Staying Safe: Long-Term Injection Drug Users Who Have Avoided HIV & Hepatitis C

描述（由申请人提供）： 艾滋病毒/艾滋病的流行已经持续了20多年。虽然我们对促进注射毒品使用者（IDUs）中HIV和HCV传播的特定事件行为和背景了解很多，但我们对许多长期注射毒品使用者设法保持未感染任何病毒的机制知之甚少。考虑到毒品注射者经常面临的心理、行为和社会问题以及混乱的生活，以及这些问题可能使他们在高风险环境中从事危险行为的方式，令人困惑的是，有些人如何长期保持未感染。我们的目标是发现帮助注射吸毒者保持不受感染的战略、资源、做法和预防策略，以及他们面临的障碍和克服这些障碍的方法。我们将通过对80名长期注射吸毒者进行详细的生活史访谈来做到这一点，这些人按感染状态分为两个不同的类别：（1）HIV和HCV抗体均阴性的双重未感染者;（2）两种病毒均阳性的双重感染者。定性分析将比较和对照这几类注射吸毒者的生活史，以发现他们在战略、社会经济资源、使用药物治疗和其他服务以及处理风险和避免风险的方法方面有何不同。以人为中心的定量分析方法将用于发现两组人的生活方式之间的其他差异。我们还将开发和评估一个问卷模块，以衡量出现的重要概念。这将促进相关研究的3个新领域：1。流行病学验证; 2.根据项目调查结果制定和评估预防方案; 3.病原学研究，以确定使一些注射吸毒者更有可能实施提供一定程度长期保护免受感染的策略的生理、心理和社会因果因素。 该项目将为制定新一代艾滋病毒和丙型肝炎病毒预防方案提供概念基础，以协助无法停止注射的注射吸毒者制定长期避免感染的战略，并更好地利用现有的预防和治疗形式。

DESCRIPTION (provided by applicant): We are more than 20 years into the HIV/AIDS epidemic. Although much is known about event-specific behaviors and contexts that facilitate HIV and HCV transmission among injecting drug users (IDUs), we know very little about the mechanisms by which many long-time IDUs have managed to remain uninfected with either virus. Given the psychological, behavioral and social problems and chaotic lives that drug injectors often face, and the ways in which these may predispose them to engage in risky behaviors in high-risk settings, it is a puzzle how some nonetheless remain uninfected over the long term. We aim to discover strategies, resources, practices, and prevention tactics that help IDUs to remain uninfected, as well as the obstacles they face and the ways in which they overcome these obstacles. We will do this by conducting detailed life history interviews with 80 long-term current IDUs who fall into two distinct categories by infection status: (1) Doubly uninfected who are both HIV- and HCV-antibody negative; and (2) Doubly infected who are positive for both viruses. Qualitative analyses will compare and contrast the life histories of IDUs in these categories to discover how they differ in terms of strategies, socioeconomic resources, use of drug treatment and other services, and approaches to risk and risk-avoidance. Person-centered quantitative analysis methods will be used to discover additional differences between the life pathways of the two groups. We will also develop and assess a questionnaire module to measure concepts that emerge as important. This will facilitate 3 new areas of related research: 1. Epidemiologic verification; 2. Development and evaluation of prevention programs based on project findings; and 3. Etiologic research to determine physiological, psychological and social causal factors that make some IDUs more likely to implement strategies that offer a degree of long term protection from infection. This project will provide the conceptual basis for developing a new generation of HIV and HCV prevention programs to assist IDUs who are unable to quit injecting to develop strategies to avoid infection over the long run and to make better use of existing forms of prevention and treatment.