Reducing HIV/AIDS and Drug Abuse: Linking Compulsory Rehabilitation to Methadone

描述（申请人提供）：中国面临吸毒和艾滋病双重流行的挑战。尽管从强制戒毒所释放出来的成瘾者复吸率很高，但在中国，社区中帮助这些成瘾者的项目很少。在美国和其他国家进行的研究显示，美沙酮维持治疗可有效减少海洛因成瘾者的吸毒和感染艾滋病毒的风险。我们建议发展和试行一项康复管理干预措施，以便及早发现复吸情况，并在复吸后，将已从强制康复服务获释的吸毒者迅速转介至社区为本的市场失当行为治疗。上海有一个由政府资助的社会工作者联盟，在社区帮助吸毒成瘾者，这为拟议的干预提供了一个独特的试验场。通过社会工作者网络开发和实施RMI，拟议的研究解决了中国减少艾滋病毒/艾滋病的迫切需要，并可能对改善吸毒者从康复机构成功过渡到社区产生巨大而持久的影响。建议的项目有以下主要目标：1）让当地社区的主要利益相关者参与支持海洛因成瘾者从强制康复释放到社区的过渡; 2）确定在中国参与MMT的潜在障碍; 3）开发和提供关于艾滋病毒风险、预防复吸和MMT的教育/培训材料; 4）调整和发展中国强制戒毒者的康复管理干预计划; 5）进行试点试验，并获得与标准治疗相关的RMI的初步结果数据;以及次要目标：6）探索复发和HIV/AIDS危险行为的预测因素。拟开发的项目和拟议研究中收集的数据将为未来更大规模的干预项目有效性试验奠定基础。如果证明有效，该计划可以在中国和世界其他地区广泛应用，以减少海洛因使用和相关的艾滋病毒危险行为。

DESCRIPTION (provided by applicant): China faces the challenge of dual epidemics of drug use and HIV/AIDS. Despite the high relapse rate among addicts released from compulsory rehabilitation facilities, there are few programs available in China to assist these addicts in the community. Studies conducted in the United States and other countries have shown that methadone maintenance treatment (MMT) is effective in reducing drug use and HIV risks among heroin addicts. We propose to develop and pilot-test a Recovery Management Intervention (RMI) to allow early detection of relapse and prompt linkage of addicts released from compulsory rehabilitation to community-based MMT upon relapse. Shanghai has a well-established social worker consortium funded by the government to assist drug addicts in the community, which provides a unique testing ground for the proposed intervention. By developing and implementing RMI via the social worker network, the proposed study addresses an urgent need for reducing HIV/AIDS in China and is likely to have a great and long-lasting impact on improving the successful transition of addicts released from the rehabilitation facilities to the community. The proposed project has the following primary aims: 1) to engage key stakeholders in the local communities involved in supporting the transition of heroin addicts released from compulsory rehabilitation to the community; 2) to identify potential barriers for participating in MMT in China; 3) to develop and deliver educational/training materials on HIV risks, relapse prevention, and MMT; 4) to adapt and develop the Recovery Management Intervention program for addicts released from compulsory rehabilitation in China; 5) to conduct a pilot trial and obtain preliminary outcome data associated with RMI, relative to standard care; and a secondary aim: 6) to explore predictors of relapse and HIV/AIDS risk behaviors. The program to be developed and the data collected in the proposed study will establish a basis for a future, larger trial on effectiveness of the intervention program. If proven effective, the program can be widely applied in China and in other parts of the world to reduce heroin use and related HIV risk behaviors.