权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

Barriers to Treatment-based HIV Prevention for IDU Couples

注射吸毒者夫妇基于治疗的艾滋病毒预防的障碍

基本信息

批准号：
7487442
负责人：
Janie Elizabeth Simmons
金额：
$ 17.9万
依托单位：
NATIONAL DEVELOPMENT AND RESEARCH INSTITUTES, INC.
依托单位国家：
美国
项目类别：
财政年份：
2007
资助国家：
美国
起止时间：
2007-08-20 至 2010-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7487442
关键词：
AIDS prevention Accounting Address African American Area Attitude Behavior Therapy Classification Couples Data Data Reporting Development Drug abuse Drug usage Ethnography HIV Health Benefit Health Personnel Heterosexuals Infection Injecting drug user Injection of therapeutic agent Knowledge Latino Lead Left Literature Maintenance Mediating Methods Minority Modeling National Institute of Drug Abuse Needle Sharing Neighborhoods New York City Numbers Outcome Personal Communication Pharmaceutical Preparations Pilot Projects Policies Population Principal Investigator Public Health Publications Rate Recommendation Recording of previous events Reporting Research Research Personnel Risk Risk Behaviors Risk Reduction Risk Reduction Behavior Sampling Shapes Site System Target Populations Testing Translating Treatment outcome Woman Work base condoms experience interest men metropolitan programs protective behavior racial and ethnic disparities safer sex sex success transmission process

项目摘要

DESCRIPTION (provided by applicant): Despite recent advances in HIV prevention, injecting drug users (IDUs) in the U.S. still account for 1/3 of new infections. Racial/ethnic disparities in injection drug use also continue to cause a disproportionate share of new HIV cases among minorities and women. This proposal targets a vulnerable and understudied population of IDUs - minority, heterosexual, IDU couples (i.e. partnered IDUs). While research on partnered IDUs is scarce, existing literature indicates that partnered IDUs are at high risk for HIV from both drug- related and sexual risk behaviors. Partnered IDUs, especially partnered women IDUs, also have limited success in reducing drug use, accessing or completing drug abuse treatment, and maintaining treatment outcomes (reduced drug use, safer drug-use practices, safer sex). This profile of partnered IDUs has important implications for treatment-based HIV prevention. Drug abuse treatment is an effective method for reducing drug-and sex-related HIV risk among IDUs. A recent NIDA publication concludes that "drug abuse treatment is HIV prevention." However, the median proportion of IDUs who access treatment in the U.S. is extremely low - less than 9%. Clearly, the full efficacy of HIV prevention cannot be realized unless more IDUs enter treatment. Since a substantial number of IDUs are sexually partnered with other IDUs (more than 40%, according to out own NYC data), understanding and overcoming barriers to successful treatment and treatment-based HIV prevention among partnered IDUs will have a substantial impact on reducing drug use and HIV risk, especially among minority women. This qualitative study of IDU couples and treatment providers focuses on two sets of barriers to drug treatment and treatment-based HIV risk reduction among African American and Latino heterosexual IDU couples in NYC: (1) relationship dynamics among partnered IDUs that deter treatment entry, retention or the maintenance of outcomes; and (2) couples-specific structural barriers in the treatment system that further inhibit treatment entry, retention, and the maintenance of outcomes. We are also interested in (3) how these two kinds of barriers interact. Findings from the proposed research will inform subsequent work to quantify these barriers and develop and evaluate programs to overcome them. This study is proposed by a new investigator and utilizes the R-21 mechanism. PUBLIC HEALTH STATEMENT HIV transmission among injection drug users (IDUs) continues to be an important public health issue. Despite recent advances in HIV prevention, injection drug users in the U.S. still account for 1/3 of all new infections. Racial/ethnic disparities in injection drug use also continue to cause a disproportionate share of infections. The proposed study primarily targets African American and Latino IDUs who are partnered in intimate relationships. While research on partnered IDUs is scarce, existing literature indicates that they are at high risk for HIV from both drug-related and sexual risk behaviors. In addition, they have limited success in reducing drug use, accessing or completing drug abuse treatment and maintaining treatment outcomes (reduced drug use, safer drug use practices, safer sex). The proposed study will contribute to an understanding of interpersonal and structural barriers to drug treatment and treatment-mediated HIV prevention and lead to recommendations for needed improvements.

描述（由申请人提供）：尽管最近在艾滋病毒预防方面取得了进展，但美国注射吸毒者 (IDU) 仍占新感染病例的 1/3。注射吸毒方面的种族/民族差异也继续导致少数族裔和妇女中新发艾滋病毒病例比例过高。该提案针对弱势且未被充分研究的注射吸毒者群体——少数民族、异性恋、注射吸毒者夫妇（即有伴侣的注射吸毒者）。虽然对有伴侣的注射吸毒者的研究很少，但现有文献表明，有伴侣的注射吸毒者因毒品相关行为和性危险行为而面临感染艾滋病毒的高风险。有伴侣的注射吸毒者，特别是有伴侣的女性注射吸毒者，在减少吸毒、获得或完成吸毒治疗以及维持治疗结果（减少吸毒、更安全的吸毒行为、更安全的性行为）方面也取得了有限的成功。注射吸毒者的这种合作概况对于基于治疗的艾滋病毒预防具有重要意义。药物滥用治疗是降低注射吸毒者中与药物和性相关的艾滋病毒风险的有效方法。 NIDA 最近的一份出版物得出的结论是“药物滥用治疗就是艾滋病毒预防”。然而，在美国接受治疗的注射吸毒者比例中位数极低——不到 9%。显然，除非更多的注射吸毒者接受治疗，否则艾滋病毒预防的全部功效就无法实现。由于大量注射吸毒者与其他注射吸毒者有性伴侣（根据纽约市自己的数据，超过 40%），了解并克服有伴侣的注射吸毒者成功治疗和基于治疗的艾滋病毒预防的障碍将对减少吸毒和艾滋病毒风险产生重大影响，特别是在少数族裔妇女中。这项针对 IDU 夫妇和治疗提供者的定性研究重点关注纽约市非裔美国人和拉丁裔异性 IDU 夫妇中药物治疗和基于治疗的 HIV 风险降低的两组障碍：(1) 合作的 IDU 之间的关系动态，阻碍治疗进入、保留或维持结果； (2) 治疗系统中夫妻特有的结构性障碍，进一步抑制治疗的进入、保留和结果的维持。我们还对（3）这两种障碍如何相互作用感兴趣。拟议研究的结果将为后续工作提供信息，以量化这些障碍并制定和评估克服这些障碍的计划。这项研究由一位新研究者提出，利用了 R-21 机制。公共卫生声明注射吸毒者 (IDU) 中的艾滋病毒传播仍然是一个重要的公共卫生问题。尽管最近在艾滋病毒预防方面取得了进展，但美国注射吸毒者仍然占所有新感染病例的 1/3。注射吸毒方面的种族/民族差异也继续导致感染比例过高。拟议的研究主要针对有亲密关系的非裔美国人和拉丁裔注射吸毒者。虽然对有伴侣的注射吸毒者的研究很少，但现有文献表明，他们因毒品相关行为和性危险行为而面临感染艾滋病毒的高风险。此外，他们在减少药物使用、获得或完成药物滥用治疗以及维持治疗结果（减少药物使用、更安全的药物使用习惯、更安全的性行为）方面取得的成功有限。拟议的研究将有助于了解药物治疗和治疗介导的艾滋病毒预防的人际和结构性障碍，并提出需要改进的建议。