EPIDEMIOLOGY OF US SYRINGE EXCHANGE PARTICIPANTS

描述：(申请人摘要) 项目公告#94 0077“药物使用和相关的调查研究” 来自NIDA流行病学和预防研究部的《行为》 呼吁创新研究以改进评估药物的调查方法 在美国使用注射器的行为虽然在政治上有争议，但交换注射器 (SE)项目越来越多地被用作基于社区的干预 为减少美国注射吸毒者中艾滋病毒的传播 在过去的两年里，美国社会保障体系的比例从33增加到88。系统化 对SE参与者的调查可以极大地促进疟疾的流行病学 在美国，注射吸毒和艾滋病毒感染的风险都很高。我们会 进行方法论研究，为这种系统化奠定基础 调查。 对艾滋病毒风险行为的潜在漏报可能是最关键的 未来对SE参与者的调查的一个方面。初步数据显示， SE计划人员可以在不严重漏报的情况下收集数据，而且 音频计算机辅助结构化面试(CASI)可以减少 报道不足。在随机分配的2x2析因设计中 根据数据收集条件，我们将比较潜在的 在1)进行的面对面访谈中低估了风险行为 独立研究人员；2)SE计划进行面对面采访 工作人员；3)由独立研究人员管理的CASI音频访谈； 4)在SE计划人员主持的CASI音频访谈中。数据在 艾滋病毒危险行为和目前艾滋病毒危险行为水平的变化将 从来自4个不同SE项目的800名受试者中获得。 除了美国SE项目的快速增长外，还有大量 个别项目的组织结构也在发生变化。我们会 对美国所有可识别的SE计划进行两次年度调查。 将使用聚类分析来确定SE计划的基本类型和 随着时间的推移，美国SE计划的变化。我们将每年制作一次 “最先进的”国家的SE项目的报道。这些 组织研究将为口译提供语境 从SE参与者收集的流行病学数据，并提供所需的 为未来全国调查制定抽样战略的信息 参与者的数量。从我们以前在SE研究方面的经验和从 在这项建议中，我们将编写一本《最先进的》专著 关于收集SE参与者的流行病学数据。这本专著将 还涉及从SE参与者那里收集生物样本，以便 潜在的艾滋病毒和肝炎检测。

DESCRIPTION: (Applicant's Abstract) Program Announcement #94 0077 "Survey Research on Drug Use and Associated Behaviors" from the NIDA Division of Epidemiology and Prevention Research calls for innovative research to improve survey methods for assessing drug use behaviors in the U.S. Though politically controversial, syringe exchange (SE) programs are increasingly being used as a community based intervention to reduce HIV transmission among injecting drug users in the U.S. The number of U.S. SEs has increased from 33 to 88 in the last two years. Systematic surveys for SE participants could contribute greatly to the epidemiology of both injecting drug use and risk for HIV infection in the nation. We will conduct methodological research to lay a foundation for such systematic surveys. Potential underreporting of HIV risk behavior is perhaps the most critical aspect of future surveys of SE participants. Preliminary data suggest that SE program staff can collect data without high underreporting, and that audio computer-assisted structured interviewing (CASI) can reduce underreporting. In a 2x2 factorial design with random assignment of subjects to data collection conditions, we will compare potential underreporting of risk behavior in 1) face-to-face interviews conducted by independent researchers; 2) face-to-face interviews conducted by SE program staff; 3) in audio CASI interviews administered by independent researchers; and 4) in audio CASI interviews administered by SE program staff. Data on changes in HIV risk behavior and on current levels of HIV risk behavior will be obtained from 800 subjects from 4 different SE programs. In addition to the rapid growth in SE programs in the U.S., substantial organizational change is also occurring among individual programs. We will conduct two annual surveys of all identifiable SE programs in the U.S. Cluster analysis will be used to identify basic "types" of SE programs and changes in U.S. SE programs over time. We will produce annual "state-of-the-art" reports of SE programs in the country. These organizational studies will both provide the context for interpreting epidemiologic data collected from SE participants and provide needed information for developing sampling strategies for future national surveys of participants. From our previous experience in SE research and from the experience in this proposal, we will prepare a "state-of-the-art" monograph on collecting epidemiologic data from SE participants. The monograph will also address collecting biological samples from SE participants for potential HIV and hepatitis testing.