A couple-based antiretroviral therapy adherence intervention for people who inject drugs in Kazakhstan

针对哈萨克斯坦注射吸毒者的基于夫妇的抗逆转录病毒治疗依从性干预

基本信息

批准号：
10194437
负责人：
Alissa Davis
金额：
$ 18.07万
依托单位：
COLUMBIA UNIV NEW YORK MORNINGSIDE
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-07-01 至 2023-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10194437
关键词：
AIDS prevention Address Adherence Affect Africa Appalachian Region Area Asia Behavior Behavioral Blood Caring Centers for Disease Control and Prevention (U.S.)Central Asia Clinical Communication Community Healthcare Country Couples Data Development Development Plans Diphosphates Directly Observed Therapy Discrimination Disease Disease Outbreaks Disease Progression Dose Drug Legislation Eastern Europe Educational workshop Epidemic Epidemiology Evidence based intervention Face Family Family member Focus Groups Goals HIV HIV Infections HIV Seropositivity Health Personnel Healthcare Systems Heterosexuals Incidence Individual Inherited Injecting drug user Injections Intervention Interview Kazakhstan Lead Light Measurement Measures Mentored Research Scientist Development Award Methodology Methods Middle East Monitor Morbidity - disease rate Opioid replacement therapy Outcome Patient Self-Report Pharmaceutical Preparations Pharmacy facility Policies Population Prevention approach Randomized Research Research Project Grants Resources Risk Behaviors Risk Reduction Science Scientist Sexual Partners Social support Spottings Structure Tenofovir Test Result Testing Training Treatment Efficacy USSR United States National Institutes of Health Viral Viral Load result Work acceptability and feasibility antiretroviral therapy base career career development control trial design effective therapy evidence base experience hands on research improved injection drug use longitudinal analysis marginalized population medication compliance mobile application monitoring device mortality novel opioid injection response rural area safety and feasibility skills social stigma standard of care substance use therapy adherence tool transmission process treatment arm treatment as prevention

项目摘要

PROJECT SUMMARY/ABSTRACT The purpose of this Mentored Research Scientist Development Award (K01) is to provide the candidate with the training and expertise needed to transition to research independence in the science of HIV prevention and intervention. The fastest growing HIV epidemics globally are driven by injection drug use. Central Asia has some of the highest rates of injection drug use and one of the fastest growing HIV epidemics in the world. HIV- positive people who inject drugs (PWID) face many barriers to antiretroviral therapy (ART) adherence, such as misperceptions about ART, stigma and substance use. Previous research among this population has shown that couple-based HIV interventions are highly efficacious at reducing risk behaviors, but there is currently no couple-based ART adherence intervention for PWID. The research aims of this proposal are to 1) identify core components of the SMART Couples intervention and other existing ART adherence intervention strategies and assess their appropriateness and feasibility as an integrated, couple-based ART adherence intervention for HIV+ PWID living in Kazakhstan; 2) adapt and refine SMART Couples and identify augmentative intervention strategies to create an integrated, couple-based ART adherence intervention for HIV+ PWID and their primary sex partners using results from Aim 1; and 3a) pilot test the resulting couple-based intervention among 66 heterosexual PWID couples in Kazakhstan through a randomized control trial to assess the safety, feasibility, and acceptability of the intervention and obtain preliminary estimates of adherence outcomes in the intervention arm versus standard of care; and 3b) assess the feasibility and acceptability of conducting dried blood spot testing as part of an adherence intervention in a clinical setting. The proposed career development plan has been designed to augment the candidate’s current training in epidemiology and enable her to 1) gain research skills in the design and adaptation of HIV interventions, with an emphasis on adherence among marginalized populations; 2) obtain methodological expertise in dyad and intensive longitudinal analysis and the triangulation of behavioral, biomedical, and technological data, particularly for the purposes of interpreting and analyzing these types of data to assess intervention efficacy and measure ART adherence; 3) acquire training in the conduct and analysis of qualitative in-depth interviews and focus groups, particularly for designing and adapting HIV interventions and assessing intervention feasibility and acceptability; and 4) increase professional skills for a successful independent research career. These training goals will be achieved through a combination of didactic courses, specialized workshops and seminars, hands-on research, and an interdisciplinary team of experts. The research findings and methodological skills to be gained from this K01 have wide applicability for disease research and high transferability across diverse research settings.

项目概要/摘要导师研究科学家发展奖（K01）的目的是为候选人提供在艾滋病毒预防科学领域过渡到研究独立性所需的培训和专业知识全球增长最快的艾滋病毒流行是由注射毒品造成的。是世界上注射毒品使用率最高的国家之一，也是艾滋病毒流行速度最快的国家之一。注射吸毒者 (PWID) 的阳性人士在坚持抗逆转录病毒治疗 (ART) 方面面临许多障碍，例如先前对该人群的研究表明，人们对抗逆转录病毒治疗、耻辱和药物滥用存在误解。以夫妻为基础的艾滋病毒干预措施对于减少危险行为非常有效，但目前还没有针对吸毒者的基于夫妇的 ART 依从性干预本提案的研究目的是 1) 确定核心。 SMART 夫妻干预和其他现有 ART 依从性干预策略的组成部分，评估其作为综合的、基于夫妇的 ART 依从干预措施的适当性和可行性生活在哈萨克斯坦的 HIV+ 吸毒者；2) 调整和完善 SMART Couples 并确定增强干预措施为艾滋病毒携带者及其主要吸毒者制定综合的、以夫妻为基础的 ART 依从性干预措施的策略性伴侣使用目标 1 的结果；以及 3a) 在 66 名参与者中试点测试基于夫妇的干预措施哈萨克斯坦的异性吸毒者夫妇通过一项随机对照试验来评估安全性、可行性、和干预措施的可接受性，并获得依从性结果的初步估计干预组与护理标准；以及 3b) 评估实施的可行性和可接受性血斑测试作为临床环境中依从性干预的一部分。拟议的职业发展。该计划旨在增强候选人当前的流行病学培训，并使她能够 1) 获得设计和调整艾滋病毒干预措施的研究技能，重点是各方的坚持 2) 获得二元分析和强化纵向分析方面的方法学专业知识行为、生物医学和技术数据的三角测量，特别是为了解释分析这些类型的数据以评估干预效果并衡量 ART 依从性 3) 获取；进行和分析定性深入访谈和焦点小组的培训，特别是针对设计和调整艾滋病毒干预措施并评估干预措施的可行性和可接受性；4) 提高专业技能，以实现成功的独立研究生涯。通过教学课程、专门讲习班和研讨会、实践研究和从 K01 中获得的跨学科专家团队的研究成果和方法技能。对疾病研究具有广泛的适用性，并且在不同的研究环境中具有很高的可移植性。