PREVENTION OF INFECTIOUS DISEASE--INJECTION DRUG USERS

描述：（申请人摘要） 此K 01应用程序将支持的职业发展 候选人作为艾滋病毒预防领域的调查员。 这 建议的重点是发展一个以医院为基础的传染病 为不再接受治疗的注射毒品使用者提供的疾病风险降低方案 （注射吸毒者）。注射吸毒者患人体免疫缺陷的风险很高 病毒（HIV）感染、B型和C型肝炎、皮肤和软组织 感染和其他传染病。 因为这些传染病 疾病是通过特定的危险行为传播的， 执行减少注射吸毒者艾滋病毒风险战略至关重要， 重要性 将进行一项随机临床试验， 传染病预防的有效性 该计划旨在减少艾滋病毒的危险行为， 注射毒品使用者的健康。 该研究的具体目标是 评估干预措施对患者结局、健康 服务利用率和医疗保健成本，并制定印刷 英文和西班牙文的安全自我注射实践材料- 会说话的瘾君子 研究受试者将接受治疗外注射 在医院急诊室寻求医疗护理的吸毒者 部门 他们将被随机分配到四个条件之一： 1)医院注射器交换和标准艾滋病毒风险降低 2）加强艾滋病毒风险降低教育（包括教育 安全自我注射做法）; 3）医院内的注射器交换 加强减少艾滋病毒风险的教育（包括安全教育）， 自我注射做法）; 4）转介到社区注射器 交换计划。 评估将在随机化前和 6和12个月。据推测，研究参与者谁是 分配到医院的注射器交换和增加艾滋病毒的风险 教育组将显示危险注射毒品的减少 使用和注射吸毒有关的传染病比那些谁 分配给其他各组。 还预期 那些正在进行注射器交换的人，并加强艾滋病毒风险教育 组将显示出更大的减少使用紧急和 住院医疗服务和相关的保健费用。

DESCRIPTION: (Applicant's Abstract) This K01 application will support the career development of the candidate as an investigator in the area of HIV prevention. This proposal focuses on the development of a hospital-based infectious disease risk reduction program for out-of-treatment injection drug users (IDUs). Injection drug users are at high risk for human immunodeficiency virus (HIV) infection, hepatitis B and C, skin and soft tissue infections, and other infectious diseases. Because these infectious disease are transmitted by specific risky behaviors, the design and implementation of HIV risk-reduction strategies for IDUs are of critical importance. A randomized, clinical trial will be conducted to examine the effectiveness of the components of an infectious disease prevention program designed to reduce HIV risk behaviors and to improve the general health of injection drug users. The specific aims of the study are to assess the impact of the intervention on patient outcomes, health service utilization, and health care costs, and to develop printed materials on safe self-injection practices for English and Spanish- speaking IDUs. Research participants will be out-of-treatment injection drug users seeking medical care in a hospital-based emergency department. They will be randomly assigned to one of four conditions: 1) hospital-based syringe exchange and standard HIV risk reduction education; 2) enhanced HIV risk reduction education (including education on safe self-injection practices); 3) hospital-based syringe exchange and enhanced HIV risk reduction education (including education on safe self injection practices); 4) referral to a community-based syringe exchange program. Assessments will occur before randomization and at 6 and 12 months. It is hypothesized that research participants who are assigned to the hospital-based syringe exchange and enhanced HIV risk education group will show a greater reduction in risky injection drug use and in injection drug use-related infectious diseases than those who are assigned to each of the other groups. It is also expected that those who are in the syringe exchange and enhanced HIV risk education group will show a greater reduction in the use of emergency and inpatient medical services and in related health care costs.