Methadone maintenance and HIV risk in Ukraine

描述（由申请人提供）：治疗类阿片依赖是减少艾滋病毒和其他传染病传播的重要途径，特别是在乌克兰，因为静脉注射类阿片是这些感染传播的主要途径。这项建议将在基辅市麻醉科医院与来自阿拉巴马大学和科罗拉多大学的合作者一起完成。该研究将对50名阿片类药物依赖者（25名HIV阳性和25名HIV-）进行为期3个月的美沙酮维持疗程的可接受性和影响进行研究。拟议的工作将建立在与乌克兰联合首席研究员Sergiy Dvoryak医学博士建立的关系基础上，Sergiy Dvoryak医学博士于1999-2000年在约翰霍普金斯大学获得汉弗莱奖学金期间与dr。宾大成瘾治疗和研究中心的伍迪和梅茨格。它还将扩展阿片类药物依赖的药物治疗研究和降低风险的行为干预。伍迪，舒马赫和布斯在俄罗斯和乌克兰。主要目的是：1)衡量HIV+和HIV-患者3个月美沙酮维持疗程的可接受性和依从性；2)衡量3个月美沙酮疗程对减少阿片类药物使用和艾滋病毒风险行为的影响。次要目的是：1)评估调查小组获得研究结果测量的程度；2)评估3个月美沙酮维持疗程减少非法活动、改善就业和精神症状的程度；3)确定美沙酮治疗完成后的短期疗效；4)获得研究患者中乙型和丙型肝炎患病率的试点数据。该提案解决了NIH的两个优先领域：艾滋病毒预防和药物滥用。它将提供关于美沙酮短期维持治疗在文化环境中可接受性和有效性的试点数据，在基辅对阿片类药物依赖者进行药理学研究的可行性，并将加强基辅调查人员对未来艾滋病毒预防和治疗研究的研究能力。

DESCRIPTION (provided by applicant): Treatment of opioid dependence is an important way to reduce the spread of HIV and other infectious diseases, particularly in Ukraine since intravenous opioid use is the major way these infections are being spread. This proposal will be done at the Kiev City Narcology Hospital with collaborators from the University of Alabama and the University of Colorado. It will study the acceptability and impact of a 3-month course of methadone maintenance on 50 persons with opioid dependence, 25 who are HIV+ and 25 HIV-. The proposed work will build upon a relationship that was established with the Ukrainian Co-Principal Investigator, Sergiy Dvoryak, MD, during his Humphrey Fellowship at Johns Hopkins in 1999-2000 when he spent time with Drs. Woody and Metzger at the Penn Addiction Treatment and Research Center. It will also extend studies of pharmacologic treatment for opioid dependence and risk reduction behavioral interventions that are being done by Drs. Woody, Schumacher and Booth in Russia and Ukraine. Primary aims are to: 1) Measure the acceptability and compliance with a 3-month course of methadone maintenance in HIV+ and HIV- patients; and 2) Measure the impact of a 3-month course of methadone in reducing opioid use and HIV risk behavior. Secondary aims are to: 1) Assess the degree to which the investigative team obtains study outcome measures; 2) Assess the degree to which the 3-month course of methadone maintenance reduces illegal activities and improves employment and psychiatric symptoms; 3) Determine short term outcome after completion of methadone treatment; and 4) Obtain pilot data on the prevalence of hepatitis B and C among study patients. This proposal addresses two priority areas of NIH: HIV prevention and substance abuse. It will provide pilot data on the acceptability and efficacy of a short term course of methadone maintenance in a cultural setting where this treatment has not been evaluated, on the feasibility of conducting a pharmacological study of opioid dependent persons in Kiev, and will enhance research capabilities of Kiev investigators for future HIV prevention and treatment studies.