Examining the social, spatial, and temporal context of injection drug use and HIV and HCV risk among people who inject drugs in Ukraine

项目摘要 本项目将使用活动空间方法来探索HIV/HCV注射风险行为的差异 和保护因素之间的人谁使用毒品（PWID）在乌克兰。流行病学报告估计， 在乌克兰，超过三分之一的PWID是艾滋病毒阳性，68%的PWID是艾滋病毒/丙型肝炎病毒合并感染。用药 乌克兰的情况提出了独特的艾滋病毒/HCV预防挑战。与世界上许多地方不同， 乌克兰注射毒品以液体形式出售。经销商可以通过后装或前装来分销毒品 或者用户可以购买预装注射器中的药物或从注射器中抽取制备好的药物。 一个普通的容器。乌克兰PWID通常在网络成员群体中注射，并在不同的地方使用毒品。 这些场所包括在家中、街道上、俱乐部中以及空地和小巷中。通过他们的日常活动， PWID遇到不同的地方与独特的个人组成谁是从事保护或风险 加剧行为。此外，社交网络和地点已被认为具有重要作用 在塑造HIV/HCV风险行为方面。吸毒者的社交网络在不同地点并不是静态的， 不同的质量（例如，风险等级），基于特定位置的网络组成， 该地点的特征（例如，公共或私人）。“活动空间”是指这种独特的组合， 个人在日常活动中直接接触的场所、社交网络和行为。 这项为期2年的研究的具体目的是：1）描述敖德萨PWID的日常生活和日常路径， 乌克兰，并调整活动空间清单，以适应乌克兰的情况;和2）审查差异， 活动空间的场所和自我中心网络特征。我们将对30名 乌克兰敖德萨的PWID围绕日常事务（他们从事的活动）和日常路径（他们的活动）进行组织。 他们的活动发生的具体地点），以了解他们的社会和基于地点的背景， PWID的生活，包括吸毒和非吸毒活动。这些数据将被分析， 按活动空间划分的HIV/HCV注射风险和保护行为。这些信息将用于 定量探讨150名PWID中的地点、社交网络和HIV/HCV风险之间的关系 通过活动空间清单。乌克兰毒品使用的独特方面对联合国毒品和犯罪问题办公室构成了严峻挑战， 为PWID制定有效的HIV/HCV预防干预措施。这项研究将PWID置于更广泛的 背景，探讨他们的吸毒相关的社交网络，规范和行为，以及非毒品使用 可能减少或加剧HIV/HCV风险的社会背景。结果将告知发展和安置 针对具体吸毒情况和相关社会网络成员的干预战略， 规范高效 .

Project Summary This project will use an activity space approach to explore differences in HIV/HCV injection risk behaviors and protective factors among people who use drugs (PWID) in Ukraine. Epidemiological reports estimate that over a third of PWID in Ukraine are HIV-positive, and 68% of PWID are HIV/HCV coinfected. The drug use context in Ukraine presents unique HIV/HCV prevention challenges. Unlike many places in the world, in Ukraine injection drugs are sold in liquid form. A dealer may distribute drugs by backloading or frontloading the solution into users' syringes, or users may purchase drugs in pre-loaded syringes or draw prepared drugs from a common container. Ukrainian PWID typically inject in groups of network members and use drugs in diverse places, including in homes, on streets, in clubs, and in vacant lots and alleys. Through their daily activities, PWID encounter various places with unique compositions of individuals who are engaged in protective or risk exacerbating behaviors. Moreover, social networks and place have been recognized as having important roles in shaping HIV/HCV risk behaviors. Drug users' social networks are not static across locations and have different qualities (e.g., levels of risk) based upon the composition of a network at a particular location and characteristics of that place (e.g., public or private). An “activity space” refers to this unique combination of place, social network, and behavior that individuals have direct contact with as a result of their daily activities. The Specific Aims of this 2 year study are: 1) To describe the daily routine and daily path of PWID in Odesa, Ukraine, and adapt an Activity Space Inventory to the Ukrainian context; and 2) To examine differences in place and egocentric network characteristics by activity space. We will conduct in-depth interviews with 30 PWID in Odesa, Ukraine structured around daily routine (the activities that they engage in) and daily path (the specific places in which their activities occur) in order to understand the social and place-based contexts of PWIDs' lives, including both drug use and non-drug using activities. These data will be analyzed to examine HIV/HCV injection risk and protective behaviors by activity space. This information will then be used to quantitatively explore the relationship between place, social networks, and HIV/HCV risk among 150 PWID through an Activity Space Inventory. The unique aspects of drug use in Ukraine create acute challenges to the development of effective HIV/HCV prevention interventions for PWID. This study places PWID in a broader context that explores both their drug use related social networks, norms, and behaviors, and the non-drug use social context that may diminish or exacerbate HIV/HCV risk. Results will inform development and placement of intervention strategies tailored to specific drug use contexts and associated social network members and norms. .