权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

Heroin Cessation and Hiv Risk: A Case-Control Study

海洛因戒断和艾滋病毒风险：病例对照研究

基本信息

批准号：
8055105
负责人：
DAVID VLAHOV
金额：
$ 5.12万
依托单位：
NEW YORK ACADEMY OF MEDICINE
依托单位国家：
美国
项目类别：
财政年份：
2007
资助国家：
美国
起止时间：
2007-09-20 至 2011-02-15
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8055105
关键词：
AIDS prevention Abstinence Acquired Immunodeficiency Syndrome Aftercare Age Age-Years Awareness Case-Control Studies Censuses Characteristics Child Chronic Cities Cocaine Communities Consent Control Groups Counseling Criminal Justice Cues Data Disadvantaged Drug Metabolic Detoxication Drug abuse Drug usage Economically Deprived Population Epidemiology Ethnic Origin Ethnography Event Factor Analysis Family Frequencies Goals HIV HIV Infections Heroin Heroin Users Human immunodeficiency virus test Imprisonment Incidence Individual Injection of therapeutic agent Intervention Interview Jamaica Libido Life Literature Location Logistic Regressions Long Island Maps Marital Status Medical Methadone Methods Minority Groups Modeling Narcotics Natural History Neighborhoods New York City Opiates Opioid Outcome Overdose Participant Patient Self-Report Pattern Persons Pharmaceutical Preparations Policies Population Race Recording of previous events Recovery Recruitment Activity Relapse Replacement Therapy Reporting Research Research Personnel Respondent Risk Risk Factors Risk Reduction Route Sampling Services Sexual Partners Social support Specific qualifier value Structure System Techniques Testing Therapeutic Time Unsafe Sex Urine Visit Work base case control demographics density experience high risk sexual behavior land use outreach prognostic prognostic indicator programs segregation sex sex risk success

项目摘要

The purpose of this case-control study is to characterize the prognostic indicators, including HIV infection, for the positive outcome of sustained heroin cessation among persons with a prior history of chronic heroin use within economically disadvantaged, predominantly racial/ethnic minority neighborhoods in New York City (NYC). With drug use as a major risk factor for HIV and a chronic relapsing condition, identifying factors that promote sustained cessation can be key to enhancing HIV prevention and treatment efforts. Also unknown is what happens with sexual risk after short and long term cessation; an important but understudied consideration. Previous studies that have described patterns of cessation have been limited for several reasons. First, while much work has been done on relapse and cessation, the literature is sparse on long- term effective cessation. Second, most studies have sampled from treatment settings which misses persons who cease use without treatment. Third, previous research has not investigated the possible impact of determinants at multiple levels, including initial circumstances of cessation (e.g., influence of incarceration, family, etc.), potential influences of individual-level factors (e.g., social support, network characteristics) and one's neighborhood context (e.g., availability of drugs, density of AIDS cases). Post treatment relapse is more common in disadvantaged communities where persons return to settings with cues for druguse, however a proportion sustains cessation; characterizing neighborhood factors that contribute to this remains understudied. To identify factors associated with sustained cessation, we will recruit 1800 heroin using individuals utilizing venue- and respondent-driven sampling in 36 NYC neighborhoods. Eligible individuals will be those aged >27 years with a history of heroin use at least five years before interview. Eligible and consenting participants will undergo structured interviews include a year by year recall for the prior 6 years as has been used successfully in earlier studies. For analyses, cases will be defined as former heroin users, i.e., non-use at interview (N=744). Two control groups are specified: (1) heroin users who used continuously through past six years, (N=527) and (2) relapsed heroin users who were abstinent sometime in the past 5 years but who subsequently relapsed to drug use (N=527). Cases (sustained cessation) and controls will be frequency matched on age and age at heroin initiation (¿2 years) during analysis. Determinants of sustained cessation will be assessed using conditional logistic regression and hierarchical modeling. Data from this study can be used to identify modifiable factors that can be subjected to individual, group or policy intervention to promote sustained cessation from opiate use. Additionally, we will consider heroin cessation as an "exposure" by examining the relation between cessation and high-risk sexual behavior.

本病例对照研究的目的是表征预后指标，包括艾滋病毒感染