Hispanic Heroin Users, Transitions to Injecting and HIV

描述(申请人提供)：非注射海洛因的快速增长 使用(NIU)对控制注射吸毒(IDU)有严重后果， 人类免疫缺陷病毒(HIV)和其他血液的传播 病原体，因为注射毒品是吸毒者疾病和死亡的主要来源， 特别是在美国的种族和民族群体中。墨西哥裔美国人 在吸食毒品的人群中经历了这种增长， 以注射毒品和艾滋病危险行为的高比率为特征。在……里面 在这项研究中，我们建议通过使用一个 “网络便利化”方法与文化和语境变量 与海洛因从NIU到注射的转变有关，以及在 美国国立卫生研究院墨西哥裔美国海洛因样本中艾滋病毒、乙肝病毒和丙型肝炎病毒的传播 圣安东尼奥的用户。社交网络可能会促进这一过程 确定一个人在多大程度上容易患上 转换为注射或血清转换转换为注射和 就会被感染。 研究设计将包括300名墨西哥裔美国人NIU的队列， 在基线和三岁时进行HIV、乙肝病毒和丙型肝炎病毒的面谈和检测 每隔6个月进行一次随访。该设计还包含一种人种学 构成部分，包括观察和采访三个20岁的人 受试者和后续访谈每年两次，一直持续到第四年。这个 这项研究的目的是确定：1.向吸毒者过渡的比率和 过渡的预测因素，包括网络、危险行为、对 文化价值观和规范，以及个人易感性；2. 高危性行为和网络的预测和变化 女性女性性行为风险增加的程度；3. 高危注射行为和网络的预测因素和变化 那些过渡到注射的；4.流行的程度和预测因素 (艾滋病毒、乙肝和丙型肝炎)感染；5.艾滋病毒、乙肝和丙型肝炎的发病率和 血清转换的预测因素；以及6.文化和文化因素的性质和影响 关于过渡到注射以及关于艾滋病毒、乙肝病毒和丙型肝炎病毒的背景变异 流行率和发病率。 这项研究将为现有的知识提供新的数据 NIUS向IDU过渡的网络和社会过程的作用 与艾滋病毒、乙肝病毒和丙型肝炎病毒相关的高危行为。这项研究将 提供可用于制定基于网络的干预措施的信息 这不仅可以在情侣和友谊团体之间进行，而且还可以在 通过在全社区范围内传播规范和做法 NIUS防止注射和其他有害健康的过渡 非注射海洛因使用的后果。

DESCRIPTION (provided by applicant): The rapid growth of non-injecting heroin use (NIU) has serious consequences for controlling injecting drug use (IDU), the spread of Human Immunodeficiency Virus (HIV) and other blood born pathogens, since IDU is a major source of illness and death among drug users, especially among US racial and ethnic groups. Mexican Americans are experiencing this increase among a drug using population that has consistently been characterized by high rates of drug injecting and AIDS risk behavior. In this study, we propose to examine the roles of social networks by using a "network facilitation" approach and cultural and contextual variables associated with transitioning from NIU of heroin to injecting and in the transmission of HIV, HBV, and HCV among a sample of NIU Mexican American heroin users in San Antonio. Social networks may facilitate the process that determines the extent to which an individual who is susceptible for transitioning to injecting or for seroconverting transitions to injecting and becomes infected. The study design will include a cohort of 300 Mexican American NIUs that will be interviewed and tested for HIV, HBV, and HCV at baseline and at three follow-ups at 6-month intervals. The design also contains an ethnographic component that includes observations and interviews with three cohorts of 20 subjects and follow-up interviews twice each year through the fourth year. The aims of the study are to determine: 1. the rate of transitioning to IDU and predictors of transitioning, including networks, risk behaviors, adherence to cultural values and norms, and personal susceptibility; 2. the extent of, predictors of, and changes in high-risk sexual behavior and networks and the extent to which female NIUs are at elevated sexual risk; 3. the extent of, predictors of, and changes in high-risk injecting behaviors and networks among those transitioning to injecting; 4. the extent of and predictors of prevalent (HIV, HBV and HCV) infection; 5. the incidence rate of HIV, HBV and HCV and predictors of seroconversions; and 6. the nature and influence of cultural and contextual variations on transitioning to injecting and on HIV, HBV, and HCV prevalence and incidence. This research will contribute to existing knowledge by providing new data on the role of networks and social processes by which NIUs transition to IDU and high-risk behaviors associated with HIV, HBV, and HCV. The research will provide information that can be used to develop network-based interventions that can be conducted not only among couples and friendship groups, but also at the community-wide level through the diffusion of norms and practices among NIUs to prevent the transition of injecting and other harmful health consequences of non-injecting heroin use.