Risk Factors for HIV/AIDS in Drug Users

描述(由申请人提供)：风险因素项目研究了1978年以来纽约市注射吸毒者中艾滋病毒的大规模流行(使用储存的血清)和自1995年以来非注射海洛因和可卡因吸毒者中艾滋病毒的大规模流行。在我们目前的研究中，我们证明了注射吸毒者中艾滋病毒传播的急剧减少，但在死亡者中艾滋病毒的传播也大幅增加。(在过去十年中，纽约市死亡者中艾滋病毒流行率翻了一番)。单纯疱疹病毒-2(HSV-2)与HIV的传播密切相关，我们已确定HSV-2的流行是纽约市死点中HIV传播的主要因素。拟议研究的具体目标包括：1)在纽约市死亡者和注射吸毒者中监测艾滋病毒流行持续演变过程中的危险行为、艾滋病毒流行率和发病率和服务利用情况。2)量化纽约市海洛因和可卡因吸毒者中HIV和HSV-2感染之间的长期人口水平关系，包括检验HSV-2和HIV之间的关联强度随着时间的推移而增加的假设。最近的干预研究极大地增加了理解HSV-2/HIV关系的必要性。3)评价纽约市卫生局(NYC DOH)安全套社会营销活动对纽约市注射吸毒者和死因人群的性危险行为和HIV和HSV-2感染的影响。4)监测纽约市注射吸毒者中与性有关和注射相关的艾滋病毒传播模式。在纽约市，死因和注射毒品之间有许多联系。最好将吸毒者和注射吸毒者视为纽约市吸食海洛因和可卡因的单一人群中的关联群体。彻底了解死因中的性传播需要了解该市注射吸毒者中的性传播和性传播。5)评估死亡者和注射吸毒者感染艾滋病毒的种族/族裔差异的新模式。6)干预性发展。这些目标将通过继续我们对死亡者和注射吸毒者进入纽约贝丝以色列药物治疗计划的研究来实现。这项拟议的研究将是第一次研究艾滋病毒在非常大的死因人群中随时间的传播，第一次评估在死因人群中人类免疫缺陷病毒-2与艾滋病毒的关系随时间的变化，以及第一次评估非常大的避孕套社会营销活动对死因和注射吸毒者的性危险行为的影响。

DESCRIPTION (provided by applicant): The Risk Factors project has studied the very large HIV epidemic among injecting drug users (IDUs) in New York City from 1978 (using stored sera) and the very large HIV epidemic among non-injecting heroin and cocaine drug users (NIDUs) since 1995. In our current research, we have demonstrated a dramatic reduction in HIV transmission among IDUs, but also a substantial increase in HIV among NIDUS. (HIV prevalence has doubled among NIDUs in NYC over the last decade). Herpes simplex virus-2 (HSV-2) is strongly associated with HIV transmission, and we have identified prevalence HSV-2 as a major factor associated with HIV transmission among NIDUs in NYC. The specific aims of the proposed research include: 1) Monitoring risk behavior, HIV prevalence and incidence and service utilization in the continuing evolution of the HIV epidemic among NIDUs and IDUs in New York City. 2) Quantifying the long-term population-level relationships between HIV and HSV-2 infections among heroin and cocaine users in NYC, including testing the hypothesis that the strength of the association between HSV-2 and HIV increases over time. Recent intervention studies have dramatically increased the need for understanding HSV-2/HIV relationships. 3) Evaluating effects of the New York City Department of Health (NYC DOH) Condom Social Marketing campaign on sexual risk behaviors and HIV and HSV-2 infection among IDUs and NIDUs in NYC. 4) Monitoring patterns of sexual and injection related HIV transmission among IDUs in NYC. There are many linkages between NIDUs and IDUs in NYC. NIDUs and IDUs are best viewed as linked groups within a single population of heroin and cocaine users in NYC. A thorough understanding of sexual transmission among NIDUs requires an understanding of both injecting and sexual transmission among IDUs in the city. 5) Assess new patterns of racial/ethnic differences in HIV infection among NIDUs and IDUs. 6) Intervention development. These aims will be accomplished through continuation of our studies of NIDUs and IDUs entering Beth Israel drug treatment programs in NYC. The proposed research will be the first study of the spread of HIV over time in a very large population of NIDUs, the first assessment of change in the relationship of HVS-2 to HIV over time among NIDUs, and the first assessment of the effects of a very large condom social marketing campaign on sexual risk behavior of NIDUs and IDUs.