Community-based Methamphetamine Use & HIV Risk in China

描述(申请人提供)：近年来，在美国、欧洲、加拿大、澳大利亚和亚洲，甲基苯丙胺的使用量急剧增加。联合国毒品和犯罪问题办公室(2004年)报告称，中国的甲基苯丙胺生产和滥用大幅增加。然而，目前几乎没有来自社区研究的流行病学数据来检查中国滥用甲基苯丙胺的性质和程度。本R21申请“中国地区甲基苯丙胺使用与艾滋病风险社区研究”是根据国际药物成瘾研究合作组织(PA-07-310)的公告提交的。该项目的总体目标是利用定性和定量的方法，识别和描述中国地区冰毒吸毒者中的吸毒和艾滋病毒风险相关行为。该项目的长期目标是为中国城区冰毒使用者开展以理论为基础的艾滋病风险降低干预。人种学方法，包括对40名甲基苯丙胺使用者的访谈，将产生关于甲基苯丙胺滥用和艾滋病毒风险的描述性数据。此外，还将采用受访者驱动抽样方法，从湖南省省会城市长沙市抽取300名冰毒使用者，对中国进行结构化调查。样本将在基线访谈后3个月进行跟踪调查。本研究的具体目的是：1)采用人种学/定性的方法，描述中国地区冰毒吸毒者吸毒行为和艾滋病危险行为的关键维度。2)对中南部中国地区冰毒吸毒者进行冰毒使用情况、其他吸毒情况、吸毒因素、健康问题、治疗利用、治疗障碍、涉黑情况等的调查，并调查三个月期间吸毒行为、健康状况、治疗利用、社会问题等方面的变化。3)确定中国冰毒使用者在三个月内的艾滋病毒危险行为。以及4)生成数据，为中国甲基苯丙胺使用者制定艾滋病毒风险降低干预措施。本研究具有重要意义：1)中国中南部地区冰毒吸毒者滥用冰毒的性质、程度及艾滋病危险行为知之甚少。2)这项拟议研究的结果将被用于开发第一个基于理论的艾滋病毒风险降低干预措施，该干预措施对中国冰毒使用者具有文化敏感性。这项拟议的研究具有创新性，因为1)这将是中国第一次以社区为基础的甲基苯丙胺滥用研究。2)这将是首次使用中南中国的数据对冰毒使用和艾滋病毒风险进行研究，南宁存在严重的药物滥用问题。3)采用被调查者驱动抽样(RDS)的方式招募冰毒吸毒者。因此，与传统的外展方法相比，样本将更能代表目标隐藏人口。 公共卫生相关性：本研究将探讨滥用甲基苯丙胺在中国中南部地区艾滋病危险行为中的作用。具体地说，通过探索启蒙经验和最近的使用模式，我们将探索冰毒使用如何在中国塑造艾滋病毒风险的社会模式。这项研究的发现将使开发一种文化敏感的、基于理论的艾滋病毒风险降低干预措施成为可能。

DESCRIPTION (provided by applicant): The use of methamphetamine has increased dramatically in recent years in the United States, Europe, Canada, Australia, and Asia. The United Nations Office on Drugs & Crime (2004) reports large increases in methamphetamine production and abuse in China. However, little epidemiologic data from community-based studies is currently available to examine the nature and extent of methamphetamine abuse in China. This R21 application, "Community-based study on methamphetamine use & HIV risk in China," is submitted in response to the International Research Collaboration on Drug Addiction (PA-07-310) announcement. The project's overall aim is to identify and describe drug abuse and HIV risk-related behaviors among methamphetamine users in China, using qualitative and quantitative methods. The long-term goal of this project is to develop a theory-based HIV risk-reduction intervention for methamphetamine users in the urban areas of China. Ethnographic methods, including interviews with 40 methamphetamine users, will generate descriptive data on methamphetamine abuse and HIV risk. In addition, Respondent-Driven Sampling (RDS) will be used to recruit 300 methamphetamine users from provincial capital city Changsha in the Hunan Province located in the Central South China for a structured survey. The sample will be followed at 3-months after the baseline interview. The specific aims of the study are to: 1) Describe key dimensions in drug use practices and HIV risk behaviors among methamphetamine users in China, using ethnographic/qualitative methods. 2) Examine methamphetamine users in the Central South China on patterns of methamphetamine use, patterns of other drug use, and factors associated with drug use, health problems, treatment utilization, barriers to treatment, and criminal involvement, and to examine changes in drug use practices, health status, treatment utilization, and social problems over a three-month period. 3) Identify HIV risk behaviors among Chinese methamphetamine users over a three-month period. And 4) generate data to develop an HIV risk reduction intervention for Chinese methamphetamine users. This study is significant: 1) Little is known about the nature and extent of methamphetamine abuse, as well as HIV risk behaviors among methamphetamine users in Central South China. 2) Findings from the proposed study will be used to develop the first theory-based HIV risk reduction intervention that is culturally sensitive for Chinese methamphetamine users. The proposed study is innovative because 1) It will be the first community based study of methamphetamine abuse in China. 2) It will be the first study of methamphetamine use and HIV risk using data from Central South China, which has serious substance abuse problems. 3) It applies respondent-driven-sampling (RDS) to recruit methamphetamine users. Thus, the sample will be more representative of the target hidden population, compared with traditional outreach approaches. PUBLIC HEALTH RELEVANCE: This study will explore the role of methamphetamine abuse in HIV risk behaviors in Central South China. Specifically, through the exploration of initiation experiences and recent patterns of use, we will explore the ways in which methamphetamine use shapes the social patterning of HIV risk in China. The findings from this study will enable the development of a culturally-sensitive, theory-based HIV risk reduction intervention.