HEPATITIS B AND C AMONG HOMELESS ADULTS

描述：申请者摘要 感染乙肝病毒(乙肝)或丙型肝炎病毒(丙肝)的人 是严重的长期健康问题的高危人群，而且他们 可能会传染给其他人。因为这些问题的严重性 为了防止感染，美国国立卫生研究院制定了一项防止传播的国家议程 以及乙肝病毒和丙型肝炎的后果。这项议程包括早期发现， 为高危和感染者提供治疗和预防工作。 在今天的美国，无家可归已经达到了危机的程度。最近的研究，由 我们的团队和其他人认为，城市地区无家可归的成年人是一个群体 由于高风险比率，乙肝病毒和丙型肝炎病毒感染的风险特别高 吸毒和危险的性行为。然而，尽管存在明显的高风险， 在这个群体中，只有有限的关于病毒性肝炎的研究。我们建议 在中国开展有关乙肝和丙型肝炎的流行病学和卫生服务研究 以人口为基础的500名无家可归成年人的样本。我们将招募一名概率 30名注射吸毒者过度抽样的无家可归成年人样本 洛杉矶贫民窟地区的避难所和餐饮计划。受访者 将接受两个小时的面试(包括诊断性面试 日程表-DIS-IV)和采血进行肝炎血清学检查。我们将估计 乙肝病毒和丙型肝炎病毒的流行情况，并确定各自的危险因素。我们将评估 无论是有注射吸毒史和非注射吸毒史的无家可归成年人， 危险的性行为，严重的酒精或精神障碍，或慢性无家可归 这些感染的风险增加。我们还将开展卫生服务 我们将描述受访者过去的乙肝/丙型肝炎病史的研究 检测，对感染状态的了解，对乙肝病毒和丙型肝炎病毒的医疗护理，以及 愿意回来看乙肝病毒/丙型肝炎病毒检测结果。此外，我们将确定 利用医疗和非医疗环境来确定未来的地点 筛查、治疗和预防工作。我们将提供乙肝 为那些乙肝检测呈阴性的人接种疫苗。我们将在 利用计划行为理论研究和预防之间的差距 了解无家可归的成年人为避免暴露在 传染病。

DESCRIPTION: Applicant's Abstract Persons infected with the hepatitis B virus (HBV) or hepatitis C virus (HCV) are at high risk for serious long-term health problems, and they are potentially infectious to others. Because of the seriousness of these infections, the NIH has developed a national agenda for preventing the spread and consequences of HBV and HCV. This agenda includes early detection, treatment, and prevention efforts for high-risk and infected persons. Homelessness has reached crisis proportions in the US today. Recent research by our team and others suggests that homeless adults in urban areas are a group at particularly high risk for HBV and HCV infections due to high rates of risky drug use and risky sexual behaviors. Despite the apparent high risk, however, there is only limited research on viral hepatitis in this group. We propose to conduct epidemiologic and health services research regarding HBV and HCV in a population-based sample of 500 homeless adults. We will recruit a probability sample of homeless adults with oversampling of injection drug users from 30 shelters and meal programs in the Skid Row area of Los Angeles. Respondents will undergo a two-hour interview (including the Diagnostic Interview Schedule-DIS-IV) and blood draw for hepatitis serology. We will estimate the prevalence of HBV and HCV and identify risk factors for each. We will evaluate whether homeless adults with histories of injection and non-injection drug use, risky sex, serious alcohol or mental disorders, or chronic homelessness have an elevated risk for these infections. We will also conduct health services research in which we will describe the respondents' past history of HBV/HCV testing, awareness of infection status, medical care for HBV and HCV, and willingness to return for HBV/HCV test results. Further, we will identify utilization of medical and non-medical settings to identify sites for future screening, treatment, and prevention efforts. We will provide hepatitis B immunization to those that test negative for hepatitis B. We will bridge the gap between research and prevention by using the Theory of Planned Behavior to understand protective behaviors used by homeless adults to avoid exposure to infectious diseases.