Risk Factors for HIV/AIDS in Drug Users

描述（由申请人提供）：风险因素项目研究了自1978年以来纽约市注射吸毒者（IDUs）中非常大的艾滋病毒流行（使用储存的血清），以及自1995年以来非注射海洛因和可卡因吸毒者（NIDUs）中非常大的艾滋病毒流行。在我们目前的研究中，我们已经证明了注射吸毒者中艾滋病毒传播的急剧减少，但在非注射吸毒者中艾滋病毒的大量增加。(HIV在过去十年中，纽约市NIDUs的患病率翻了一番）。单纯疱疹病毒-2（HSV-2）与HIV传播密切相关，我们已经确定HSV-2的流行率是纽约市NIDUs中与HIV传播相关的主要因素。拟议研究的具体目标包括：1）监测纽约市NIDU和IDU中艾滋病毒流行持续演变的风险行为、艾滋病毒流行率和发病率以及服务利用情况。2)量化纽约市海洛因和可卡因使用者中HIV和HSV-2感染之间的长期人口水平关系，包括测试HSV-2和HIV之间的关联强度随时间推移而增加的假设。最近的干预研究大大增加了了解HSV-2/HIV关系的必要性。3)评价纽约市卫生署（NYC DOH）安全套社会营销活动对纽约市注射吸毒者和非注射吸毒者中的性风险行为以及HIV和HSV-2感染的影响。4)监测纽约市注射吸毒者中与性和注射有关的艾滋病毒传播模式。在纽约市，NIDUs和IDUs之间有许多联系。NIDUs和IDUs最好被视为纽约市海洛因和可卡因使用者单一人群中的联系群体。要彻底了解非注射吸毒者之间的性传播，就需要了解城市注射吸毒者之间的注射和性传播。5)评估非注射吸毒者和注射吸毒者中艾滋病毒感染的新的种族/族裔差异模式。6)干预发展。这些目标将通过继续我们对NIDUs和IDUs进入纽约市Beth Israel药物治疗计划的研究来实现。拟议的研究将是第一次研究艾滋病毒随着时间的推移在一个非常大的NIDUs人群中的传播，第一次评估HVS-2与艾滋病毒随着时间的推移在NIDUs中的关系变化，以及第一次评估一个非常大的安全套社会营销活动对NIDUs和IDUs的性风险行为的影响。

DESCRIPTION (provided by applicant): The Risk Factors project has studied the very large HIV epidemic among injecting drug users (IDUs) in New York City from 1978 (using stored sera) and the very large HIV epidemic among non-injecting heroin and cocaine drug users (NIDUs) since 1995. In our current research, we have demonstrated a dramatic reduction in HIV transmission among IDUs, but also a substantial increase in HIV among NIDUS. (HIV prevalence has doubled among NIDUs in NYC over the last decade). Herpes simplex virus-2 (HSV-2) is strongly associated with HIV transmission, and we have identified prevalence HSV-2 as a major factor associated with HIV transmission among NIDUs in NYC. The specific aims of the proposed research include: 1) Monitoring risk behavior, HIV prevalence and incidence and service utilization in the continuing evolution of the HIV epidemic among NIDUs and IDUs in New York City. 2) Quantifying the long-term population-level relationships between HIV and HSV-2 infections among heroin and cocaine users in NYC, including testing the hypothesis that the strength of the association between HSV-2 and HIV increases over time. Recent intervention studies have dramatically increased the need for understanding HSV-2/HIV relationships. 3) Evaluating effects of the New York City Department of Health (NYC DOH) Condom Social Marketing campaign on sexual risk behaviors and HIV and HSV-2 infection among IDUs and NIDUs in NYC. 4) Monitoring patterns of sexual and injection related HIV transmission among IDUs in NYC. There are many linkages between NIDUs and IDUs in NYC. NIDUs and IDUs are best viewed as linked groups within a single population of heroin and cocaine users in NYC. A thorough understanding of sexual transmission among NIDUs requires an understanding of both injecting and sexual transmission among IDUs in the city. 5) Assess new patterns of racial/ethnic differences in HIV infection among NIDUs and IDUs. 6) Intervention development. These aims will be accomplished through continuation of our studies of NIDUs and IDUs entering Beth Israel drug treatment programs in NYC. The proposed research will be the first study of the spread of HIV over time in a very large population of NIDUs, the first assessment of change in the relationship of HVS-2 to HIV over time among NIDUs, and the first assessment of the effects of a very large condom social marketing campaign on sexual risk behavior of NIDUs and IDUs.