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: 8073625
• 负责人: Don C Des Jarlais
• 金额: $ 91.67万
• 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/8073625
• 关键词: AIDS prevention; AIDS/HIV problem; Address; Adherence; Area; Automobile Driving; Behavior; Behavior Therapy; Central Asia; Collaborations; Communities; Country; Developing Countries; Drug abuse; Drug usage; Drug user; 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; 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; substance abuse treatment; 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相互关联的关键问题：如何制止注射吸毒者中艾滋病毒的持续传播，以及如何制止从注射吸毒者集中流行病向异性恋者普遍流行病的转变。虽然有几种干预措施已被证明在减少注射吸毒者的危险行为方面有效，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提供了一个理想的背景下，研究预防方案的组合。本研究的具体目的有五个：1.系统评价减少注射吸毒者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），以及建立社区和政策支持预防注射吸毒者艾滋病的干预措施。3.关于与以前的系统干预措施相结合的干预措施，以减少注射吸毒者中的注射和性风险行为，以及在不同覆盖水平上的综合干预措施，包括减少注射吸毒者之间以及从注射吸毒者向非吸毒性伴侣传播艾滋病毒的优化战略。监测爱沙尼亚塔林注射吸毒者中艾滋病毒流行病血清阳性反应率居高不下的情况，以评估目前的干预措施，并为这一流行病制定一套“最佳”干预措施。在塔林，注射吸毒者中艾滋病毒流行率目前超过50%，估计发病率超过20/100人年，处于危险之中，注射吸毒者报告说，多个性伴侣的比率很高，而且避孕套的使用不一致。4.在塔林进行注射吸毒者性传播感染筛查和治疗试点研究，以评估减少注射吸毒者之间以及从注射吸毒者向非注射毒品性伴侣的性传播的可行性和有效性。试点研究将包括生物医学干预（筛查和治疗），从注射吸毒者向非注射毒品的性伴侣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一个理想的背景下，研究联合艾滋病预防计划的影响。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毒品的性伴侣传播是许多不同国家的两个关键的公共卫生问题。这些相互关联的问题是一个理想的背景下，研究联合艾滋病预防计划的影响。