Partner-Oriented Drug Treatment and HIV Risk Reduction

描述(申请人提供)：美沙酮维持是一种有效的工具 以减少注射吸毒者感染艾滋病毒的风险和发病率。然而，很多时候， 接受美沙酮治疗的患者继续使用鸦片类药物和其他药物， 通常与一位亲密的朋友或家庭成员目前没有参加 治疗。对这个问题的一种回应是鼓励至少一名成员 美沙酮客户的个人吸毒网络也进入治疗， 从而减少了出现吸毒机会的个人数量。 在这项试点研究中，268名新的美沙酮治疗参与者(指数参与者) 会被约谈并被邀请带一名吸食鸦片的性伴侣， 被描述为属于的家庭成员或密友(伙伴参与者) 对他们目前的个人注射吸毒网络进行了采访。我们期待着 这268人中的一半将能够招募到面试伙伴。这个 产生的134名合作伙伴参与者将被随机分配到 干预条件(提供13周免费美沙酮维持)或 控制情况(不提供免费治疗)。自我报告，尿检记录 在临床图表中，和其他生物指标数据(头发样本)将 在基线和随机化后4个月收集，以评估治疗 结果、艾滋病毒危险行为的改变和个人用药的改变 指数参与者及其指定用户的网络特征 合作伙伴参与者。这项两组随机分配的先导研究 解决以下具体目标：具体目标1：确定是否 向一个伴侣提供免费药物治疗将改善治疗结果，并 减少指数参与者中的艾滋病毒危险行为。具体目标2： 确定向合作伙伴提供免费药物治疗是否会导致 减少伙伴参与者的艾滋病毒危险行为和药物使用。特定的 目标3：确定向一个伴侣提供免费药物治疗是否会 显著改变个人吸毒的大小、密度和稳定性 合作伙伴的网络，最终是推荐索引的网络。建议数 这项研究解决了一个实际的公共卫生问题，即在 美沙酮治疗倾向于由亲密的朋友、家人或 重要的其他人。拟议研究的总体目标是证明 治疗结果可以得到改善，艾滋病毒危险行为可以减少 同时参与戒毒的至少两名网络成员。

DESCRIPTION (provided by applicant): Methadone maintenance is an effective tool for reducing HIV risk and incidence among IDUs. All too often, however, individuals in methadone treatment continue to use opiates and other drugs, usually with a close friend or family member not currently enrolled in treatment. One response to this problem is to encourage at least one member of the methadone client's personal drug-using network to also enter treatment, thereby reducing the number of individuals presenting drug use opportunities. In this pilot study, 268 new methadone treatment entrants (Index Participants) will be interviewed and invited to bring in an opiate using sexual partner, family member, or close friend (Partner participants) described as belonging to their current personal injection drug-use network for interview. We anticipate that half of the 268 will be able to recruit a Partner for interview. The resulting 134 Partner participants will be randomly assigned to either the Intervention condition (offered 13 weeks of free methadone maintenance) or to a Control condition (no offer of free treatment). Self-report, urinalysis records in the clinical charts, and other biological indicator data (hair samples) will be collected at baseline and 4 months post-randomization to assess treatment outcomes, change in HIV risk behaviors, and change in personal drug-using network characteristics for both Index participants and their designated Partner participants. This two-group, random assignment pilot study is designed to address the following specific aims: Specific Aim 1: to determine if offering free drug treatment to one Partner will improve treatment outcomes and reduce HIV risk behaviors among Index participants. Specific Aim 2: to determine if offering free drug treatment to the Partner will result in reductions in Partner participant's HIV risk behaviors and drug use. Specific Aim 3: to determine if offering free drug treatment to one Partner will significantly alter the size, density, and stability of the personal drug-using network of the Partner, and ultimately of the referring Index. The proposed study addresses a practical public health problem, that ongoing drug use during methadone treatment tends to be initiated by close friends, family members, or significant others. The overall goal of the proposed study is to demonstrate that treatment outcomes can be improved and HIV risk behaviors reduced by involving at least two network members in drug treatment simultaneously.