Initiation of injection drug use and HIV risks among street-involved youth

街头青少年开始注射吸毒和艾滋病毒风险

• 批准号: 8213125
• 负责人: Evan Wood
• 金额: $ 39.07万
• 依托单位: UNIVERSITY OF BRITISH COLUMBIA
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-04-15 至 2013-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8213125
• 关键词: Address; Adult; Age-Years; American; Area; Biological; Canada; Characteristics; Chemicals; Cities; Cohort Studies; Communicable Diseases; Data; Drug usage; Drug user; Environment; Environmental Risk Factor; Epidemic; Epidemiologic Methods; Epidemiology; Evaluation; Event; Evidence based intervention; Exposure to; Face; Future; Growth; HIV; HIV Infections; Health; Home environment; Housing; Illicit Drugs; Incidence; Individual; Infection; Injecting drug user; Injection of therapeutic agent; Intervention; Laboratories; Lead; Location; Maps; Methamphetamine; Methods; North America; Pattern; Peer Review; Pharmaceutical Preparations; Police; Policies; Population; Prevention; Preventive Intervention; Prodrugs; Publications; Questionnaires; Research; Risk; Risk Behaviors; Risk Factors; Sexually Transmitted Diseases; Source; Specimen; Street Youths; Techniques; United States; United States Public Health Service; Update; Work; Youth; aged; base; cohort; drug market; experience; high risk; innovation; member; men who have sex with men; novel; prevent; prospective; public health relevance; response; sex risk; social; trend

DESCRIPTION (provided by applicant): The purpose of this application is to evaluate the impacts of methamphetamine and a range of social, structural, and environmental factors on initiation into injection drug use, HIV risk behavior and sexually transmitted infection (STI) incidence among street-involved youth. Globally, it is estimated that there are as many as 100 million street-involved youth, and illicit drug use and related harms (e.g., infectious diseases) have consistently been shown to be elevated among this population. Thus, there is an urgent need for data to inform interventions aimed at addressing the health needs of this growing population. In particular, given the challenges preventing harms (e.g., HIV infection) that occur after youth begin drug injecting, data to inform strategies to prevent initiation into injection drug use are urgently needed. We propose to undertake this work in a western Canadian setting where the explosive growth in methamphetamine use has mirrored a steady growth in the use of this drug in the western United States. While these trends are a source of growing concern due to methamphetamine's relationship with rising HIV risk behavior among men who have sex with men and adult IDU, the epidemiology of methamphetamine use and its relationship to sexual and injection-related HIV risk behavior remain poorly defined. Vancouver, Canada, is ideally suited for the proposed study for several reasons. First, the city is presently experiencing an explosive rise in the use of methamphetamine among street-involved youth, and past experience demonstrates that drug market trends in Vancouver are often reflected in other western US cities, and the city is known to be a North American port of entry for several illicit drugs and precursor chemicals which subsequently flow into the US. Thus, this research will provide valuable data to inform US drug trends and interventions. Vancouver is also home to a large and visible street-youth problem and street-based illicit drug market, and the risk environment in which street youth become involved in illicit drugs has not been well described. Herein, we propose to create an open prospective cohort study of 500 street-involved youth aged 14 to 25 who will complete a standardized questionnaire and provide biological specimens on a semi-annual basis. Given the local drug use and risk environment characteristics, as well as the local laboratory capacity, our proposed research plan offers an ideal opportunity to examine the impact of evolving drug use patterns and a range of social, structural, and environmental factors on the rates of initiation into injection drug use, sexual risk behavior and STI incidence. This research also presents a unique opportunity to create a cohort of street-involved non-injecting youth which will enable comparisons with an ongoing study of adult injection drug users. Together, this research will address several questions central to the urgent challenges facing street-involved youth in North America as a result of the growth of methamphetamine use and illicit drug injecting, and will allow for the evaluation of a range of individual and contextual determinants of HIV risk behavior and STI incidence among this population. PUBLIC HEALTH RELEVANCE: While increasing methamphetamine use among youth is a source of growing concern due to methampheta- mine's relationship with rising HIV risk behavior among men who have sex with men and adult injection drug users, the epidemiology of methamphetamine use and its relationship to initiation of injection drug use, HIV risk behaviour, and sexually transmitted infection incidence among high-risk youth remains poorly defined. This research will fill this void by evaluating patterns of methamphetamine use and other illicit drug patterns, as well as the risk environment in which drugs are used, to describe their effects on initiation of injection drug use, sexual risk behavior, and incidence of sexually transmitted infections among a cohort of 500 street-involved youth.

描述（由申请人提供）：本申请的目的是评估甲基苯丙胺以及一系列社会、结构和环境因素对街头青少年开始注射吸毒、艾滋病毒危险行为和性传播感染 (STI) 发病率的影响。据估计，全球有多达 1 亿青少年流落街头，而这些人群中非法药物使用和相关危害（例如传染病）的情况持续增加。因此，迫切需要数据来为旨在满足不断增长的人口的健康需求的干预措施提供信息。特别是，考虑到预防青少年开始注射吸毒后发生的伤害（例如艾滋病毒感染）的挑战，迫切需要提供数据来指导预防注射吸毒的策略。我们建议在加拿大西部地区开展这项工作，那里甲基苯丙胺使用量的爆炸性增长反映了美国西部该药物使用量的稳定增长。尽管由于甲基苯丙胺与男男性行为者和成年注射吸毒者中艾滋病毒危险行为上升的关系，这些趋势日益引起人们的关注，但甲基苯丙胺使用的流行病学及其与性和注射相关艾滋病毒危险行为的关系仍然不明确。出于多种原因，加拿大温哥华非常适合进行拟议的研究。首先，目前温哥华街头青少年吸食甲基苯丙胺的现象呈爆炸性增长，过去的经验表明，温哥华的毒品市场趋势往往反映在美国其他西部城市，而且该市是多种非法毒品和前体化学品的北美入境口岸，这些毒品和前体化学品随后流入美国。因此，这项研究将为美国药物趋势和干预措施提供有价值的数据。温哥华也是一个巨大而明显的街头青年问题和街头非法毒品市场的所在地，而街头青年参与非法毒品的风险环境尚未得到很好的描述。在此，我们建议对 500 名 14 至 25 岁的街头青少年开展一项开放的前瞻性队列研究，他们将填写标准化调查问卷，并每半年提供一次生物样本。考虑到当地的吸毒和风险环境特征以及当地实验室的能力，我们提出的研究计划提供了一个理想的机会来研究不断变化的吸毒模式以及一系列社会、结构和环境因素对注射吸毒起始率、性危险行为和性传播感染发病率的影响。这项研究还提供了一个独特的机会，可以创建一组街头非注射吸毒青少年，以便与正在进行的成人注射吸毒者研究进行比较。这项研究将共同​​解决北美街头青年因甲基苯丙胺使用和非法注射毒品增长而面临的紧迫挑战的几个核心问题，并将评估该人群中艾滋病毒风险行为和性传播感染发病率的一系列个人和背景决定因素。 公共卫生相关性：尽管由于甲基苯丙胺与男男性行为者和成人注射吸毒者中艾滋病毒风险行为上升的关系，青少年中甲基苯丙胺使用的增加日益引起人们的关注，但甲基苯丙胺使用的流行病学及其与高危青少年开始注射吸毒、艾滋病毒风险行为和性传播感染发病率的关系仍然不明确。这项研究将通过评估甲基苯丙胺和其他非法药物的使用模式以及使用毒品的风险环境来填补这一空白，以描述它们对 500 名街头青少年开始注射毒品、性危险行为和性传播感染发病率的影响。