STRIDES (Strategies To Reduce Intersectional Drug usE Stigma): A mixed-methods, human-centered approach to address barriers to HIV services

STRIDES（减少交叉吸毒污名的策略）：采用混合方法、以人为本的方法来解决艾滋病毒服务障碍

• 批准号: 10394383
• 负责人: Felicia Amira Browne
• 金额: $ 21.45万
• 依托单位: RESEARCH TRIANGLE INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-05-01 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10394383
• 关键词: AIDS prevention; AIDS/HIV problem; Address; Adherence; Affect; African American; African American population; American; Area; Attitude; Awareness; Behavior; COVID-19 morbidity; COVID-19 risk; Caring; Clinic; Cluster randomized trial; Communities; Continuity of Patient Care; County; Diagnosis; Discrimination; Drug usage; Drug user; Educational Curriculum; Ensure; Frequencies; Goals; HIV; HIV diagnosis; Health; Health Personnel; Human; Human immunodeficiency virus test; Incidence; Intervention; Interview; Manuals; Medical; Methods; Modification; North Carolina; Opioid; Outcome; Pharmaceutical Preparations; Population; Populations at Risk; Prevention; Process; Public Health; Qualitative Research; Reduce health disparities; Reporting; Research; Research Methodology; Research Priority; Service setting; Services; Stigmatization; Surveys; Testing; Training; United States National Institutes of Health; acceptability and feasibility; antiretroviral therapy; efficacy testing; evidence base; experience; health care settings; health disparity; health service use; improved; injection drug use; innovation; intervention program; mortality; pre-exposure prophylaxis; prevention service; racial disparity; response; social stigma; transmission process; treatment services

PROJECT SUMMARY/ABSTRACT The US South has a greater proportion of HIV transmission associated with drug use than any other US region, and African Americans are disproportionately affected. Drug use stigma is a significant barrier to engagement and retention at every stage of the HIV prevention and care continuum. HIV-related stigma- reduction interventions in healthcare settings have shown positive outcomes, feasibility, and acceptability in the US and globally. However, few of these interventions address drug use stigma. Consequently, there is a critical need to understand how drug use stigma impacts engagement and retention in HIV services for African Americans who use drugs and to develop targeted interventions and programs to reduce drug use stigma. Failing to elucidate and actively address drug use stigma will result in stigma remaining a barrier to HIV services for a key population and in the region most affected by HIV in the US. The long-term goal is to develop an evidence-based drug use stigma-reduction intervention that can be implemented in HIV services, and ultimately reduce racial disparities in the HIV prevention and care continuum. The overarching objective for the proposed project is to use mixed methods to elucidate how drug-related stigma impacts engagement and retention in HIV services and use these findings to select, adapt, and pretest an evidence-informed HIV stigma-reduction intervention to address drug use stigma and other intersecting forms of stigma. The Specific Aims are: Aim 1. To conduct mixed methods research to assess and examine drug use stigma in human service settings among people who use drugs and health clinic staff. Aim 2. To select and adapt an evidence-informed HIV stigma curriculum to reduce drug use stigma and discrimination and to increase/improve engagement and retention in the HIV prevention and care continuum among people who use drugs. Aim 3. To pretest the adapted stigma and discrimination reduction curriculum to evaluate preliminary acceptability and feasibility. This research is innovative because it will shift current research paradigms regarding drug use stigma via the use of human-centered and status-neutral approaches. The proposed formative research will lay the groundwork for subsequent research to test the efficacy and preliminary impact of the tailored drug use stigma-reduction intervention. This study aligns with the high-priority areas identified in the NIH HIV/AIDS Research Priorities, specifically research to ultimately reduce health disparities in HIV incidence.

项目摘要/摘要 美国南部比其他任何人都有比其他任何人相关的艾滋病毒传播的比例 地区和非裔美国人受到不成比例的影响。吸毒污名是对 在艾滋病毒预防和护理连续体的每个阶段的参与和保留。与HIV相关的污名 - 减少医疗保健设置的干预措施表现出积极的结果，可行性和可接受性 美国和全球。但是，这些干预措施中很少有人解决药物使用污名。因此，有一个 了解毒品使用污名如何影响艾滋病毒服务的参与和保留艾滋病毒服务的批判性需求 使用药物并制定有针对性的干预措施和计划减少药物使用的非裔美国人 柱头。无法阐明并积极解决毒品使用污名将导致污名仍然是 为关键人群和美国受艾滋病毒影响最大的地区的艾滋病毒服务。 长期目标是开发基于证据的药物使用污名干预措施，可以是 在艾滋病毒服务中实施，最终减少了预防艾滋病毒和护理中的种族差异 连续。拟议项目的总体目标是使用混合方法来阐明如何 与药物有关的污名会影响艾滋病毒服务中的参与和保留率，并使用这些发现选择， 适应并测试证据发现的艾滋病毒污名干预措施，以应对药物使用污名和 其他相交形式的污名。 具体目的是： 目的1。进行混合方法研究以评估和检查人类服务中的毒品使用污名 使用毒品和健康诊所人员的人之间的设置。 目标2。选择并适应证据中有证据的HIV污名课程，以减少药物使用污名和 歧视并提高/改善艾滋病毒预防和护理中的参与和保留 使用毒品的人中的连续体。 目标3。预测试适应的污名和歧视减少课程以评估初步 可接受性和可行性。 这项研究具有创新性，因为它将通过目前的研究范式来改变有关药物使用污名的范式 以人为中心和地位中性方法的使用。拟议的形成性研究将为 随后研究的基础工作，以测试量身定制的药物使用的功效和初步影响 减少污名干预。这项研究与NIH HIV/AIDS中确定的高优先级区域保持一致 研究优先级，特别是研究最终减少艾滋病毒发病率的健康差异。