HIV RISK BEHAVIORS AMONG URBAN NOMAD DRUG INJECTORS

城市游牧吸毒者的艾滋病毒风险行为

• 批准号: 6379083
• 负责人: DON C DES JARLAIS
• 金额: $ 60.3万
• 依托单位: NATIONAL DEVELOPMENT AND RESEARCH INSTITUTES, INC.
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-09-05 至 2004-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6379083
• 关键词: AIDS; AIDS /HIV diagnosis; HIV infections; behavioral /social science research tag; clinical research; communicable disease diagnosis; communicable disease transmission; computer assisted diagnosis; counseling; data collection methodology /evaluation; disease /disorder proneness /risk; hepatitis B; hepatitis C; high risk behavior /lifestyle; human migration; human subject; interview; intravenous drug abuse; longitudinal human study; questionnaires; residential mobility; substance abuse related behavior; urban area; young adult human (21-34)

The global diffusion of HIV, hepatitis B and hepatitis C among injecting drug users (IDUs) shows both that they engage in substantial travel and that research is needed on their travel patterns. Previous research makes it clear that IDUs travel regionally, nationally, and internationally, but has not adequately described travel patterns nor the factors that influence IDUs' HIV risk behavior when they travel. Through our street-based research with IDUs in New York City, we have developed considerable familiarity with a large group of highly mobile, young IDUs, self-defined as "urban nomads", who travel frequently and widely throughout the U.S. These urban nomads are often homeless, but are conceptually and behaviorally distinct from "locally homeless" drug injectors who are not geographically mobile. The specific aims include both methodological and substantive objectives: (Aim 1) Analytically describe a large sample (n = 800) of "urban nomad" young IDUs, including their demographics, drug use histories, travel histories, HIV risk behaviors and serostatus. Identify factors associated with (a) HIV risk behaviors and (b) frequency of intercity travel. (Aim 2) Identify patterns of drug use and HIV risk behavior during travel by urban nomad IDUs, including numbers of "person-trips" (a trip by a person to another metropolitan area), the geographic distribution of person- trips where HIV risk behaviors do and do not occur, and factors that differentiate person-trips with and without HIV risk behavior. Aims 1 and 2 will be achieved through interviews with 600 urban nomad IDUs recruited in New York City and 200 urban nomad IDUs recruited at collaborating research sites across the country. (Aim 3) Implement and assess a long-distance telephone follow-up interview system for collecting data from urban nomad IDUs in their travels. Subjects will be intensively prepared to maintain telephone contact with researchers. Long-distance telephone interviewing will be supplemented by referrals to local research studies for HIV counseling and testing, by referrals to syringe exchange programs, and by e-mail and web site communication. (Aim 4) Determine potential biases in loss to follow-up in using these techniques. Estimated biases can then be used to adjust estimates of continuing drug use and risk behaviors. Aims 3 and 4 will be achieved through a cohort study of 300 subjects recruited in New York. Drug use and HIV risk behavior among IDUs are often viewed as local phenomena, with drug practices, risk behaviors and HIV epidemics occurring within defined geographic areas. The proposed research will provide data and research technologies for a complementary perspective that sees drug use practices and blood-borne pathogens diffusing within a loosely integrated nation-wide "system" of illicit drug use.

艾滋病毒、乙型肝炎和丙型肝炎在注射吸毒者中的全球传播表明，他们从事大量旅行，需要对他们的旅行模式进行研究。以往的研究清楚地表明，注射吸毒者在区域、国家和国际上旅行，但没有充分描述旅行模式，也没有充分描述影响注射吸毒者旅行时艾滋病毒风险行为的因素。通过我们对纽约市注射吸毒者的街头研究，我们对一大群高度流动的年轻注射吸毒者有了相当的了解，他们自称为“城市游牧民”，他们经常在美国各地广泛旅行。这些城市游牧民通常无家可归，但在概念和行为上与“当地无家可归”的注射吸毒者不同，他们在地理上不流动。具体目标包括方法学和实质性目标：（目标1）分析描述一个大样本（n = 800）的“城市游牧”年轻注射吸毒者，包括他们的人口统计、药物使用史、旅行史、艾滋病毒风险行为和血清状况。确定与(a)艾滋病毒风险行为和(b)城际旅行频率相关的因素。（目标2）确定城市游牧民IDUs旅行期间的吸毒和艾滋病毒风险行为模式，包括“个人旅行”（一个人前往另一个大都市地区的旅行）的次数，发生和不发生艾滋病毒风险行为的个人旅行的地理分布，以及区分有艾滋病毒风险行为和没有艾滋病毒风险行为的个人旅行的因素。目标1和目标2将通过对在纽约市招募的600名城市游牧民idu和在全国合作研究地点招募的200名城市游牧民idu的访谈来实现。（目标3）实施和评估用于收集城市游牧民IDUs旅行数据的长途电话随访访谈系统。受试者将做好充分准备，与研究人员保持电话联系。长途电话访谈将通过向当地艾滋病毒咨询和检测研究机构推荐、向注射器交换项目推荐以及通过电子邮件和网站交流进行补充。（目标4）确定在使用这些技术时对随访损失的潜在偏差。估计的偏差可以用来调整对持续使用药物和危险行为的估计。目标3和4将通过在纽约招募300名受试者的队列研究来实现。注射吸毒者中的药物使用和艾滋病毒风险行为往往被视为地方现象，药物做法、风险行为和艾滋病毒流行发生在确定的地理区域内。拟议的研究将为一个互补的观点提供数据和研究技术，该观点认为药物使用实践和血液传播的病原体在一个松散整合的全国范围的非法药物使用“系统”中扩散。