NONINJECTING HEROIN USERS, NEW INJECTORS AND HIV RISK

非注射海洛因的使用在纽约市和许多其他城市很普遍。非注射海洛因使用者(NIU)成为注射吸毒者(IDU)的风险很高。新的注射吸毒者数量的增加可能导致许多新的艾滋病毒、乙肝和丙型肝炎的感染。这项研究将继续“艾滋病毒风险和非注射海洛因使用的转变”(NIU)队列研究，研究对象约为600名NIU。它将跟踪国家注射吸毒者队列和一组新的注射吸毒者，以确定：(1)过渡到注射的发生率和时间趋势；(2)过渡到注射和其他药物使用结果的行为和网络风险；(3)分别对于新的注射吸毒者和新的吸毒者，艾滋病毒、乙肝和丙型肝炎血清转换的发生率和时间趋势；(4)在新的吸毒者、性和其他非注射危险行为和预测艾滋病毒、乙肝和丙型肝炎血清转换的网络中；(5)在新的注射吸毒者、注射毒品和性危险行为以及预测艾滋病毒、乙肝和丙型肝炎血清转换的风险网络中；(6)毒品和性危险行为和危险网络的流行的时间趋势，以及预测这些趋势的因素；和(7)海洛因的质量和可获得性以及其他社区因素的变化对给药模式和其他毒品和性危险行为和危险网络的影响。样本将包括：来自父母研究的新的吸毒者；从艾滋病毒、乙肝和丙型肝炎感染的网络风险补充研究中招募的新的注射吸毒者；以及在研究继续期间招募的新的吸毒者和新的注射吸毒者。参与者将接受面谈和艾滋病毒、乙肝病毒和丙型肝炎病毒检测。民族志将被用来研究毒品市场的影响。对过渡到注射和血清转换的风险因素的分析将通过检查网络特征与危险行为的互动在多大程度上促进过渡到注射或停止使用海洛因和其他药物使用结果以及血清转换，来探索“网络促进”假说。这种方法将提高我们对网络过程和危险行为之间相互作用的了解，并可用于开发干预措施，以改变危险行为和危险网络，并防止过渡到注射和艾滋病毒、乙肝和丙型肝炎病毒感染的风险。

Non-injecting heroin use is widespread in New York City and in many other cities. Non-injecting heroin users (NIUs) are at high risk of becoming injecting drug users (IDUs). Increases in the number of new IDUs can lead to many new infections with HIV, hepatitis B (HBV) and hepatitis C (HCV). This study will continue the "HIV Risk and Transitions from Non- Injecting Heroin Use" (NIU) cohort study of approximately 600 NIUs. It will follow the NIU cohort and a cohort of new IDUs, to determine: (1) the incidence and time-trends in transitions to injecting; (2) behavioral and network risks for transitions to injecting and other drug use outcomes; (3) separately, for new IDUs and for NIUs, the incidence and time-trends in HIV, HBV and HCV seroconversions; (4) among NIUs, sexual and other non- injecting risk behaviors and networks predicting HIV, HBV and HCV seroconversion; (5) among new IDUs, drug injecting and sexual risk behaviors and risk networks predicting HIV, HBV and HCV seroconversion; (6) time-trends in the prevalence of drug and sexual risk behaviors and risk networks, and factors predicting these trends; and (7) the impact of changes in the quality and availability of heroin, and in other community factors, on modes of drug administration and other drug and sexual risk behaviors and risk networks. The sample will include: NIUs from the parent study; new IDUs recruited from a supplemental study of network risks for HIV, HBV and HCV infection; and NIUs and new IDUs recruited during the study continuation. Participants will be interviewed and tested for HIV, HBV, and HCV. Ethnography will be used to study the impact of drug markets. Analyses of risk factors for transitions to injecting and seroconversions will explore the "network facilitation" hypothesis by examining the extent to which network characteristics, in interaction with risk behaviors, facilitate transitions to injecting or the cessation of heroin use and other drug use outcomes, and seroconversions. This approach will advance our knowledge of the interaction between network processes and risk behaviors, and can be used to develop interventions to change both risk behaviors and risk networks, and to prevent transitions to injecting and the risk of HIV, HBV and HCV infection.