Environmental Factors in HIV Transmission among Suburban IDUs

最近的证据表明，郊区居民中注射毒品的使用正在增加。一点儿 研究的重点是这一趋势，其经济、社会和医学后果尚未得到 考虑过了。为了缩小这一差距，我们建议确定、招募和研究有效的注射器样本。 他们居住在康涅狄格州郊区，使用受访者驱动抽样(RDS)。之所以选择RDS，是因为 它在从隐藏的人群中识别个人并允许对样本进行统计分析方面具有优势。 我们提交这份申请书是为了响应PAR-06-114《路径链接研究》 环境、行为和艾滋病毒/艾滋病“。不仅将把重点放在环境--郊区-- 已经被忽视了，但我们将进一步关注在两个不同环境中进行注射的郊区注射器。 初步研究表明，有一些人主要是在郊区城镇注射的 他们居住在城市地区，注射毒品的人在那里获得毒品。我们正在建设我们的书房 围绕两种环境导致(1)注射吸毒模式不同的假设；(2) 艾滋病毒、乙肝和丙型肝炎感染的知识、风险和流行率；(3)社会人口学 稳定性；以及(4)减少注资负面后果的服务的使用和障碍。 我们的研究将招募居住在郊区的600名活跃的注射吸毒者作为样本。样本 将通过结构化访谈、血清学和深入的生活史进行研究。样品将是 纵向跟踪，以确定郊区或城市注入的模式是否稳定，并确定 与注射环境变化和注射器传播病毒感染风险相关的因素。 我们的研究旨在回答以下问题：(1)样本对 潜在人群，(2)两组郊区注射者是否根据注射地点而有所不同 在疾病知识、风险和流行率方面存在差异，(3)艾滋病毒、乙肝病毒、 丙型肝炎病毒可以通过个人、群体和环境水平的变量来预测，(4)郊区 注射器在地理上是集群的，这是否会影响疾病流行率，(5)如何与 刑事司法系统影响毒品使用和危险注射做法，(6)哪些因素与之相关 以及(7)注射者如何使用药物治疗和疾病预防方案以及 他们认为这是更广泛使用这些服务的障碍。 为了达到本研究的目标，我们组建了一支经验丰富的多学科团队，能够 收集和分析定量、定性和血清学数据，并将研究结果传播到 科学界通过学术和公共卫生渠道，并通过 我们的艾滋病跨学科研究中心。

Recent evidence suggests that injection drug use is increasing among suburban residents. Little research has focused on this trend, and the economic, social, and medical consequences have not been considered. To close this gap, we are proposing to identify, recruit, and study a valid sample of injectors who reside in Connecticut suburbs using respondent driven sampling (RDS). RDS was selected because of its strengths in identifying individuals from hidden populations and allowing statistical analysis of the sample. We are submitting this application in response to PAR-06-114, "Research on Pathways Linking Environments, Behaviors andHIV/AIDS". Not only will befocusing onanenvironment - thesuburbs - that has been neglected, but we will further focus on suburban injectors who inject in two distinct environments. Preliminary studies revealed that there are those who inject predominantly in the suburban town in which they reside and those who inject in urban areas where they obtain their drugs. We are building our study around the hypothesis that the two environments result in differences in (1) injection drug use patterns; (2) knowledge of, risk for, and prevalence of HIV, hepatitis B, and hepatitis C infections; (3) sociodemographic stability; and (4) the use of and barriers to services that reduce the negative consequences of injection. Our study will recruit a sample of 600 active injection drug users who reside in the suburbs. The sample will be studied through structured interviews, serology, and in-depth life histories. The sample will be followed longitudinally to ascertain whether the pattern of suburban or urban injection is stable and to identify factors associated with changes in injection environments and in risk for syringe-borne viral infection. Our study is designed able to answer questions including (1) how representative the sample is of the underlying population, (2) whether two groups of suburban injectors who differ based on where they inject differ in terms of disease knowledge, risk, and prevalences, (3) how much of the prevalence of HIV, HBV, and HCV can be predicted by individual, group, and environmental level variables, (4) how suburban injectors are geographically clustered and whether this affects disease prevalence, (5) how interaction with the criminal justice system influences drug use and risky injection practices, (6) which factors are associated with arrest and incarceration and (7) how injectors use drug treatment and disease prevention programs and what they perceive as the barriers to larger use of these services. To meet the objectives of this study, we have assembled an experienced, multidisciplinary team that can collect and analyze the quantitative, qualitative, and serological data and disseminate research findings to the scientific community through scholarly and public health channels and to the service community through our Center for Interdisciplinary Research on AIDS.