Conflict, Substance Use and HIV and Related Diseases

冲突、药物滥用和艾滋病毒及相关疾病

• 批准号: 8602999
• 负责人: Bradley Townsend Kerridge
• 金额: $ 5.16万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-08-01 至 2016-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8602999
• 关键词: Accounting; Acquired Immunodeficiency Syndrome; Address; Affect; Africa South of the Sahara; African; Alcohol consumption; Alcohol or Other Drugs use; Applications Grants; Attention; Behavioral; Biometry; Communicable Diseases; Conflict (Psychology); Consensus; Country; Data; Disease; Drug usage; Economics; Epidemic; Epidemiology; Equation; Evidence based intervention; Federal Government; Geographic Locations; Goals; Government Agencies; HIV; Health Expenditures; Hepatitis B Virus; Hepatitis C virus; Illicit Drugs; Immigration; Infection; Intervention; Knowledge; Learning; Life; Link; Manuscripts; Mediating; Mediator of activation protein; Mentors; Mission; Modeling; Morbidity - disease rate; National Institute of Drug Abuse; Outcome Measure; Persons; Population; Populations at Risk; Predisposition; Preparation; Prevalence; Prevention; Process; Public Health; Research; Research Priority; Research Training; Resistance; Risk Factors; Role; Sexually Transmitted Diseases; Subgroup; Testing; Theoretical model; Training; Tuberculosis; Virus Diseases; World Health Organization; Writing; arm; disease transmission; experience; global health; health training; injection drug use; interest; member; migration; model development; mortality; peace; public health relevance; responsible research conduct; skills; social; transmission process

DESCRIPTION (provided by applicant): The objective of the proposed project is to develop and test a theoretical model of the relationship between conflict and human immunodeficiency virus (HIV) and related diseases (e.g. tuberculosis) among World Health Organization Member States. The model defines the direct effects of conflict on HIV, and the indirect effects of conflit on HIV spread operating through two sets of indicators; background susceptibility factors (e.g. baseline prevalence of HIV) and vulnerability factors (e.g. substance use) that reflect changes induced by conflict. In this explanatory model, susceptibility and vulnerability factors are hypothesized to serve as moderators and mediators of the conflict-HIV relationship. One vulnerability factor of central interest is substance use including alcohol use, non-injection illiit drug use and especially injection drug use (IDU). Consideration of IDU in explaining the conflict-HIV relationship is important given that IDU accounts for about 10% of the estimated 27 million new HIV infections that occur each year and for 30% of these new infections occurring outside Sub-Saharan Africa. Research attention has focused on the relationship between IDU and HIV, Hepatitis B virus, Hepatitis C virus, and sexually transmitted infections (STIs), tending to overshadow the importance of these diseases associated with non-injection drug use and alcohol use. The proposed project also aims to: (1) identify new and refine existing indicators of susceptibility and vulnerability; (2) examine hypothesized direct and indirect effects of conflict n HIV among relevant subgroups in which the relationship may differ (e.g. Sub-Saharan African vs. Non-Sub-Saharan African countries); and (3) test alternative explanatory models using structural equation modeling. These objectives and aims will be supported by a research training plan that involves learning/enhancing knowledge of advanced epidemiology, biostatistics and HIV and related infectious diseases and global health and training in presentation skills, conduct of research, manuscript writing and preparation of fundable grant proposals, mentoring and receiving training in the responsible conduct of research. This project is of substantial relevance to the research priorities of the National Institute on Drug Abuse, tha is, its focus on prevention and treatment of HIV, including developing intervention strategies, addressing HIV/AIDS, understanding IDU epidemics in different geographic areas, assessing the role of immigration/migration on HIV transmission and research addressing the epidemiology of HIV/AIDS and related co-infections and other STIs and tuberculosis, epidemiology, and behavioral, social and economic determinants of HIV/AIDS.

说明(申请人提供)：拟议项目的目标是开发和测试世界卫生组织成员国之间冲突与人类免疫机能丧失病毒(艾滋病毒)和相关疾病(如结核病)之间的关系的理论模型。该模型界定了冲突对艾滋病毒的直接影响，以及冲突对艾滋病毒传播的间接影响，通过两套指标：反映冲突引起的变化的背景易感因素(如艾滋病毒基线流行率)和脆弱性因素(如物质使用)。在这一解释性模型中，假设易感性和脆弱性因素充当冲突-艾滋病毒关系的调停人和调解人。人们最感兴趣的一个脆弱性因素是物质使用，包括酒精使用、非注射毒品使用，特别是注射毒品使用。考虑注射吸毒者在解释冲突与艾滋病毒之间的关系是重要的，因为注射吸毒者约占每年发生的2700万艾滋病毒新感染病例的10%，而这些新感染病例中有30%发生在撒哈拉以南非洲以外。研究关注的重点是注射吸毒与艾滋病毒、乙肝病毒、丙型肝炎病毒和性传播感染的关系，往往掩盖了这些与非注射吸毒和酗酒有关的疾病的重要性。拟议的项目还旨在：(1)确定新的和改进现有的易感性和脆弱性指标；(2)在可能存在不同关系的相关分组(例如撒哈拉以南非洲国家和非撒哈拉以南非洲国家)中审查冲突对艾滋病毒的假设直接和间接影响；(3)利用结构方程模型测试其他解释模型。这些目标和宗旨将得到一项研究培训计划的支持，该计划涉及学习/加强高级流行病学、生物统计学和艾滋病毒及相关传染病和全球卫生方面的知识，以及关于陈述技能的培训、开展研究、撰写手稿和编写可资助的赠款提案、指导和接受负责任地开展研究的培训。该项目与国家药物滥用问题研究所的研究重点密切相关，重点是预防和治疗艾滋病毒，包括制定干预战略，解决艾滋病毒/艾滋病问题，了解注射吸毒者在不同地理区域的流行情况，评估移民/移徙对艾滋病毒传播的作用，研究艾滋病毒/艾滋病和相关的联合感染以及其他性传播感染和结核病的流行病学、流行病学以及艾滋病毒/艾滋病的行为、社会和经济决定因素。