INTERVENTION AMONG HEROIN SNIFFERS--PREVENT IV DRUG USE

这一相互竞争的继续需要5年的资金，以继续我们的努力，减少艾滋病毒在非注射吸毒者中的传播，这些吸毒者是过渡到注射的高风险人群。这一应用采取了创新的方法，将干预研究的范围扩大到从未注射过毒品的海洛因嗅探者中的注射初级预防。 一个前瞻性的实验设计与嵌套人种志提出。 将招募750名嗅海洛因的男性和女性的三个种族样本，并随机分配到两个实验干预措施和一个对照组，并在6，12和18个月时进行随访，以评估两种干预措施的有效性和可持续性，以减少高风险性行为，防止过渡到注射并增加药物治疗的招募。 我们提出了一个有效的设计，使我们能够同时实施和评估干预措施的有效性，并前瞻性地研究过渡到注射。有三个具体目标：1）在海洛因嗅探者中实施、评估和比较两种简短的艾滋病毒风险干预措施的有效性和可持续性。 对照随机实验设计将比较两种不同的干预措施，风险预防干预和阶段增强动机面试干预与“通常的测试前和测试后咨询”组。 2)描述和模拟从海洛因嗅吸到注射的过渡的风险因素。 一个前瞻性的流行病学设计与嵌套人种学将估计注射的发生率，模型的风险因素开始注射，并描述过渡到注射/早期注射经验的海洛因嗅探者谁转移到注射的过程。 3)估计海洛因吸食者中HIV-1的流行率和发病率。 将采用标准流行病学技术。将进行特定性别和特定种族的估计。

This competing continuation requests 5 years of funding to continue our efforts to reduce the transmission of HIV among non- injection drug users at high risk for transition to injection. This application takes the innovative approach of extending intervention research to include the primary prevention of injection among heroin sniffers who have never injected drugs. A prospective experimental design with a nested ethnography is proposed. A tri-ethnic sample of 750 men and women who sniff heroin will be enrolled and randomized to two experimental interventions and one comparison group and followed at 6, 12, and 18 months to evaluate the effectiveness and sustainability of two interventions to reduce high risk sex behaviors, prevent the transition to injection and increase enrollment in drug treatment. We propose an efficient design which permits us to simultaneously implement and evaluate the effectiveness of the interventions and prospectively study the transition to injection. There are three specific aims: 1) Implement, evaluate and compare the effectiveness and sustainability of two brief HIV risk interventions among heroin sniffers. A controlled randomized experimental design will compare two distinct interventions, a Risk Prevention Intervention and a Stage-Enhanced Motivational Interviewing Intervention with a"usual pre-and post-test counseling" group. 2) Characterize and model risk factors for the transition from heroin sniffing to injection. A prospective epidemiologic design with a nested ethnography will estimate incidence of injection, model risk factors for initiation of injection, and characterize the process of transition to injection/early injection experiences of heroin sniffers who shift to injection. 3) Estimate the prevalence and incidence of HIV-1 among heroin sniffers. Standard epidemiologic techniques will be employed. Gender specific and ethnic specific estimates will be conducted.