Couples-Based HIV/STI Prevention for Injecting Drug Users in Kazakhstan

哈萨克斯坦注射吸毒者以夫妻为基础的艾滋病毒/性传播感染预防

• 批准号: 8265718
• 负责人: Nabila El-Bassel
• 金额: $ 60.98万
• 依托单位: COLUMBIA UNIV NEW YORK MORNINGSIDE
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-07-15 至 2013-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8265718
• 关键词: AIDS prevention; AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; Afghanistan; Age; Asians; Behavior; Behavior Therapy; Behavioral; Biological; Centers for Disease Control and Prevention (U.S.); Central Asia; Child Sexual Abuse; China; Chlamydia; Coitus; Collaborations; Communication; Couples; Criminal Justice; Drug Addiction; Drug abuse; Drug usage; Eligibility Determination; Epidemic; Epidemiology; Ethics; Expectancy; Gender; Gonorrhea; HIV; HIV/STD; Health; Hepatitis C; Hepatitis C Incidence; Hepatitis C virus; Heterosexuals; Incidence; Infection; Infection prevention; Injecting drug user; Injection of therapeutic agent; Institutes; Interdisciplinary Study; International; International AIDS; Intervention; Kazakhstan; Knowledge; Length; Link; Maps; Measures; Mediating; Mediator of activation protein; Needle Sharing; Needle-Exchange Programs; Needles; Outcome; Participant; Patient Self-Report; Pharmaceutical Preparations; Population; Population Study; Prevention Protocols; Prevention Research; Prevention approach; Preventive Intervention; Principal Investigator; Protocols documentation; Public Health; Race; Randomized; Randomized Controlled Trials; Recording of previous events; Recruitment Activity; Reporting; Research; Research Infrastructure; Research Institute; Research Personnel; Research Training; Risk Behaviors; Risk Reduction; Route; Russia; Schools; Self Efficacy; Sexual Partners; Sexually Transmitted Diseases; Site; Social Work; Social support; Study Section; Substance abuse problem; Syphilis; Syringes; Testing; Universities; Vagina; Venipunctures; base; condoms; efficacy testing; experience; follow-up; global health; group intervention; high risk; innovation; intimate partner violence; meetings; outreach; peer; pilot trial; post intervention; prevention service; programs; psychological distress; public health relevance; research and development; satisfaction; sex; skills; skin disorder; social; stem; trafficking; treatment effect

DESCRIPTION (provided by applicant): The proposed study will rigorously test the efficacy of an innovative, couples-based HIV/STI risk reduction intervention (CHSR) to decrease new cases of HIV and Hepatitis C (HCV) and incidence of sexually transmitted infections (STIs), as well as to reduce unsafe injection practices and increase condom use among injecting drug users (IDUs) and their heterosexual, intimate partners in Shu, Kazakhstan. Central Asia has experienced one of the fastest growing HIV/AIDS epidemics due to a sharp increase in injection drug use. This investigative team from the Social Intervention Group at Columbia University and the Shu Policlinic Needle Exchange Program in Kazakhstan completed a pilot randomized controlled trial of the proposed CHSR among 40 IDUs and their primary, heterosexual partners (N=80) in Shu, Kazakhstan. Compared to participants assigned to the wellness promotion comparison condition (WP) (n=40), CHSR participants (n=40) reported significantly fewer unsafe injection behaviors and greater condom use from baseline to the 3-month follow-up. For the proposed study, the participants will be 400 IDUs and their heterosexual, intimate partners, who meet eligibility criteria (e.g., at least one partner reports unsafe injection and unprotected sexual intercourse in the past 30 days). Participants will be recruited from the Shu Policlinic needle exchange program and through street outreach in Shu. Shu is located along a major drug trafficking route and has an estimated 4,500 IDUs out of a population of 35,000. In the proposed study, 400 couples will be randomized to one of two interventions: a 5-session couples-based HIV/STI risk reduction intervention or a 5- session couples-based wellness promotion intervention, which will serve as a comparison condition. Participants will be assessed with repeated measures at baseline, 3-, 6- and 12-months post-intervention. The primary behavioral outcomes are self- reported proportion of injection acts in which needles or syringes are shared in the past 30 days and proportion of condom-protected acts of sexual intercourse in the past 30 days. The primary biological outcomes are the rate of new HIV cases and new HCV cases, as well as the incidence of Chlamydia, gonorrhea, and syphilis over the 12-month post-intervention period. The proposed study will advance the understanding of HIV/HCV/STI risk reduction among a population of IDUs and their heterosexual partners, and thereby help to stem the rising epidemic of HIV, HCV, and STIs in Kazakhstan and Central Asia. PUBLIC HEALTH RELEVANCE The proposed study addresses a significant public health threat of HIV, HCV and other STIs among a very high risk population of active IDUs and their sexual partners in Kazakhstan - a region that is experiencing one of the fastest rising HIV epidemics in the world. There is a race to develop and implement effective HIV preventive interventions for IDUs and their sexual partners to stem the spread of HIV, HCV and other STIs in Shu and other Central Asian towns along drug trafficking routes.

描述（申请人提供）：拟议的研究将严格测试一项创新的、以夫妇为基础的艾滋病毒/性传播感染风险降低干预措施（CHSR）的有效性，以减少艾滋病毒和丙型肝炎（HCV）的新病例和性传播感染（STI）的发病率，以及减少不安全的注射做法，并增加Shu的注射毒品使用者（IDUs）及其异性亲密伴侣中安全套的使用，哈萨克斯坦.由于注射吸毒的急剧增加，中亚是艾滋病毒/艾滋病流行病蔓延最快的地区之一。来自哥伦比亚大学社会干预小组和哈萨克斯坦Shu诊所针头交换计划的调查小组在哈萨克斯坦Shu的40名注射吸毒者及其主要异性伴侣（N=80）中完成了一项拟议的CHSR的试点随机对照试验。与分配到健康促进比较条件（WP）的参与者（n=40）相比，CHSR参与者（n=40）报告从基线到3个月随访的不安全注射行为显著减少，安全套使用率显著增加。对于拟议的研究，参与者将是400名注射吸毒者及其异性恋亲密伴侣，他们符合资格标准（例如，在过去30天内，至少有一名伴侣报告了不安全注射和无保护性交）。参与者将从Shu Policlinic针头交换计划和Shu的街道外展中招募。舒位于沿着一条主要的贩毒路线上，在35，000人口中估计有4，500名注射吸毒者。在这项拟议的研究中，400对夫妇将被随机分配到两种干预措施中的一种：一种是以5对夫妇为基础的艾滋病毒/性传播感染风险降低干预措施，另一种是以5对夫妇为基础的健康促进干预措施，这两种干预措施将作为比较条件。将在基线、干预后3个月、6个月和12个月对参与者进行重复测量评估。主要行为结果是过去30天内共用针头或注射器的注射行为的自我报告比例和过去30天内避孕套保护性交行为的比例。主要的生物学结果是新的HIV病例和新的HCV病例的比率，以及在干预后12个月内衣原体、淋病和梅毒的发病率。 拟议的研究将增进对注射吸毒者及其异性伴侣中艾滋病毒/丙型肝炎病毒/性传播感染风险降低的理解，从而有助于遏制哈萨克斯坦和中亚艾滋病毒、丙型肝炎病毒和性传播感染流行病的上升。 公共卫生相关性拟议的研究涉及哈萨克斯坦活跃注射吸毒者及其性伴侣的极高风险人群中艾滋病毒、丙型肝炎病毒和其他性传播感染的重大公共卫生威胁-该地区正在经历世界上艾滋病毒流行上升最快的地区之一。在舒和其他中亚城镇，人们竞相为注射吸毒者及其性伴侣制定和实施有效的艾滋病毒预防干预措施，以阻止艾滋病毒、丙型肝炎病毒和其他性传播感染在贩毒路线沿着传播。

项目成果

HIV among injection drug users and their intimate partners in Almaty, Kazakhstan.

• DOI: 10.1007/s10461-013-0484-2
• 发表时间: 2013-09
• 期刊: AIDS and behavior
• 影响因子: 4.4
• 作者: El-Bassel N;Gilbert L;Terlikbayeva A;Wu E;Beyrer C;Shaw S;Hunt T;Ma X;Chang M;Ismayilova L;Tukeyev M;Zhussupov B;Rozental Y
• 通讯作者: Rozental Y

Depression Among People Who Inject Drugs and Their Intimate Partners in Kazakhstan.

哈萨克斯坦注射毒品者及其亲密伴侣的抑郁症。

• DOI: 10.1007/s10597-015-9883-3
• 发表时间: 2016
• 期刊: Community mental health journal
• 影响因子: 2.7
• 作者: Shaw,StaceyA;El-Bassel,Nabila;Gilbert,Louisa;Terlikbayeva,Assel;Hunt,Tim;Primbetova,Sholpan;Rozental,Yelena;Chang,Mingway
• 通讯作者: Chang,Mingway

Intimate relationships and patterns of drug and sexual risk behaviors among people who inject drugs in Kazakhstan: A latent class analysis.

哈萨克斯坦注射吸毒者的亲密关系以及毒品和性危险行为模式：潜在阶级分析。

• DOI: 10.1016/j.drugalcdep.2018.07.046
• 发表时间: 2018
• 期刊: Drug and alcohol dependence
• 影响因子: 4.2
• 作者: Marotta,PhillipL;Terlikbayeva,Assel;Gilbert,Louisa;Hunt,Tim;Mandavia,Amar;Wu,Elwin;El-Bassel,Nabila
• 通讯作者: El-Bassel,Nabila

HIV testing and access to HIV medical care among people who inject drugs and their intimate partners in Kazakhstan.

哈萨克斯坦注射吸毒者及其亲密伴侣的艾滋病毒检测和艾滋病毒医疗服务。

• DOI: 10.3109/14659891.2016.1143046
• 发表时间: 2017
• 期刊: Journal of substance use
• 影响因子: 0.8
• 作者: Shaw,StaceyA;Terlikbayeva,Assel;Famouri,Leila;Hunt,Tim;Gilbert,Louisa;Rozental,Yelena;Primbetova,Shopan;Chang,Mingway;Ma,Xin;El-Bassel,Nabila
• 通讯作者: El-Bassel,Nabila

State of the science of adherence in pre-exposure prophylaxis and microbicide trials.

• DOI: 10.1097/qai.0b013e31826f9962
• 发表时间: 2012-12-01
• 期刊: Journal of acquired immune deficiency syndromes (1999)
• 作者: Muchomba FM;Gearing RE;Simoni JM;El-Bassel N
• 通讯作者: El-Bassel N