South East Asia has witnessed a rapid increase in unintended medical consequences associated with high-risk drug injection practices, including increases in the prevalence and incidence of viral pathogens prevalent in IDU populations such as HIV-1, HBV, and HCV. These trends raise grave concerns about the future spread of HIV infection in South East Asia and may portend the emergence of a self-sustaining epidemic in the region. Of particular concern, is the rapid increase in new infections among young, male heroin IDUs in Viet Nam. Structured as a unique type of collaboration between HIV researchers at NDRI and public health researchers and community-based physicians at Hanoi Medical University, this study has the dual goal of developing an epidemiological profile of injection-mediated risk among young male heroin users, while simultaneously advancing the technical capacity of researchers in Viet Nam to respond to the emerging HIV epidemic among IDUs.
Specific aims of the proposed demonstration project include: [1] To develop an epidemiological typology of the physical settings, situational events, social groups, and economic exchanges, in which young men use opiate-based drugs, including opium, morphine-base, and heroin, as well as the knowledge, attitudes, and beliefs regarding HIV risk in the injection of these substances; [2] To describe variability in behavioral practices employed in the preparation and injection of heroin-based drug solutions, including local drug marketing patterns, drug-acquisition strategies, and drug-sharing practices that may facilitate transmission of blood-borne pathogens; [3] To describe individual, social, and economic correlates of injectors' apprenticeship into heroin injection, including the pedagogical processes in which IDUs learn to prepare and inject heroin, their rationale for initiating and maintaining injection as a mode of drug (heroin) administration, and the early social course of heroin dependence; [4] To describe the accumulation of unintended medical consequences associated with the onset of heroin injection, particularly HIV and other viral pathogens prevalent among IDU populations; and [5] To extend concepts and methods adapted from anthropological ethnography in conducting epidemiological research among """"""""out-of-treatment"""""""" populations in the U.S., with the goal of enhancing the technical capacity of researchers in Viet Nam in identifying and monitoring emerging trends associated with drug abuse and HIV.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
1R01DA016188-01
Application #
6592661
Study Section
Special Emphasis Panel (ZRG1-AARR-8 (01))
Program Officer
Lambert, Elizabeth
Project Start
2003-07-01
Project End
2008-05-31
Budget Start
2003-07-01
Budget End
2004-05-31
Support Year
1
Fiscal Year
2003
Total Cost
$579,990
Indirect Cost
Name
National Development & Research Institutes
Department
Type
DUNS #
080481880
City
New York
State
NY
Country
United States
Zip Code
10010
Goldsamt, Lloyd A; Clatts, Michael C; Le, Giang et al. (2015) Injection and sexual risk practices among young heroin users in Hanoi, Vietnam. Drugs (Abingdon Engl) 22:166-172
Giang, Le Minh; Clatts, Michael C; Goldsamt, Lloyd A et al. (2014) High rates of oral STIs among male sex workers in Vietnam. Sex Transm Infect 90:528
Clatts, Michael C; Goldsamt, Lloyd A; Giang, Le Minh et al. (2011) Accelerated transition to injection among male heroin initiates in Hanoi, Vietnam: implications for early harm reduction interventions. J Community Health 36:999-1003
Clatts, Michael C; Colón-López, Vivian; Giang, Le M et al. (2010) Prevalence and incidence of HCV infection among Vietnam heroin users with recent onset of injection. J Urban Health 87:278-291
Clatts, Michael; Giang, Le M; Goldsamt, Lloyd et al. (2010) Nonmedical use of promethazine hydrochloride among heroin injectors in Vietnam: unrecognized risks and unintended consequences. Subst Use Misuse 45:515-27
Clatts, Michael C; Giang, Le M; Goldsamt, Lloyd A et al. (2007) Male sex work and HIV risk among young heroin users in Hanoi, Vietnam. Sex Health 4:261-7
Clatts, Michael C; Giang, Le M; Goldsamt, Lloyd A et al. (2007) Novel heroin injection practices: implications for transmission of HIV and other bloodborne pathogens. Am J Prev Med 32:S226-33