Preventing Rural Thai Methamphetamine Abuse and HIV by Community Mobilization

通过社区动员预防泰国农村地区甲基苯丙胺滥用和艾滋病毒

• 批准号: 7914052
• 负责人: DAVID D. CELENTANO
• 金额: $ 50.28万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-09-30 至 2012-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7914052
• 关键词: AIDS/HIV problem; Address; Adolescent; Affect; Age-Years; Alcohols; Area; Attention; Behavior Therapy; Behavioral; Cohort Studies; Communities; Counseling; Data; Data Collection; Discrimination; Drug abuse; Drug usage; Enrollment; Environment; Ethnography; Evaluation; Future; Grant; HIV; HIV/STD; Incidence; Individual; Injection of therapeutic agent; International; Intervention; Investigation; Knowledge; Lead; Life; Measures; Medical; Methamphetamine; Modeling; National Institute of Drug Abuse; Occupational; Outcome; Pharmaceutical Preparations; Policies; Population; Procedures; Process; Public Health; Randomized; Randomized Controlled Trials; Recommendation; Recording of previous events; Recruitment Activity; Research; Risk; Risk Behaviors; Risk Reduction; Rural; Social Planning; Stigmata; Surveys; Testing; Thailand; Variant; Work; Youth; aged; behavior change; behavioral/social science; cohort; experience; farmer; follow-up; forging; methamphetamine abuse; prevent; randomized trial; response; rural area; sample collection; sex risk; social; social stigma; urban area; young adult

DESCRIPTION (provided by applicant): This revised competing continuation application of R01 DA14702-01 continues our behavioral interventions to reduce adolescent and young adult HIV sexual risks associated with non-injection methamphetamine use in northern Thailand. During the first five years of our grant, we characterized variation in MA use and sexual risks for HIV acquisition. In 2004, we started study procedures and enrollment was completed (n=987) in May 2006; data collection ends in July 2007. We have had excellent recruitment, participation and retention (>90%) in the trial and we now shift our focus to remote, rural areas. Ethnography shows MA and other non-injection drug use is pervasive among rural youth and associated with HIV risk. We seek to prevent MA abuse and HIV risk by promoting community-level structural interventions developed by and with the affected communities. Our specific aims are: (1) to follow the Connect to Protect (C2P) approach to promote community mobilization, community capacity building, and community involvement to forge structural changes leading to decreased MA and other non-injection drug use risks for HIV acquisition. (2) to conduct a cluster-randomized trial of C2P over 3 years in 5 community clusters of 25 villages and compare its efficacy in MA and sexual risk reduction compared to 25 villages in 5 nearby community clusters that offer referrals for HIV VCT referrals. HIV and STI incidence, drug and sex risks, and stigma will be assessed in cohorts before and for two 15 month intervals after C2P mobilization. Finally, (3) within experimental communities, to evaluate components of the C2P intervention that generate behavior change using qualitative process evaluation data. Ethnography in targeted communities will determine local priorities for mobilization, capacity building and involvement. We will recruit 40 randomly selected community dwellers aged 14-29 years of age from each of 50 selected communities to participate in a cohort study (n=2000) to systematically determine risk. We will conduct a statistical evaluation of process and ethnographic data on components of the interventions associated with reductions in community-level MA risk. The proposed study takes a successful theoretically grounded approach from the USA to confronting problems experienced by youth at the community level in Thailand, and it promotes this model in an international setting. This project proposes a community-level behavioral intervention to reduce adolescent and young adult HIV sexual risks associated with non-injection methamphetamine use in northern Thailand. We will use an approach to community mobilization, community capacity building, and community involvement to forge structural changes leading to decreased MA and other non-injection drug use risks for HIV acquisition that has been used in the USA to respond to community-identified youth drug problems.

描述（由申请人提供）：R01 DA14702-01 的修订后的竞争性延续申请继续我们的行为干预措施，以减少泰国北部与非注射甲基苯丙胺使用相关的青少年和青年艾滋病毒性风险。在我们资助的前五年中，我们描述了 MA 使用的变化和艾滋病毒感染的性风险。 2004年，我们开始学习程序，并于2006年5月完成入学（n=987）；数据收集于 2007 年 7 月结束。我们在试验中取得了出色的招募、参与和保留率 (>90%)，现在我们将重点转向偏远的农村地区。民族志显示，MA 和其他非注射毒品的使用在农村青年中普遍存在，并且与艾滋病毒风险相关。我们力求通过促进由受影响社区制定并与受影响社区共同制定的社区一级结构性干预措施来防止 MA 滥用和艾滋病毒风险。我们的具体目标是：(1) 遵循“连接到保护”(C2P) 方法，促进社区动员、社区能力建设和社区参与，以形成结构性变革，从而降低 MA 和其他非注射毒品使用导致艾滋病毒感染的风险。 (2) 在 25 个村庄的 5 个社区集群中进行为期 3 年的整群随机试验，并将其在 MA 和性风险降低方面的功效与 5 个附近社区集群中提供 HIV VCT 转诊服务的 25 个村庄进行比较。艾滋病毒和性传播感染的发病率、毒品和性风险以及耻辱感将在 C2P 动员之前和之后的两个 15 个月的时间间隔内对队列进行评估。最后，(3) 在实验社区内，使用定性过程评估数据来评估 C2P 干预中产生行为改变的组成部分。目标社区的民族志将确定当地动员、能力建设和参与的优先事项。我们将从50个选定的社区中随机招募40名14-29岁的社区居民参加队列研究（n=2000），以系统地确定风险。我们将对与降低社区一级 MA 风险相关的干预措施的组成部分的过程和人种学数据进行统计评估。拟议的研究采用了美国成功的理论基础方法来解决泰国社区一级青年所遇到的问题，并在国际环境中推广了这一模式。该项目提出了一项社区层面的行为干预措施，以减少泰国北部青少年和年轻人与非注射甲基苯丙胺使用相关的艾滋病毒性风险。我们将采用社区动员、社区能力建设和社区参与的方法来推动结构性变革，从而降低 MA 和其他非注射吸毒导致艾滋病毒感染的风险，这种方法已在美国用于应对社区确定的青少年吸毒问题。