Long Term Injection Cessation among Injection Drug Users (IDUs)

注射吸毒者 (IDU) 长期戒断注射

• 批准号: 7548091
• 负责人: Becky Lynn Genberg
• 金额: $ 5.17万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-07-01 至 2010-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7548091
• 关键词: AIDS prevention; Abstinence; Accounting; Acquired Immunodeficiency Syndrome; African American; Age; Alcohol or Other Drugs use; Baltimore; Behavior; Censuses; Characteristics; Cities; Code; Cohort Studies; Communities; Computer software; Data; Data Collection; Depth; Disadvantaged; Drug usage; Economic Conditions; Economic Factors; Economics; Employment; Enrollment; Environment; Frequencies; Geographic Information Systems; Goals; HIV; HIV Infections; Home environment; Imprisonment; Income; Individual; Injecting drug user; Injection of therapeutic agent; Intervention; Interview; Intravenous; Lead; Link; Longitudinal Studies; Maryland; Methodology; Natural History; Neighborhoods; Pattern; Pharmaceutical Preparations; Population; Prevention strategy; Purpose; Rate; Recording of previous events; Recovery; Relapse; Research; Research Infrastructure; Sampling; Societies; Time; addiction; base; case control; cohort; design; experience; indexing; interest; prevent; social; success; transmission process

DESCRIPTION (provided by applicant): The main objective of this study is to increase understanding of the natural history of injection drug use, with a specific focus on long-term injection cessation, using data from the AIDS Link to the IntraVenous Experience (ALIVE) study, a community-based cohort of injection drug users (IDUs) in Baltimore, Maryland. The majority of HIV prevention strategies directed at IDUs focus on reducing the frequency and harms associated with injection drug use. While these efforts are important, the ultimate goal of HIV prevention for IDUs is long-term injection cessation. Previous research on injection cessation has focused primarily on individual-level factors that predict short periods of cessation (i.e. 6 months to one year). Studies of individual factors associated with short-term cessation do not take into account the factors that maintain longer periods of cessation or the broader social factors that create environments that encourage and sustain cessation. Since addiction is often characterized by periods of abstinence and relapsed use within relatively short time spans, predictors of short-term cessation may differ from predictors of long-term cessation and short-term cessation may not lead to long term recovery for all IDUs. The current study will be nested within the ALIVE study, which has enrolled and followed nearly 4,000 predominantly African-American IDUs since 1988 in Baltimore City. The specific aims of this study are: 1) To characterize the longitudinal patterns of injection and non-injection drug use, including long term injection cessation, among IDUs; 2) To identify individual-level predictors of long-term injection cessation among IDUs; and 3) To determine neighborhood- level predictors of long-term cessation of injection among IDUs. We propose a combination of qualitative, longitudinal, and multilevel analyses to investigate long-term injection cessation. Each aim will be explored qualitatively with iterative in-depth interviews with IDUs who have achieved long-term cessation. The quantitative analysis will begin by using the rich longitudinal data collected in the ALIVE study to determine the frequency of long-term cessation, defined as no injection for at least 3 years, as well as other injection and non-injection drug use patterns from 1988 to 2007. We will employ a nested case-control design to determine the longitudinal predictors of long-term cessation, as well as factors that maintain cessation, at the individual- level. Finally we will conduct multilevel analyses using Geographic Information System (GIS) software to link individual residential data to US Census and other administrative neighborhood-level data to examine the neighborhood characteristics (e.g. socio-economic disadvantage) in Baltimore City that promote and maintain long-term injection cessation. The proposed study will inform HIV and substance use interventions aimed at promoting and maintaining long-term injection cessation among IDUs. Project Narrative. The main objective of this study is to increase understanding of the natural history of injection drug use, with a specific focus on long-term injection cessation. We propose a combination of qualitative, longitudinal, and multilevel analyses to investigate the individual and neighborhood-level predictors of long-term injection cessation among injection drug users (IDUs). The proposed study will inform HIV prevention and substance use interventions aimed at promoting and maintaining long-term injection cessation among IDUs.

描述（由申请人提供）：本研究的主要目的是增加对注射药物使用的自然史的理解，特别关注长期注射停止，使用来自艾滋病与静脉注射体验（ALIVE）研究的数据，这是马里兰州巴尔的摩以社区为基础的注射吸毒者（IDUs）队列。针对注射吸毒者的大多数艾滋病毒预防战略侧重于减少与注射吸毒有关的频率和危害。虽然这些努力很重要，但预防注射吸毒者感染艾滋病毒的最终目标是长期停止注射。以前关于停止注射的研究主要集中在预测短期停止（即6个月至1年）的个人水平因素上。对与短期戒烟相关的个别因素的研究没有考虑到维持较长戒烟期的因素或创造鼓励和维持戒烟环境的更广泛的社会因素。由于成瘾通常以在相对较短的时间内戒断和复发为特征，短期戒断的预测因素可能与长期戒断的预测因素不同，短期戒断可能不会导致所有注射吸毒者的长期恢复。目前的研究将嵌套在ALIVE研究中，该研究自1988年以来在巴尔的摩市招募并跟踪了近4000名主要是非裔美国人的注射吸毒者。本研究的具体目的是：1)描述注射和非注射药物使用的纵向模式，包括长期停止注射；2)确定注射吸毒者长期停止注射的个体水平预测因素；3)确定注射吸毒者长期停止注射的社区水平预测因素。我们建议结合定性、纵向和多水平分析来调查长期停止注射。每个目标都将通过对长期戒烟的注射吸毒者的反复深入访谈进行定性探讨。定量分析将从使用ALIVE研究中收集的丰富的纵向数据开始，以确定1988年至2007年期间长期戒烟（定义为至少3年不注射）以及其他注射和非注射吸毒模式的频率。我们将采用嵌套病例对照设计来确定长期戒烟的纵向预测因素，以及维持戒烟的因素，在个人水平上。最后，我们将使用地理信息系统（GIS）软件进行多层次分析，将个人住宅数据与美国人口普查和其他行政社区数据联系起来，以检查巴尔的巴尔的市促进和维持长期停止注射的社区特征（例如社会经济劣势）。拟议的研究将为旨在促进和维持注射吸毒者长期停止注射的艾滋病毒和药物使用干预措施提供信息。项目的叙述。本研究的主要目的是增加对注射药物使用的自然史的了解，特别关注长期停止注射。我们建议结合定性、纵向和多水平分析来调查注射吸毒者（IDUs）长期停止注射的个人和社区水平预测因素。拟议的研究将为艾滋病毒预防和药物使用干预提供信息，旨在促进和维持注射吸毒者长期停止注射。