INCIDENCE OF HIV INFECTIONS IN A COHORT OF IV DRUG USERS

静脉注射毒品使用者群体中艾滋病毒感染的发生率

• 批准号: 6155104
• 负责人: STEFFANIE A. STRATHDEE
• 金额: $ 13.61万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-09-01 至 2003-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6155104
• 关键词: HIV infections; clinical research; computer program /software; data collection methodology /evaluation; epidemiology; health behavior; hepatitis C; hepatitis C virus; human subject; intravenous drug abuse; longitudinal human study; questionnaires; sex behavior

The purpose of this study is to continue analyses of HIV incidence among a cohort of uninfected injection drug users (IDUs), and provide time-sensitive identification of risk factors for infection. In addition, we will study morbidity and mortality associated with injection drug use, including the natural history of hepatitis C virus (HCV) infection. To meet these aims, we will continue to prospectively follow 1000 HIV-seronegative IDUs on a semi-annual basis, among whom we have maintained a follow-up rate of 90 percent/yr and an HIV incidence greater than 2 percent/year since 1988. Over a 4 year period, we will identify temporal trends in HIV incidence and morbidity and mortality using person-time methods. We will determine period-specific HIV risk factors and attributable risks associated with illicit drug use and sexual behaviors using Poisson regression. We propose to determine the extent to which the use of a new survey method, audio computer-assisted self- interviewing (A-CASI) is associated with higher rates of self-reported HIV risk behaviors over time compared to interviewer-administered questionnaires, and the magnitude of these associations with respect to HIV seroconversion. Continuation of this cohort will enable us to evaluate the effectiveness of HIV behavioral interventions (e.g. needle exchange and pharmacy access to sterile syringes), using descriptive statistics and Poisson regression to compare users/non-users of these programs. We will examine morbidity and mortality in HIV seronegative IDUs as a basis for quantifying health effects of illicit drug use (compared to local population data), as a competing factor for HIV seroconversion (within the cohort), and as a basis for an HIV-seropositive cohort (DA04334) to identify HIV-related non-AIDS outcomes in the era of highly active antiretroviral therapy. We will characterize the natural history and pathogenesis of HCV infection including evaluation of interactions between HIV infection and HCV. The ongoing nature of this cohort allows for rapid assessment of emerging blood-borne pathogens. Eleven ongoing and already separately funded studies critically depend on this cohort to provide a key population base for their studies.

本研究的目的是继续分析未感染的注射吸毒者（IDUs）队列中的HIV发病率，并提供感染风险因素的时间敏感性识别。 此外，我们还将研究与注射吸毒相关的发病率和死亡率，包括丙型肝炎病毒（HCV）感染的自然史。 为了实现这些目标，我们将继续每半年前瞻性地随访1000名HIV血清阴性的注射吸毒者，自1988年以来，我们一直保持90%/年的随访率和2%/年以上的HIV发病率。 在4年的时间里，我们将确定艾滋病毒的发病率和发病率和死亡率的时间趋势使用人的时间方法。 我们将使用泊松回归确定特定时期的HIV风险因素和与非法药物使用和性行为相关的归因风险。 我们建议确定在何种程度上使用一种新的调查方法，音频计算机辅助自我访谈（A-CASI）与更高的自我报告的艾滋病毒风险行为率随着时间的推移相比，访谈者管理的问卷调查，以及这些协会与艾滋病毒血清转换的幅度。该队列的继续将使我们能够评估艾滋病毒行为干预措施的有效性（例如针头交换和药房获得无菌注射器），使用描述性统计和泊松回归来比较这些方案的使用者/非使用者。 我们将检查HIV血清阴性注射吸毒者的发病率和死亡率，作为量化非法药物使用的健康影响的基础（与当地人口数据相比），作为HIV血清转换的竞争因素（队列内），并作为HIV血清阳性队列（DA 04334）的基础，以确定在高活性抗逆转录病毒治疗时代与HIV相关的非艾滋病结局。 我们将描述HCV感染的自然史和发病机制，包括评估HIV感染和HCV之间的相互作用。 该队列的持续性质允许快速评估新出现的血源性病原体。 11项正在进行的和已经单独资助的研究严重依赖于这一队列，为他们的研究提供关键的人群基础。