HIV, HCV and STI Risk Associated with Nonmedical Use of Prescription Opioids

与非医疗用途处方阿片类药物相关的 HIV、HCV 和 STI 风险

• 批准号: 8613482
• 负责人: Pedro Mateu-Gelabert
• 金额: $ 61.37万
• 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: 2013-02-15 至 2017-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8613482
• 关键词: Abbreviations; Adolescent; Adolescent and Young Adult; Age; Area; Behavior; Biological; Blood; Characteristics; Chlamydia; Dependence; Development; Disease; Drug Prescriptions; Drug usage; Drug user; Employee Strikes; Equipment; Ethnic Origin; Friends; Gonorrhea; Gossypium; HIV; HIV Infections; Harm Reduction; Health; Hepatitis C; Hepatitis C virus; Heroin; Household; Illicit Drugs; Individual; Infection; Injection of therapeutic agent; Intervention; Interview; Knowledge; Lead; Legal; Marijuana; Methodology; Methods; Minority; New York City; Opiate Addiction; Opioid; Organism; Outcome; Overdose; Participant; Pathway interactions; Pattern; Pharmaceutical Preparations; Pilot Projects; Population; Predisposition; Prevalence; Preventive; Public Health; Qualitative Methods; Race; Recording of previous events; Recreational Drugs; Recruitment Activity; Relative (related person); Reporting; Research; Research Design; Respondent; Risk; Risk Behaviors; Route; Sampling; Services; Sex Behavior; Shapes; Social Environment; Source; Street Drugs; Subgroup; Syringes; Testing; Time; United States Substance Abuse and Mental Health Services Administration; Unsafe Sex; Virus Diseases; Water; Youth; base; disorder prevention; disorder risk; high risk; injection drug use; innovation; life history; nonmedical use; prescription opioid; prevent; public health relevance; research study; sex; sex risk; sexual relationship; sexual risk taking; theories; therapy design; trend; young adult

DESCRIPTION (provided by applicant): Currently, an estimated 4.8% of the U.S. population reports past-year nonmedical use of prescription opioids (NMU-POs), an increase of over 40% from 10 years ago. Among young adults 18-25 years old, the prevalence is markedly higher (11.1%). Young NMU-POs are often naive to the serious risks associated with such use, tending to view prescription drugs as relatively safe in comparison to illicit street drugs. Although the majority of NMU-POs begin ingesting POs orally, emerging research demonstrates that a significant minority may transition to heroin use and/or injection drug use (IDU), often within 2-3 years of NMU-PO initiation. This suggests that NMU-PO may function as a new pathway into heroin use and dependence and IDU among youth. IDU and heroin use is associated with significant negative health outcomes, increased sexual risk behavior and increased susceptibility to route-specific infections. These risks are exacerbated by the fact that harm reduction services aimed at preventing HIV among IDUs typically serve older heroin injectors who have been found to differ in age, race/ethnicity and other characteristics from the emerging group of young NMU-POs. The striking increases in NMU-PO throughout the U.S. are thus alarming from a public health perspective, and may lead to increases in HCV and HIV prevalence among groups of NMU-POs. However, research on drug-use trajectories, drug and sexual risk behaviors and, most notably, HIV, HCV and STI prevalence rates, in NMU-PO populations remains scarce. Although very little research to date has examined the sexual risk behaviors of NMU-POs, the body of research on young urban drug users, as well as our team's pilot study of 18-29 year-old NMU-POs, suggests that high levels of sexual risk-taking may be common among NMU-PO young adults. The proposed mixed-methods study will assess the drug and sex-related HIV/HCV/STI risk associated with NMU-PO among young adults. Specifically, we will: characterize the drug-use patterns and sexual behaviors of a representative RDS-recruited sample of 600 NMU-POs (ages 18-29) in the New York City area; determine the proportion of this population that engages in IDU and/or heroin use; and identify individual, network and socio-structural factors that may predispose some NMU-PO young adults to engage in IDU and/or the use of heroin. In addition, key objectives of this research will be to systematically document the HIV/HCV/Chlamydia and Gonorrhea risk and preventive behaviors, knowledge, testing practices and prevalence rates of NMU-PO young adults. Foundational research that elucidates drug- and sex-related risk behaviors and HIV, HCV and other STI prevalence rates among this growing group of young NMU-POs is necessary for the development of disease prevention messages and interventions tailored to their specific characteristics, needs and drug-use and sexual practices. Furthermore, this research will help identify young NMU-POs who are likely to transition to heroin use and/or IDU, enabling interventions designed to prevent or delay these behaviors to be targeted to groups of youth who are most at-risk.

目前，估计有4.8%的美国人口报告去年非医疗使用处方阿片类药物（NMU-PO），比10年前增加了40%以上。在18-25岁的年轻人中，患病率明显较高（11.1%）。年轻的NMU-PO往往对与这种使用相关的严重风险一无所知，倾向于认为处方药与非法街头毒品相比相对安全。虽然大多数非吸毒者开始是口服毒品，但新的研究表明，相当一部分人可能会过渡到海洛因使用和/或注射毒品使用（IDU），通常在2-3年内。 多年的NMU-PO启动。这表明，NMU-PO可能是青年人海洛因使用和依赖以及注射吸毒的新途径。IDU和海洛因的使用与显著的负面健康结果、性风险行为增加和对特定途径感染的易感性增加有关。由于旨在预防注射吸毒者中艾滋病毒的减少危害服务通常为年龄较大的海洛因注射者提供服务，这些人被发现在年龄、种族/族裔和其他特征上与新出现的年轻非吸毒者组织的参与者群体不同，因此这些风险更加严重。因此，从公共卫生的角度来看，整个美国NMU-PO的显著增加是令人震惊的，并且可能导致NMU-PO群体中HCV和HIV流行率的增加。然而，对非流动人口中的吸毒轨迹、吸毒和性风险行为，特别是艾滋病毒、丙型肝炎病毒和性传播感染流行率的研究仍然很少。虽然迄今为止很少有研究调查NMU-PO的性风险行为，但对年轻城市吸毒者的研究以及我们团队对18-29岁NMU-PO的试点研究表明，高水平的性风险行为在NMU-PO年轻人中可能很常见。拟议的混合方法研究将评估年轻人中与NMU-PO相关的药物和性别相关的HIV/HCV/STI风险。具体而言，我们将：描述在纽约市地区由RDS招募的600名NMU-PO（年龄18-29岁）的代表性样本的吸毒模式和性行为;确定这一人群中从事注射吸毒和/或海洛因使用的比例;并确定可能使一些NMU-PO年轻成年人从事注射吸毒和/或海洛因使用的个人、网络和社会结构因素。此外，本研究的主要目标将 系统地记录NMU-PO年轻人的HIV/HCV/衣原体和淋病风险和预防行为、知识、检测实践和患病率。有必要开展基础研究，阐明这一日益增多的年轻非流动人口中与毒品和性有关的风险行为以及艾滋病毒、丙型肝炎病毒和其他性传播感染的流行率，以制定针对其具体特点、需求以及吸毒和性行为的疾病预防信息和干预措施。此外，这项研究将有助于确定可能过渡到海洛因使用和/或注射吸毒的年轻NMU-PO，使旨在预防或延迟这些行为的干预措施能够针对风险最高的青年群体。