Multiple HIV Prevention Packages for IDUs in Estonia

爱沙尼亚为注射吸毒者提供多种艾滋病毒预防方案

• 批准号: 8279278
• 负责人: Don C Des Jarlais
• 金额: --
• 依托单位: BETH ISRAEL MEDICAL CTR (NEW YORK)
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-06-08 至 2014-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8279278
• 关键词: AIDS prevention; AIDS/HIV problem; Address; Adherence; Area; Automobile Driving; Behavior; Behavior Therapy; Central Asia; Collaborations; Communities; Country; Developing Countries; Drug abuse; Drug usage; Drug user; Eastern Europe; Effectiveness; Epidemic; Estonia; Financial compensation; Future; Goals; HIV; HIV Infections; HIV Seroprevalence; Heterosexuals; Incidence; Individual; Injecting drug user; Intervention; Knowledge; Low income; Meta-Analysis; Methods; Modeling; Monitor; Needle Sharing; Persons; Pharmacologic Substance; Pilot Projects; Policies; Population; Prevalence; Prevention; Prevention program; Public Health; Reporting; Research; Risk; Risk Assessment; Risk Behaviors; Screening procedure; Seroprevalences; Sexual Partners; Sexual Transmission; Sexually Transmitted Diseases; Signal Transduction; Southern Asia; Specific qualifier value; Syringes; Testing; Treatment Protocols; Update; Woman; Work; condoms; design; high risk; improved; intervention effect; motivational enhancement therapy; non-drug; prevent; programs; psychologic; response; sex risk; sexually active; social; substance abuse treatment; systematic review; transmission process

DESCRIPTION (provided by applicant): High seroprevalence epidemics among IDUs pose two critical inter-related questions for public health: how to halt ongoing HIV transmission among IDUs and how to halt the transition from a concentrated IDU epidemic to a generalized heterosexual epidemic. While there are several interventions that have been shown effective in reducing risk behavior among IDUs, no single intervention is effective for all IDUs. Thus, these inter-related problems provide an ideal context for studying combinations of prevention programs. There are five Specific Aims in the proposed research: 1.Conduct systematic reviews of social structural and behavioral interventions to reduce injecting and sexual risk behavior, and biomedical interventions (drug abuse treatment, STI treatment) to reduce risk behavior among injecting drug users, and interventions to build community and policy support for HIV prevention among IDUs. For interventions with previous systeml interventions to reduce injecting and sexual risk behaviors among IDUs and of combinations of interventions at different levels of coverage, including optimization strategies for reducing HIV transmission among IDUs and from IDUs to non-drug using sexual partners 3. Monitor the ongoing high seroprevalence HIV epidemics among IDUs in Tallinn, Estonia to assess current interventions and model an "optimal" set of interventions for that epidemic. HIV prevalence is currently over 50% among IDUs in Tallinn, estimated incidence is over 20/100 person-years at risk and IDUs report high rates of multiple sexual partnerships with inconsistent condom use. 4. Conduct a pilot study of screening and treatment for sexually transmitted infections (STIs) among IDUs in Tallinn to assess feasibility and effectiveness in reducing sexual transmission among IDUs and from IDUs to non-drug injecting sexual partners. The pilot study will include biomedical intervention (screening and treatment) with a state-o transmission from IDUs to non-drug injecting sexual partners are two critical public health problems in many different countries. These inter-related problems are an ideal context for studying the effects of combined HIV prevention programs. Public health significance: Reducing HIV transmission among IDUs and preventing transmission from IDUs to non-drug injecting sexual partners are two critical public health problems in many different countries. These inter-related problems are an ideal context for studying the effects of combined HIV prevention programs.

描述(由申请人提供)： 注射吸毒者中的高血清流行率对公共卫生提出了两个相互关联的关键问题：如何阻止注射吸毒者中持续的艾滋病毒传播，以及如何阻止从集中的注射吸毒者流行向普遍的异性流行的过渡。虽然有几种干预措施被证明在减少注射吸毒者风险行为方面是有效的，但没有一种干预措施对所有注射吸毒者有效。因此，这些相互关联的问题为研究预防方案的组合提供了理想的背景。拟议的研究有五个具体目标：1.对减少注射和性危险行为的社会结构和行为干预措施、减少注射吸毒者危险行为的生物医学干预措施(药物滥用治疗、性传播感染治疗)进行系统审查，以及为静脉注射吸毒者预防艾滋病毒建立社区和政策支持的干预措施。为减少注射吸毒者中的注射和性危险行为而采取的干预措施，以及在不同覆盖水平上的干预措施组合，包括减少注射吸毒者之间以及从注射吸毒者向非吸毒性伴侣传播艾滋病毒的优化战略3.监测爱沙尼亚塔林注射吸毒者中目前高血清阳性率的艾滋病毒流行，以评估目前的干预措施，并为这一流行病建立一套“最佳”干预措施模式。目前在塔林的注射吸毒者中艾滋病毒流行率超过50%，估计发病率超过20/100人-年处于危险之中，注射吸毒者报告多次性伴关系和安全套使用不一致的比率很高。4.在塔林对注射吸毒者进行性传播感染筛查和治疗的试点研究，以评估在减少注射吸毒者和注射毒品者向非注射毒品性伴侣传播方面的可行性和有效性。试点研究将包括生物医学干预(筛查和治疗)，从注射吸毒者向非注射毒品的性伴侣传播是许多不同国家的两个关键公共卫生问题。这些相互关联的问题是研究艾滋病毒综合预防方案效果的理想环境。公共卫生意义：在许多不同的国家，减少艾滋病毒在注射吸毒者中的传播和防止从注射毒品者向非注射毒品的性伴侣传播是两个严重的公共卫生问题。这些相互关联的问题是研究艾滋病毒综合预防方案效果的理想环境。

项目成果

Transitions from injection-drug-use-concentrated to self-sustaining heterosexual HIV epidemics: patterns in the international data.

• DOI: 10.1371/journal.pone.0031227
• 发表时间: 2012
• 期刊: PloS one
• 影响因子: 3.7
• 作者: Des Jarlais DC;Feelemyer JP;Modi SN;Arasteh K;Mathers BM;Degenhardt L;Hagan H
• 通讯作者: Hagan H

Effectiveness of structural-level needle/syringe programs to reduce HCV and HIV infection among people who inject drugs: a systematic review.

结构水平的针/注射器计划的有效性减少注射药物的人的HCV和HIV感染：系统评价。

• DOI: 10.1007/s10461-013-0593-y
• 发表时间: 2013-11
• 期刊: AIDS and behavior
• 影响因子: 4.4
• 作者: Abdul-Quader AS;Feelemyer J;Modi S;Stein ES;Briceno A;Semaan S;Horvath T;Kennedy GE;Des Jarlais DC
• 通讯作者: Des Jarlais DC

Are females who inject drugs at higher risk for HIV infection than males who inject drugs: an international systematic review of high seroprevalence areas.

• DOI: 10.1016/j.drugalcdep.2011.12.020
• 发表时间: 2012-07-01
• 期刊: DRUG AND ALCOHOL DEPENDENCE
• 影响因子: 4.2
• 作者: Des Jarlais, Don C.;Feelemyer, Jonathan P.;Modi, Shilpa N.;Arasteh, Kamyar;Hagan, Holly
• 通讯作者: Hagan, Holly

Retention of participants in medication-assisted programs in low- and middle-income countries: an international systematic review.

• DOI: 10.1111/add.12303
• 发表时间: 2014-01
• 期刊: Addiction (Abingdon, England)
• 作者: Feelemyer J;Des Jarlais D;Arasteh K;Abdul-Quader AS;Hagan H
• 通讯作者: Hagan H

Socio-demographic factors, health risks and harms associated with early initiation of injection among people who inject drugs in Tallinn, Estonia: evidence from cross-sectional surveys.

爱沙尼亚塔林注射吸毒者与早期开始注射相关的社会人口因素、健康风险和危害：来自横断面调查的证据。

• DOI: 10.1016/j.drugpo.2012.08.003
• 发表时间: 2013
• 期刊: The International journal on drug policy
• 作者: Vorobjov,Sigrid;DesJarlais,DonC;Abel-Ollo,Katri;Talu,Ave;Rüütel,Kristi;Uusküla,Anneli
• 通讯作者: Uusküla,Anneli