The process of long term abstinence from opioid use among HIV+ respondents

描述（由申请人提供）：本定性研究侧重于70名艾滋病毒+前阿片类药物使用者为保持健康而采用的策略。在本已艰难的阿片类药物康复过程中，艾滋病毒+前阿片类药物使用者必须同时处理艾滋病毒血清阳性，包括药物管理和机构隶属关系，这不仅对个人而且对其家庭/社会网络构成多重挑战。这个重新提交的申请是由一位早期职业研究者在PAR-10-021艾滋病科学跟踪研究过渡奖（A-START）下提交的。他在成功参与街头吸毒者研究方面有着悠久的历史，现在他将重点采访已经停止滥用阿片类药物五年或更长时间的艾滋病毒+持续戒酒者。使用非处方和/或滥用阿片类药物，特别是海洛因，(但包括一些药物药丸形式-奥施康定，维柯丁，Percocet，吗啡，甚至最近的糖浆形式，即。“瘦”)与高复发率、传染病易感性、刑事司法介入和社会不和谐有关。定性研究人员已经开发了招募和调查活跃吸毒者吸毒生涯的技术，但通常没有记录不使用毒品的模式。从这项能够保持戒断的艾滋病毒血清阳性前阿片类药物使用者的探索性试点研究中收集的数据将作为检查艾滋病毒/艾滋病，药物滥用和公共卫生问题交叉的更大规模研究的平台。本研究的前使用者将来自纽约大都会地区，所有人都有每天使用海洛因和/或其他非法阿片类药物超过一年的历史，持续戒断这些物质超过五年，并且通过自我报告测量HIV血清阳性状态。项目团队将通过要求提供文件（例如测试结果、医生信函、艾滋病毒药物处方等）来核实艾滋病毒状况。开放式访谈旨在引出描述他们康复过程的信息，并确定其他身体和情感问题的共同发生。疾病控制和预防中心表示，药物使用，主要是阿片类药物的使用，作为艾滋病毒的主要传播途径正在增加。这项研究有望为未来的干预措施提供信息，并描绘出维持康复和健康的路线图，正如艾滋病毒阳性患者在药物使用方面的生活经历所证明的那样。

DESCRIPTION (provided by applicant): This qualitative study focuses on the strategies 70 HIV+ former opioid users employ to maintain wellness. HIV+ former opioid users who must simultaneously deal with HIV seropositivity, including medication management and institutional affiliation, amid an already difficult process of opioid recovery, pose multiple challenges not only for the individuals but also for their families/social networks. This re- submission application is being submitted under PAR-10-021 AIDS Science Track Award for Research Transition (A-START) by an Early Career Investigator. He has a long history of successfully engaging participants in street drug user studies, and will now focus on interviewing this population of HIV+ sustained abstainers who have ceased their opioid misuse for five or more years. The use of non- prescribed and/or abuse of opioids, particularly heroin, (but including a number of pharmaceutical pill forms - Oxycontin, Vicodin, Percocet, morphine, and even more recent syrup forms, i.e. "Lean") are associated with high relapse rates, infectious disease susceptibility, criminal justice involvement, and social disharmony. Qualitative researchers have developed technologies for recruiting and investigating the drug-using careers of active users, but have not often documented patterns of non-use. The data gathered from this exploratory pilot study of HIV seropositive former opioid users who have been able to maintain abstinence will serve as a platform for larger studies examining the intersection of HIV/AIDS, drug abuse, and public health issues. The former users in this study will be from the New York metropolitan area, all with histories of daily heroin and/or other illicit opioid use exceeding one year, greater than five years sustained abstinence from these substances, and HIV seropositive status as measured by self report. The project team will verify HIV status by asking for documentation (for example test results, correspondence from doctors, prescriptions for HIV medication, etc.). The open ended interview is designed to elicit information describing the process of their recovery as well as ascertain the co-occurrence of other physical and emotional issues. The Centers for Disease Control and Prevention suggests substance use, largely opioid use, is increasing as a primary HIV transmission route. This study holds promise for informing future interventions and sketching a roadmap to maintenance of recovery and wellness as demonstrated by HIV+ people with lived experience/s of abstinence from substance use. PUBLIC HEALTH RELEVANCE: HIV+ individuals that have overcome the misuse of opioids, (e.g., heroin and/or prescription opioids such as Oxycontin), are an understudied population. Such misuse is difficult to overcome and is associated with high relapse rates, susceptibility to infectious diseases, criminal justice involvement, and social and familial disruption. An examination of successful strategies and processes undertaken by HIV+ former heroin users/opioid abusers who are now long-term sustained abstainers can provide important insights about how they maintain abstinence while so many others failed. The findings from this pilot study may be used to develop new treatment techniques and primary and secondary intervention strategies and subsequently extend the success such persons have gained to others in similar situations, while significantly influencing substance abuse and HIV treatment policy.