Ethno-epidemiology of HCV, HIV and Overdose associated with Drug Markets and Drug Tourism

与毒品市场和毒品旅游相关的丙型肝炎病毒、艾滋病毒和药物过量的民族流行病学

基本信息

批准号：
10409999
负责人：
STEFFANIE A. STRATHDEE
金额：
$ 56.18万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN DIEGO
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-01 至 2023-01-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10409999
关键词：
Age Antibodies Behavior Behavior Therapy Behavioral COVID test COVID testing COVID-19 COVID-19 health disparity COVID-19 test COVID-19 testing COVID-19 vaccination COVID-19 vaccine COVID-19 vaccine evaluation California Caring Communities Coronavirus Country County Criminal Justice Data Data Linkages Databases Electronic Health Record Epidemiology Ethnic Origin Funding Future Geographic state HIV HIV/HCV Health Health Insurance Healthcare Systems Hepatitis B Vaccination Hepatitis C virus Homelessness Human immunodeficiency virus test Incidence Infection Infrastructure Injecting drug user Intervention Interview Legal Measures Medical Mexico Misinformation National Institute of Drug Abuse Natural experiment Needle-Exchange Programs Outcome Overdose Parents Participant Patient Self-Report Pattern Pharmaceutical Preparations Population Positioning Attribute Prevalence Prevention Professional counselor Proteins Race Randomized Reporting Research Role SARS-CoV-2 antibody SARS-CoV-2 antigen SARS-CoV-2 infection Serology Serology test Services Site Structure Subgroup Surveys Testing Training Transportation Travel Vaccinated Vaccination Vaccines Visit acceptability and feasibility addiction antigen test base brief intervention coronavirus disease drug market efficacy trial falls follow-up health literacy high risk improved member overdose prevention pandemic preparedness parent grant peer pre-exposure prophylaxis programs prospective rapid testing sex substance abuse treatment theories uptake vaccine acceptance vaccine access vaccine evaluation vaccine hesitancy vaccine-induced immunity

项目摘要

This competitive revision aims to increase access and uptake of COVID-19 testing and vaccination among people who inject drugs (PWID), a population highly vulnerable to COVID-19. The proposed RADxUP project, LinkUP, will be nested within the San Diego component of our parent grant, La Frontera, which was funded by NIDA in 04/20. To date, 31% of La Frontera PWID have tested SARS- CoV-2 antibody+, of whom 65% had not previously been tested for COVID-19. Only 3% had been vaccinated by 05/2021 and 45% were vaccine hesitant. Our specific aims are: AIM 1. To prospectively evaluate the prevalence, predictors and barriers to COVID-19 testing among PWID. AIM 2. To prospectively assess incidence, predictors and barriers to COVID-19 vaccination among PWID. AIM 3. To adapt and pilot an intervention offered at a mobile syringe services program (SSP) to improve uptake of COVID-19 testing and vaccination among PWID. AIM 4. To compare COVID testing and vaccination rates before and after the state introduces a) COVID-19 rapid testing and b) COVID-19 vaccination at the SSP, which represents a natural experiment. AIM 5. To prospectively assess the impact of COVID-19 testing and vaccination on PWIDs’ behaviors. To meet Aim 1 and 2, we will conduct interviews with 400 PWID in La Frontera, results which will be available in Fall 2021. Based on these findings and input from our Community and Scientific Advisory Board (CSAB), we will select and adapt a brief intervention to improve COVID-19 testing and vaccination uptake among PWID at the mobile van of our community partner, OnPoint. The LinkUP intervention will then be piloted among a subgroup of 150 La Frontera PWID who have not received COVID-19 vaccine or testing and will be implemented by OnPoint peer counsellors, who will also offer on-site rapid COVID-19 antigen testing and confirmatory PCR and referrals to the closest COVID-19 vaccination center (until vaccine is offered at OnPoint by the state). We will evaluate COVID-19 vaccine uptake independently through ongoing La Frontera study visits that will include self-reported interview data, linkage of electronic health records with the San Diego County COVID-19 database, and by analyzing SARSCoV-2 antibody patterns to differentiate between natural infection and vaccine-induced immunity. Results will be used to estimate effect sizes for a future efficacy trial and shared with the RADxUP consortium, policymakers and program planners. Since there are 185 SSPs across the country, our study will inform efforts to enable SSPs to become important ‘touchpoints’ to reach marginalized PWID, strengthening the nation’s pandemic preparedness infrastructure to reduce COVID-19 health disparities.

此次竞争性修订旨在增加 COVID-19 检测和疫苗接种的可及性和采用率注射吸毒者 (PWID) 是极易感染 COVID-19 的人群。 RADxUP 项目 LinkUP 将嵌套在我们母基金 La 的圣地亚哥部分中 Frontera 于 2020 年 4 月由 NIDA 资助，迄今为止，31% 的 La Frontera 吸毒者已接受过 SARS 检测。 CoV-2 抗体+，其中 65% 之前未接受过 COVID-19 检测，只有 3% 接受过检测。到 2021 年 5 月接种疫苗，45% 对疫苗犹豫不决。我们的具体目标是：目标 1. 前瞻性。评估 AIM 2. 中注射吸毒者 (PWID) 的流行率、预测因素和障碍。前瞻性评估 AIM 3 中注射吸毒者 (PWID) 的发病率、预测因素和疫苗接种障碍。调整和试点移动注射器服务计划 (SSP) 提供的干预措施，以改善 AIM 4. 比较 COVID-19 检测和疫苗接种情况。该州引入 a) COVID-19 快速检测和 b) COVID-19 前后的疫苗接种率在 SSP 进行疫苗接种，这是一项自然实验。 AIM 5. 前瞻性评估。 COVID-19 检测和疫苗接种对注射吸毒者行为的影响为了实现目标 1 和 2，我们将对拉弗龙特拉的 400 名吸毒者进行访谈，结果将于 2021 年秋季公布。基于这些发现和来自我们的社区和科学咨询委员会 (CSAB) 的输入，我们将选择并采取简短的干预措施，以改善注射吸毒者的 COVID-19 检测和疫苗接种情况我们的社区合作伙伴 OnPoint 的移动货车随后将在社区中进行试点。由 150 名拉弗龙特拉注射吸毒者组成的小组，他们尚未接受过 COVID-19 疫苗或检测，将被由 OnPoint 同伴辅导员实施，他们还将提供现场快速 COVID-19 抗原检测进行确认性 PCR 并转诊至最近的 COVID-19 疫苗接种中心（直至提供疫苗）我们将通过正在进行的 La 独立评估 COVID-19 疫苗的接种情况。 Frontera 研究访问将包括自我报告的访谈数据、电子健康记录的链接圣地亚哥县 COVID-19 数据库，并通过分析 SARSCoV-2 抗体模式来区分自然感染和疫苗诱导的免疫。结果将用于估计。未来疗效试验的效果大小，并与 RADxUP 联盟、政策制定者和由于全国有 185 个 SSP，我们的研究将为项目规划者提供信息。 SSP 将成为接触边缘化吸毒者的重要“接触点”，加强国家的流行病防范基础设施，以减少 COVID-19 健康差异。