Methadone maintenance and HIV risk in Ukraine

描述（由申请人提供）：治疗阿片类药物依赖是减少艾滋病毒和其他传染病传播的重要途径，特别是在乌克兰，因为静脉注射阿片类药物是这些感染传播的主要途径。这项建议将在基辅市麻醉医院与来自亚拉巴马大学和科罗拉多大学的合作者一起完成。它将研究对50名阿片类药物依赖者进行3个月美沙酮维持治疗的可接受性和影响，其中25人为艾滋病毒阳性，25人为艾滋病毒阴性。拟议的工作将建立在与乌克兰联合首席研究员Sergiy Dvoryak博士建立的关系基础上，Sergiy Dvoryak博士于1999-2000年在约翰霍普金斯大学获得汉弗莱奖学金期间与Woody和Metzger博士在宾夕法尼亚成瘾治疗和研究中心度过了一段时间。它还将扩展伍迪，舒马赫和布斯博士在俄罗斯和乌克兰正在进行的阿片类药物依赖和降低风险行为干预的药物治疗研究。主要目标是：1）测量HIV+和HIV-患者接受美沙酮维持3个月疗程的可接受性和依从性; 2）测量美沙酮3个月疗程对减少阿片类药物使用和HIV风险行为的影响。次要目标是：1）评估调查小组获得研究结果指标的程度; 2）评估3个月美沙酮维持治疗减少非法活动和改善就业和精神症状的程度; 3）确定美沙酮治疗完成后的短期结果;以及4）获得研究患者中B和C型肝炎患病率的初步数据。该提案涉及NIH的两个优先领域：艾滋病毒预防和药物滥用。它将提供试验性数据，说明在尚未对美沙酮维持疗法进行评价的文化环境中短期美沙酮维持疗法的可接受性和有效性，以及在基辅对阿片类药物依赖者进行药理学研究的可行性，并将提高基辅调查人员今后进行艾滋病毒预防和治疗研究的研究能力。

DESCRIPTION (provided by applicant): Treatment of opioid dependence is an important way to reduce the spread of HIV and other infectious diseases, particularly in Ukraine since intravenous opioid use is the major way these infections are being spread. This proposal will be done at the Kiev City Narcology Hospital with collaborators from the University of Alabama and the University of Colorado. It will study the acceptability and impact of a 3-month course of methadone maintenance on 50 persons with opioid dependence, 25 who are HIV+ and 25 HIV-. The proposed work will build upon a relationship that was established with the Ukrainian Co-Principal Investigator, Sergiy Dvoryak, MD, during his Humphrey Fellowship at Johns Hopkins in 1999-2000 when he spent time with Drs. Woody and Metzger at the Penn Addiction Treatment and Research Center. It will also extend studies of pharmacologic treatment for opioid dependence and risk reduction behavioral interventions that are being done by Drs. Woody, Schumacher and Booth in Russia and Ukraine. Primary aims are to: 1) Measure the acceptability and compliance with a 3-month course of methadone maintenance in HIV+ and HIV- patients; and 2) Measure the impact of a 3-month course of methadone in reducing opioid use and HIV risk behavior. Secondary aims are to: 1) Assess the degree to which the investigative team obtains study outcome measures; 2) Assess the degree to which the 3-month course of methadone maintenance reduces illegal activities and improves employment and psychiatric symptoms; 3) Determine short term outcome after completion of methadone treatment; and 4) Obtain pilot data on the prevalence of hepatitis B and C among study patients. This proposal addresses two priority areas of NIH: HIV prevention and substance abuse. It will provide pilot data on the acceptability and efficacy of a short term course of methadone maintenance in a cultural setting where this treatment has not been evaluated, on the feasibility of conducting a pharmacological study of opioid dependent persons in Kiev, and will enhance research capabilities of Kiev investigators for future HIV prevention and treatment studies.