A geospatial analysis of hotspots and targeted injection settings pilot intervention for HIV prevention among people who inject drugs in Baltimore, Maryland

对马里兰州巴尔的摩注射吸毒者的艾滋病毒预防热点地区和有针对性的注射设置试点干预进行地理空间分析

• 批准号: 10203907
• 负责人: CARL A LATKIN
• 金额: $ 75.98万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-07-01 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10203907
• 关键词: AIDS prevention; Acute Hepatitis C; Address; Area; Baltimore; Baseline Surveys; Behavior; Behavioral; Caring; Censuses; Cessation of life; Characteristics; Cities; Cluster randomized trial; Computer software; Data; Ecological momentary assessment; Education; Ensure; Equipment; Geographic Locations; Goals; HIV; HIV Infections; HIV Seronegativity; HIV Seropositivity; HIV diagnosis; HIV drug resistance; HIV risk; HIV/HCV; Health; Hepatitis C; Hepatitis C Antibodies; Hepatitis C Transmission; High School Student; Human immunodeficiency virus test; Incidence; Infection; Injecting drug user; Injections; Intervention; Intervention Trial; Location; Maps; Maryland; Massachusetts; Methods; Naloxone; Online Systems; Opioid; Outcome; Overdose; Participant; Patient Self-Report; Pharmaceutical Preparations; Prevention; Privatization; Randomized; Recording of previous events; Research; Risk; Risk Behaviors; Risk Reduction; Sampling; Social Network; Supervision; Surveys; Technology; Testing; Time; Training; Viral Load result; Washington; antibody test; base; cooking; evidence base; high risk; high risk behavior; improved; indexing; injection drug use; innovation; mortality; novel; novel strategies; opioid injection; opioid overdose; overdose prevention; overdose risk; peer; prevent; programs; recruit; social; social norm; standard of care; transmission process; treatment arm; trend; virology

Project Summary This resubmission of application R01DA050470 proposes to use innovative approaches to identify “hotspots,” defined as geographic areas in which high rates of HIV or HCV infection, high HIV viral loads, or drug-resistant HIV strains are found. We propose two novel approaches for identifying hotspots: 1) Use of web-based mapping technology to document observed and self-reported HIV and overdose risk behaviors among PWID in private and semi-public injection settings (SPIS) and the attributes of these risk settings; 2) Systematically collect cookers (containers used to mix and heat drugs before injecting) from injection settings and test them for HIV and HCV antibodies (testing cookers is a novel method developed in the Johns Hopkins Virology lab). We will recruit 600 HIV positive and negative people who inject drugs (PWID). These PWID will complete a survey using a software program developed by our team to locate and map the areas where they inject and attributes of these injection settings. These data will be used to identify high-risk behaviors in SPIS within census block groups (CBGs). These participants will be followed for 2 years. The findings from this observational portion of the study will then be used to inform an innovative pilot of an injection setting targeted peer-driven intervention to reduce HIV/HCV transmission and overdose risk behaviors. From the identified CBGs, we will select 60 non-contiguous CBGs for a pilot cluster randomized trial (CRT) of the intervention. The CBGs will be randomized to one of 4 conditions: 1) Peer education and stocking of SPIS with risk reduction materials, 2) Peer education only, 3) Stocking SPIS with risk reduction materials only, and 4) The standard of care. Based on their CBG and SPIS use, 120 index PWID participants will be selected from the 600 PWID. These index participants will receive training corresponding to the assigned condition of their CBG. The indexes will implement the intervention targeting two specific SPIS. Each index will also recruit PWID from their CBG to serve as data collectors. In the SPIS, the data collectors will use Ecological Momentary Assessment (EMA) and collect cookers for HIV/HCV testing. Data from the indexes (N=120) and data collectors (N=120) will be used as outcomes of the 4-arm intervention.

项目摘要 该应用程序R01DA0504​​70的这种重新提议使用创新方法来识别“热点”， 定义为高艾滋病毒或HCV感染率，高HIV病毒载荷或耐药性的地理区域 发现HIV菌株。我们提出了两种识别热点的新方法：1）使用基于Web的使用 绘制技术以记录观察到的和自我报告的艾滋病毒和过量的风险行为 私人和半公共注入设置（SPI）以及这些风险设置的属性； 2）系统地 从注入设置中收集炊具（用于在注射前混合和加热药物的容器并进行测试 对于HIV和HCV抗体（测试炊具是Johns Hopkins病毒学实验室中开发的一种新方法）。 我们将招募注射药物（PWID）的600名HIV阳性和负面人。这些PWID将完成 使用我们团队开发的软件程序进行调查，以找到和绘制他们注入的区域和 这些注入设置的属性。这些数据将用于识别SPI中的高风险行为 人口普查组（CBG）。这些参与者将被遵循2年。 然后，研究部分的发现将用于告知创新的飞行员 注射设定针对同行驱动的干预措施，以减少HIV/HCV传播和过量风险 行为。从确定的CBG中，我们将选择60个非连续CBG进行飞行群集随机试验 干预的（CRT）。 CBG将被随机分为4个条件之一：1）同伴教育和库存 带有降低风险材料的SPI，2）仅同行教育，3）带有降低风险材料的Spis 只有4）护理标准。根据他们的CBG和SPI使用，将有120个索引PWID参与者 从600个PWID中选择。这些指数参与者将接受与分配的相对应的培训 他们的CBG状况。索引将实施针对两个特定SPI的干预措施。每个索引将 还可以从其CBG中招募PWID作为数据收集器。在SPI中，数据收集器将使用 生态瞬时评估（EMA）并收集用于HIV/HCV测试的炊具。来自索引的数据 （n = 120）和数据收集器（n = 120）将用作4臂干预的结果。