to sterile injection equipment. The major hypothesis under study is that a complex relationship of factors, social dimensions and processes including the type of drug, the pattern of drug use, the micro social climate surrounding the user, the macro-social climate in the drug using community, and attitudinal factors create situations of sub-optimal utilization of sterile injection equipment, which in turn impact upon HIV incidence rates among injection drug using populations. We hypothesize these factors and processes may be so potent that they can outweigh the protective effects of needle exchange and legal pharmacy access. The study will use both quantitative (epidemiologic cohort) and qualitative (life-history interviews, ethnography) methodologies to study well-established groups of injection drug users in Vancouver and Montreal. The two site nature of the study will allow comparisons within and between these cities in an effort to identify common and divergent risk factors, protective factors and processes related to sub-optimal syringe utilization and increased risk of HIV infection. Explaining the reasons why needle accessibility alone is not sufficient to halt HIV transmission in injection drug using populations is of paramount importance. Such findings could help jurisdictions in the U.S. and elsewhere to avoid a repeat of our recent experience.

描述：(申请人摘要) 注射吸毒占美国艾滋病病例的近三分之一 通过直接或间接传播给其他注射毒品的国家 使用者，他们的性伴侣和后代。1996年，在拥有 保密的艾滋病毒检测、注射吸毒或与 注射毒品分别占新增吸毒者的35%和86% 对报告风险类别的男性和女性进行艾滋病毒阳性测试。在……里面 作为回应，美国国家科学院在1995年建议，艾滋病毒 美国注射吸毒者的预防策略应 包括针头交换计划和放松对处方和 附属法。美国一些州(例如康涅狄格州)已经 执行了这两项建议，而且还有更多的建议正在这样做。 尽管通过已建立的针头广泛获得无菌注射器 交流计划和药房准入，最近有证据表明艾滋病毒水平很高 蒙特利尔注射吸毒者的感染率(每年5%)和 温哥华(每年19%)。这项研究的目的是为了更好地遵循 建立了血清发病率趋势队列，并确定了影响因素和 解释人群中艾滋病毒感染率上升的过程 有机会使用无菌注射设备的注射吸毒者。这个 正在研究的主要假设是，因素之间的复杂关系， 社会层面和进程，包括毒品的类型、模式 毒品使用，围绕吸毒者的微观社会氛围，宏观社会 吸毒社区的气候和态度因素造成 无菌注射设备利用不佳的情况， 反过来影响注射吸毒人群中艾滋病毒的发病率 人口。我们假设这些因素和过程可能是如此强大 他们可以超过针头交换和法律的保护作用 进入药房。这项研究将使用定量(流行病学) 队列)和定性(人生史访谈、人种志)方法 研究温哥华成熟的注射吸毒者群体和 蒙特利尔。这项研究的两个地点性质将允许在 以及这些城市之间的合作，以努力识别共同和不同的风险 与次优注射器相关的因素、保护因素和过程 艾滋病毒的使用和艾滋病毒感染风险的增加。 解释为什么仅有针头的可及性不足以 遏制艾滋病毒在注射吸毒人群中的传播至关重要 重要性。这样的发现可能会帮助美国和 在其他地方，以避免重演我们最近的经历。