Social Course of Adherence to HAART in Active Drug Users

描述(由申请人提供)：在当今的“坚守时代” 艾滋病毒/艾滋病流行，人们对合法药物的能力提出了质疑 用户和其他边缘群体坚持高度 主动抗逆转录病毒疗法(HAART)。这个为期三年的项目旨在 通过描述遵守HAART的模式和影响这些问题 对于HIV+活跃吸毒者来说，随着时间的推移。近期目标是在现有基础上增加 了解支持遵守的实用战略，通过设计 吸毒者、他们的临床医生和他们的社交密友可以 用于设计符合HAART的个性化计划。长期的 目标是促进HAART的获取并最大限度地发挥其治疗效益 对个别吸毒者来说，并减少由 耐HAART的艾滋病毒毒株的传播。该项目使用了一种社会 从医学慢性病研究中得出的课程视角 人类学作为一个概念框架。对坚持HAART的社会影响 (社会课)将在随机选择的50人中进行一段时间的检查 患有艾滋病毒/艾滋病的活跃的非法吸毒者。研究参与者将从 津伯格诊所的病人群体，一个多学科的初级保健 剑桥医院(马萨诸塞州坎布里奇)为艾滋病毒携带者提供服务的设施 以及他们的家人。数据收集将包括六个深入的、定性的 每隔两个月对每位研究参与者进行一次访谈(总计 300)。访谈数据将由从医疗保健中提取的信息来补充 唱片。数据分析将使用扎根的理论方法和图表结构 采用来自生命历程研究的技术来开发两种类型的 描述性类别：坚持课程类别和社会影响力 类别。这些类别将作为制定和 评估以患者为中心、以临床医生为中心等的可行性 支持非法活跃用户遵守HAART的策略 毒品。

DESCRIPTION (provided by applicant): In the present "era of adherence" of the HIV/AIDS epidemic, questions are being raised about the ability of legal drug users and other marginalized groups to adhere to complex regimens of highly active antiretroviral therapies (HAART). This three-year project addresses these questions by describing patterns of and influences on adherence to HAART for HIV + active drug users over time. The immediate goal is to add to existing knowledge of practical strategies for supporting adherence, by devising strategies that drug users, their clinicians, and their social intimates can use in designing individualized plans for adherence to HAART. Long-term objectives are to facilitate access and maximize therapeutic benefit from HAART for individual drug users, and reduce the public health risk posed by the transmission of HAART-resistant strains of HIV. The project uses a social course perspective drawn from studies of chronic illness in medical anthropology as a conceptual framework. Social influences on adherence to HAART (social course) will be examined over time in a randomly selected group of 50 active illegal drug users with HIV/AIDS. Study participants will be drawn from the patient population of The Zinberg Clinic, a multidisciplinary primary care facility at The Cambridge Hospital (Cambridge, MA) that serves persons with HIV and their families. Data collection will consist of six in-depth, qualitative interviews conducted at two-month intervals with each study participant (Total 300). Interview data will be supplemented by information extracted from medical records. Data analysis will use grounded theory methods and chart construction techniques adapted from life course research to develop two types of descriptive categories: adherence course categories, and social influence categories. These categories will serve as the basis for formulating and assessing the feasibility of patient focused, clinician-focused, and other strategies for supporting adherence to HAART among active users of illegal drugs.