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: 7680539
• 负责人: Don C Des Jarlais
• 金额: $ 77.92万
• 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 2013-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7680539
• 关键词: AIDS prevention; AIDS/HIV problem; Address; Adherence; Area; Arts; Automobile Driving; Behavior; Behavior Therapy; Collaborations; Communities; Country; Developed Countries; Developing Countries; Drug abuse; Drug usage; 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; Substance abuse problem; 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; 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阳性率流行病对公共卫生提出了两个关键的相互关联的问题：如何阻止注射吸毒者中艾滋病毒的持续传播以及如何阻止从集中的注射吸毒者流行病向普遍的异性恋流行病的转变。虽然有多种干预措施已被证明可以有效减少注射吸毒者的危险行为，但没有一种干预措施对所有注射吸毒者都有效。因此，这些相互关联的问题为研究预防计划的组合提供了理想的背景。拟议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）以及为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进行系统回顾。与以前的系统性干预措施相结合，以减少注射吸毒者中的注射和性危险行为，并结合不同覆盖水平的干预措施，包括减少注射吸毒者之间以及从注射吸毒者到非吸毒性伴侣的艾滋病毒传播的优化策略 3. 监测爱沙尼亚塔林注射吸毒者中持续的高血清阳性率艾滋病毒流行，以评估当前的干预措施，并为以下群体建立一套“最佳”干预措施模型： 那个流行病。目前，塔林注射吸毒者中艾滋病毒感染率超过 50%，估计发病率超过 20/100 人年，注射吸毒者报告说，多次性伴侣且安全套使用不一致的比例很高。 4. 在塔林开展注射吸毒者性传播感染（STI）筛查和治疗试点研究，以评估减少注射吸毒者之间以及注射吸毒者向非注射吸毒性伴侣的性传播的可行性和有效性。该试点研究将包括生物医学干预（筛查和治疗），其中从注射吸毒者到非注射吸毒性伴侣的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计划效果的理想背景。公共卫生意义：减少注射吸毒者之间的艾滋病毒传播和防止注射吸毒者向非注射吸毒性伴侣传播艾滋病毒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计划效果的理想背景。