Community-based Methamphetamine Use & HIV Risk in China

描述（由申请人提供）：近年来，甲基苯丙胺的使用在美国、欧洲、加拿大、澳大利亚和亚洲急剧增加。联合国毒品和犯罪问题办事处（2004年）报告说，中国的甲基苯丙胺生产和滥用大幅增加。然而，目前几乎没有来自社区研究的流行病学数据来研究中国甲基苯丙胺滥用的性质和程度。此R21申请，“基于社区的研究甲基苯丙胺的使用和艾滋病毒的风险在中国，”提交的回应国际研究协作药物成瘾（PA-07-310）公告。该项目的总体目标是采用定性和定量方法，确定和描述中国甲基苯丙胺使用者中与药物滥用和艾滋病毒风险相关的行为。该项目的长期目标是为中国城市地区的甲基苯丙胺使用者开发基于理论的艾滋病毒风险降低干预。人种学方法，包括对40名甲基苯丙胺使用者的访谈，将产生关于甲基苯丙胺滥用和艾滋病毒风险的描述性数据。此外，还将采用应答者驱动抽样（RDS）方法，在中国中南地区湖南省省会城市长沙市招募300名甲基苯丙胺吸毒者进行结构化调查。将在基线访谈后3个月对样本进行随访。本研究的具体目的是：1）使用民族志/定性方法描述中国甲基苯丙胺使用者的药物使用行为和HIV风险行为的关键维度。2)研究甲基苯丙胺的使用模式，其他药物使用的模式，以及与药物使用，健康问题，治疗利用，治疗障碍和犯罪参与相关的因素，并检查药物使用的做法，健康状况，治疗利用和社会问题的变化在三个月的时间。3)在三个月的时间内确定中国甲基苯丙胺使用者中的艾滋病毒风险行为。4）生成数据，为中国甲基苯丙胺使用者制定降低艾滋病毒风险的干预措施。这项研究意义重大：1）对中国中南地区甲基苯丙胺滥用的性质和程度以及甲基苯丙胺使用者中的艾滋病毒危险行为知之甚少。2)这项研究的结果将用于开发第一个基于理论的艾滋病毒风险降低干预措施，该干预措施对中国甲基苯丙胺使用者具有文化敏感性。这项研究具有创新性，因为：1）它将是中国第一个以社区为基础的甲基苯丙胺滥用研究。2)这将是第一次使用中南地区的数据对甲基苯丙胺使用和艾滋病毒风险进行研究，中南地区有严重的药物滥用问题。3)它采用应答者驱动抽样（RDS）招募甲基苯丙胺使用者。因此，与传统的外联办法相比，抽样将更能代表目标隐藏人口。 公共卫生相关性：本研究将探讨甲基苯丙胺滥用在中国中南地区HIV危险行为中的作用。具体而言，通过对初入体验和最近使用模式的探索，我们将探索甲基苯丙胺使用如何塑造中国艾滋病毒风险的社会模式。这项研究的结果将有助于开发一种对文化敏感的、基于理论的艾滋病毒风险降低干预措施。

DESCRIPTION (provided by applicant): The use of methamphetamine has increased dramatically in recent years in the United States, Europe, Canada, Australia, and Asia. The United Nations Office on Drugs & Crime (2004) reports large increases in methamphetamine production and abuse in China. However, little epidemiologic data from community-based studies is currently available to examine the nature and extent of methamphetamine abuse in China. This R21 application, "Community-based study on methamphetamine use & HIV risk in China," is submitted in response to the International Research Collaboration on Drug Addiction (PA-07-310) announcement. The project's overall aim is to identify and describe drug abuse and HIV risk-related behaviors among methamphetamine users in China, using qualitative and quantitative methods. The long-term goal of this project is to develop a theory-based HIV risk-reduction intervention for methamphetamine users in the urban areas of China. Ethnographic methods, including interviews with 40 methamphetamine users, will generate descriptive data on methamphetamine abuse and HIV risk. In addition, Respondent-Driven Sampling (RDS) will be used to recruit 300 methamphetamine users from provincial capital city Changsha in the Hunan Province located in the Central South China for a structured survey. The sample will be followed at 3-months after the baseline interview. The specific aims of the study are to: 1) Describe key dimensions in drug use practices and HIV risk behaviors among methamphetamine users in China, using ethnographic/qualitative methods. 2) Examine methamphetamine users in the Central South China on patterns of methamphetamine use, patterns of other drug use, and factors associated with drug use, health problems, treatment utilization, barriers to treatment, and criminal involvement, and to examine changes in drug use practices, health status, treatment utilization, and social problems over a three-month period. 3) Identify HIV risk behaviors among Chinese methamphetamine users over a three-month period. And 4) generate data to develop an HIV risk reduction intervention for Chinese methamphetamine users. This study is significant: 1) Little is known about the nature and extent of methamphetamine abuse, as well as HIV risk behaviors among methamphetamine users in Central South China. 2) Findings from the proposed study will be used to develop the first theory-based HIV risk reduction intervention that is culturally sensitive for Chinese methamphetamine users. The proposed study is innovative because 1) It will be the first community based study of methamphetamine abuse in China. 2) It will be the first study of methamphetamine use and HIV risk using data from Central South China, which has serious substance abuse problems. 3) It applies respondent-driven-sampling (RDS) to recruit methamphetamine users. Thus, the sample will be more representative of the target hidden population, compared with traditional outreach approaches. PUBLIC HEALTH RELEVANCE: This study will explore the role of methamphetamine abuse in HIV risk behaviors in Central South China. Specifically, through the exploration of initiation experiences and recent patterns of use, we will explore the ways in which methamphetamine use shapes the social patterning of HIV risk in China. The findings from this study will enable the development of a culturally-sensitive, theory-based HIV risk reduction intervention.