HEPATITIS B AND C AMONG HOMELESS ADULTS

描述：申请人摘要 感染B型肝炎病毒（HBV）或丙型肝炎病毒（HCV）的人 有长期严重健康问题的高风险， 可能传染给其他人。由于这些问题的严重性， 感染，国家卫生研究院已经制定了一项国家议程，以防止传播 以及HBV和HCV的后果。这一议程包括早期发现， 治疗和预防高危和受感染者的努力。 今天，无家可归在美国已经达到了危机的程度。最近的研究 我们的团队和其他人认为，城市地区无家可归的成年人是一个群体， 特别是高风险的HBV和HCV感染，由于高风险的 吸毒和危险的性行为然而，尽管风险很高， 对这一群体的病毒性肝炎研究有限。我们建议 开展流行病学和卫生服务的研究，关于乙肝和丙肝病毒在一个 以500名无家可归的成年人为样本。我们会招募一个概率 从30名无家可归的成年人中过度抽样注射毒品使用者 在洛杉矶的贫民窟地区的避难所和膳食计划。受访者 将接受两个小时的面试（包括诊断面试） 附表-DIS-IV）和抽血进行肝炎血清学检查。我们将估计 HBV和HCV的患病率，并确定每种病毒的危险因素。我们将评估 无论是有注射和非注射吸毒史的无家可归的成年人， 危险的性行为、严重的酒精或精神障碍，或长期无家可归， 增加了这些感染的风险。我们还将开展卫生服务 研究中，我们将描述受访者的HBV/HCV既往史 检测，感染状况的认识，HBV和HCV的医疗护理，以及 愿意返回HBV/HCV检测结果。此外，我们将确定 利用医疗和非医疗设施确定未来的地点 筛查、治疗和预防工作。我们将提供B型肝炎 对B型肝炎检测阴性者进行免疫接种。我们将架起 研究和预防之间的差距，利用计划行为理论， 了解无家可归的成年人使用的保护行为，以避免接触 传染病

DESCRIPTION: Applicant's Abstract Persons infected with the hepatitis B virus (HBV) or hepatitis C virus (HCV) are at high risk for serious long-term health problems, and they are potentially infectious to others. Because of the seriousness of these infections, the NIH has developed a national agenda for preventing the spread and consequences of HBV and HCV. This agenda includes early detection, treatment, and prevention efforts for high-risk and infected persons. Homelessness has reached crisis proportions in the US today. Recent research by our team and others suggests that homeless adults in urban areas are a group at particularly high risk for HBV and HCV infections due to high rates of risky drug use and risky sexual behaviors. Despite the apparent high risk, however, there is only limited research on viral hepatitis in this group. We propose to conduct epidemiologic and health services research regarding HBV and HCV in a population-based sample of 500 homeless adults. We will recruit a probability sample of homeless adults with oversampling of injection drug users from 30 shelters and meal programs in the Skid Row area of Los Angeles. Respondents will undergo a two-hour interview (including the Diagnostic Interview Schedule-DIS-IV) and blood draw for hepatitis serology. We will estimate the prevalence of HBV and HCV and identify risk factors for each. We will evaluate whether homeless adults with histories of injection and non-injection drug use, risky sex, serious alcohol or mental disorders, or chronic homelessness have an elevated risk for these infections. We will also conduct health services research in which we will describe the respondents' past history of HBV/HCV testing, awareness of infection status, medical care for HBV and HCV, and willingness to return for HBV/HCV test results. Further, we will identify utilization of medical and non-medical settings to identify sites for future screening, treatment, and prevention efforts. We will provide hepatitis B immunization to those that test negative for hepatitis B. We will bridge the gap between research and prevention by using the Theory of Planned Behavior to understand protective behaviors used by homeless adults to avoid exposure to infectious diseases.