Booth Robert E, Kwiatkowski Carol F, Mikulich-Gilbertson Susan K, Brewster John T, Salomonsen-Sautel Stacy, Corsi Karen F, Sinitsyna Larisa
Department of Psychiatry, School of Medicine, University of Colorado Health Sciences Center, 1741 Vine Street, Denver, CO 80206, USA.
Drug Alcohol Depend. 2006 Apr;82 Suppl 1:S49-55. doi: 10.1016/s0376-8716(06)80009-8.
This study was designed to assess factors associated with change in needle-related risk behaviors as well as predictors of continued high-risk behavior following intervention efforts among injection drug users (IDUs) in Ukraine. In each of three locations--Kiev, Odessa, and Makeevka/Donesk--100 IDUs were recruited using modified targeted sampling methods. Following a baseline interview, participants were offered free HIV testing and, over the course of the next 5 months, individualized interventions focusing on reducing HIV-related risk behaviors. Former IDUs conducted interventions through street outreach. The intervention model was based on the Indigenous Leader Outreach Model (ILOM) and stressed assessing an individual's unique risks and developing strategies by which to minimize those risks. Follow-up assessments showed significant reductions in every risk behavior measured. Following the intervention, however, approximately one of four participants reported front- or backloading, using drugs obtained from a common container or injecting with a used needle/syringe. Although the sample as a whole averaged only 28 years of age, those who were younger were significantly more likely to engage in each of these behaviors than those who were older. In light of the overall young age of the Ukrainian IDUs observed in this study, the consistent finding that younger IDUs were at highest risk foreshadows a worsening HIV epidemic in Ukraine.
本研究旨在评估与针头相关风险行为变化相关的因素，以及乌克兰注射吸毒者（IDU）干预措施后持续高风险行为的预测因素。在基辅、敖德萨和马凯耶夫卡/顿涅茨克这三个地点，采用改良的目标抽样方法招募了100名注射吸毒者。在基线访谈之后，为参与者提供免费的艾滋病毒检测，并在接下来的5个月里，开展以减少与艾滋病毒相关风险行为为重点的个性化干预措施。曾经的注射吸毒者通过街头外展进行干预。干预模式基于本土领袖外展模式（ILOM），强调评估个人的独特风险，并制定将这些风险降至最低的策略。随访评估显示，所测量的每种风险行为都有显著减少。然而，在干预之后，约四分之一的参与者报告了预载或后载行为，即使用从公共容器中获取的毒品或用用过的针头/注射器注射。尽管整个样本的平均年龄仅为28岁，但较年轻的参与者比年长的参与者更有可能从事上述每一种行为。鉴于本研究中观察到的乌克兰注射吸毒者总体年龄较轻，较年轻的注射吸毒者风险最高这一一致发现预示着乌克兰艾滋病毒疫情将恶化。
