Opioid Use and HIV/HCV Risk among Immigrant Youth from the Former Soviet Union

前苏联移民青年中阿片类药物的使用和艾滋病毒/丙型肝炎风险

• 批准号: 8542098
• 负责人: HONORIA M GUARINO
• 金额: $ 15.35万
• 依托单位: NATIONAL DEVELOPMENT AND RESEARCH INSTITUTES, INC.
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-07-01 至 2015-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8542098
• 关键词: Acculturation; Adolescent; Affect; Age; Alcohol or Other Drugs use; American; Area; Attitude; Behavioral; Characteristics; Client; Clinical; Communities; Country; Data; Development; Disease Outbreaks; Drug Targeting; Drug Utilization; Drug usage; Drug user; Ensure; Environment; Epidemic; Epidemiological Factors; Family; Focus Groups; Fright; HIV; Health Personnel; Hepatitis C; Hepatitis C Prevalence; Hepatitis C virus; Heroin; Human; Illicit Drugs; Immigrant; Immigration; Individual; Injection of therapeutic agent; Intervention; Interview; Knowledge; Life; Measures; Methodology; Methods; Modeling; Opioid; Parents; Pattern; Pharmaceutical Preparations; Population; Predisposition; Prevention approach; Preventive Intervention; Principal Investigator; Provider; Public Health; Recommendation; Recording of previous events; Recruitment Activity; Reporting; Research; Risk; Risk Behaviors; Risk Factors; Sampling; Series; Services; Shapes; Social Environment; Societies; Source; Stigmatization; Stress; Structure; System; Testing; Theoretical model; Treatment Factor; USSR; Underserved Population; Vulnerable Populations; Work; Youth; adolescent drug use; contextual factors; cost; design; disorder prevention; disorder risk; evidence base; experience; high risk; injection drug use; meetings; member; metropolitan; opioid misuse; outreach; preference; prevent; prevention service; protective behavior; psychosocial; public health relevance; public health research; research study; sex; social; standardize measure; surveillance data; treatment program; treatment strategy; young adult

DESCRIPTION (provided by applicant): Opioid Use and HIV/HCV Risk among Immigrant Youth from the Former Soviet Union Principal Investigator: Honoria Guarino Informed by social ecological models of the "risk environment", this exploratory study uses a mixed-methods approach to gain a multi-faceted, ethnographically-informed understanding of contextual factors shaping drug use, HIV/HCV risk, and utilization of drug treatment and HIV/HCV testing and prevention services among opioid-using young adult immigrants from the former Soviet Union (FSU). FSU immigrants are an increasingly significant group throughout the U.S. (nearly 1 million). Recent empirical and clinical evidence strongly suggests that opioid misuse and injection drug use (IDU) occur at alarmingly high rates among youth within FSU communities in the U.S., yet virtually no systematic research has been conducted on this problem. Moreover, due to a combination of sociocultural, behavioral and epidemiological factors unique to this population - including high-risk drug use environments in their countries of origin and, within their post- immigration communities, high rates of risky injection practices and sex work among young drug users and high background HCV prevalence - opioid-using FSU youth may be at heightened risk for HIV/HCV infection. These sources of vulnerability are compounded by a constellation of cultural factors specific to FSU immigrants, such as discomfort with traditional psychosocial drug treatment models predicated on self- revelation and a fear of community stigmatization, which have been reported to function as barriers to youths' use of drug treatment and disease prevention services. The proposed study will recruit a sample of 80 opioid- using FSU immigrants (ages 18-29) from the NYC area, 40 of whom will be in drug treatment, and 40 of whom will be current opioid users not in drug treatment. To allow us to characterize this understudied group, document their sex- and drug-related risk behaviors and drug use patterns, and explore the potential influence of immigration and acculturation on drug use and disease risk, these 80 youth will complete a series of structured assessments. Using theoretical sampling, a diverse subset of 24 youth will also be asked to participate in in-depth, qualitative interviews. In order to ensure that the research reflects the needs and perspectives of three key groups of FSU community stakeholders, we will also conduct: interviews with 6 experts with specialized knowledge of FSU youth drug use; focus groups with 12 drug treatment providers at facilities with substantial numbers of FSU clients; and interviews with 12 parents of opioid-using FSU youth. The proposed research promises to contribute significantly to public health by providing an evidence base to inform the development of culturally-targeted drug treatment approaches for the at-risk and underserved population of opioid-using FSU youth, as well as a culturally-appropriate HIV/HCV prevention intervention, to be developed in a subsequent proposal, that will be effective, acceptable, and engaging to this vulnerable group. Such empirically-grounded intervention efforts may help prevent localized outbreaks of HIV/HCV from occurring in FSU communities in the U.S. as have occurred in many former Soviet countries.

描述（申请人提供）：前苏联移民青年中阿片类药物使用和HIV/HCV风险主要研究者：根据“风险环境”的社会生态模型，这项探索性研究使用混合方法来获得多方面的，民族志上知情的理解，了解影响药物使用，艾滋病毒/HCV风险，在来自前苏联的使用阿片类药物的年轻成年移民中使用药物治疗和艾滋病毒/丙型肝炎病毒检测和预防服务。前苏联移民是一个越来越重要的群体在整个美国（近100万）。最近的经验和临床证据强烈表明，阿片类药物滥用和注射毒品（IDU）在美国FSU社区的青年中发生率高得惊人，但对这一问题几乎没有进行过系统的研究。此外，由于这一人群特有的社会文化、行为和流行病学因素的结合-包括其原籍国和移民后社区的高风险吸毒环境、年轻吸毒者中高风险注射做法和性工作的比率以及高背景HCV流行率-使用阿片类药物的FSU青年感染艾滋病毒/HCV的风险可能更高。这些脆弱性的根源因前苏联移民特有的一系列文化因素而更加复杂，如对基于自我暴露的传统心理社会戒毒模式感到不安，以及担心社区污名化，据报告，这些因素阻碍了青年人利用戒毒和疾病预防服务。拟议的研究将招募来自纽约地区的80名使用阿片类药物的前苏联移民（年龄18-29岁），其中40人将接受药物治疗，其中40人将是目前未接受药物治疗的阿片类药物使用者。为了使我们能够描述这个未充分研究的群体，记录他们与性和毒品相关的风险行为和毒品使用模式，并探索移民和文化适应对毒品使用和疾病风险的潜在影响，这80名青年将完成一系列结构化评估。使用理论抽样，24名青年的不同子集也将被要求参加深入，定性访谈。为了确保研究反映FSU社区利益相关者的三个关键群体的需求和观点，我们还将进行：与6名具有FSU青少年药物使用专业知识的专家进行访谈;与FSU客户数量可观的设施中的12名药物治疗提供者进行焦点小组;与12名阿片类药物使用FSU青少年的父母进行访谈。拟议的研究承诺通过提供证据基础，为使用阿片类药物的FSU青年的风险和服务不足人群制定文化靶向药物治疗方法，以及文化适当的艾滋病毒/HCV预防干预措施，将在随后的提案中开发，这将是有效的，可接受的，并参与这一弱势群体，从而为公共卫生做出重大贡献。这种以药物为基础的干预措施可能有助于防止美国前苏联社区发生HIV/HCV的局部爆发，就像许多前苏联国家发生的那样。