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都很普遍。非注射海洛因使用者成为注射吸毒者的风险很高。新注射药物数量的增加可导致许多新的艾滋病毒、乙型肝炎和丙型肝炎感染。这项研究将继续“非注射海洛因使用的艾滋病毒风险和过渡”（NIU）队列研究，约600名NIU。它将跟踪NIU队列和新IDUs队列，以确定：(1)过渡到注射的发生率和时间趋势；(2)过渡到注射吸毒和其他吸毒结果的行为和网络风险；(3)新注射毒品者和新注射毒品者HIV、HBV和HCV血清转化的发生率和时间趋势；(4) niu、性和其他非注射危险行为和预测HIV、HBV和HCV血清转化的网络；(5)新增IDUs、毒品注射和性危险行为及预测HIV、HBV和HCV血清转化的风险网络；(6)毒品和性危险行为和危险网络流行的时间趋势，以及预测这些趋势的因素；(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方式、其他毒品和性风险行为和风险网络的影响。样本将包括：来自父母研究的niu；从艾滋病毒、乙型肝炎病毒和丙型肝炎病毒感染网络风险补充研究中招募的新注射吸毒者；以及在研究继续期间新招募的niu和idu。参与者将接受HIV、HBV和HCV的访谈和检测。人种学将用于研究毒品市场的影响。通过研究网络特征在多大程度上与风险行为相互作用，促进向注射过渡或停止海洛因使用和其他药物使用结果以及服务转化，对过渡到注射和服务转化的风险因素的分析将探索“网络促进”假说。这种方法将提高我们对网络过程和风险行为之间相互作用的认识，并可用于制定干预措施，以改变风险行为和风险网络，并防止过渡到注射和艾滋病毒、乙型肝炎病毒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.