Individual, Network and Spatial Drivers of HIV and HCV among PWID in India

印度吸毒者中 HIV 和 HCV 的个体、网络和空间驱动因素

• 批准号: 10406390
• 负责人: Sunil Suhas Solomon
• 金额: $ 6.31万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-01 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10406390
• 关键词: Acquired Immunodeficiency Syndrome; Area; Awareness; Biometry; Caring; Cities; Clinical; Cluster randomized trial; Code; Cohort Studies; Computer software; Continuity of Patient Care; Data; Derivation procedure; Diffusion; Drug Monitoring; Drug resistance; Drug usage; Enrollment; Environmental Risk Factor; Epidemic; Evaluation; Fingerprint; Fingers; Government; HIV; HIV Seropositivity; HIV/HCV; Harm Reduction; Health Services Accessibility; Hepatitis C; Hepatitis C Incidence; Hepatitis C Prevalence; Hepatitis C Transmission; Hepatitis C virus; Home; Incidence; India; Individual; Infrastructure; Injecting drug user; Injections; Intervention; Link; Methodology; Network-based; Out-Migrations; Outcome; Participant; Patient Self-Report; Persons; Phylogenetic Analysis; Population; Prevalence; Process; Public Health; Research Personnel; Resources; Respondent; Risk; Role; Sampling; Scanning; Services; Site; Social Network; Techniques; Therapeutic; Time; Update; Ursidae Family; Viral; behavior change; cohort; design; disease transmission; disenfranchised population; effectiveness evaluation; experience; health seeking behavior; improved; improved outcome; indexing; innovation; low and middle-income countries; member; mortality; next generation sequencing; novel; opioid user; peer; public health relevance; recruit; research study; residence; social; social metrics; transmission process; trend

 DESCRIPTION: People who inject drugs (PWID) bear a high burden of HIV and hepatitis C virus (HCV) and fare worse along the HIV care continuum. The interplay between individual, network and spatial factors on HIV/HCV risk, particularly in resource-limited settings, has been understudied. Further, most network assessments have been cross-sectional and have focused on egocentric networks. Less is understood about the dynamics of networks over time, relationship of egocentric networks to the broader sociometric or spatial networks, and the impact of these larger networks on disease transmission and health seeking behaviors. India is home to the largest number of opiate users globally; HIV and HCV prevalence is 20% and 50%, respectively. We are currently implementing a cluster-randomized trial to assess the effectiveness of integrated care centers on HIV care continuum outcomes among PWID. In the evaluation of this trial (July - December 2016), we will accrue a sample using respondent driven sampling (RDS) in 12 cities - this will serve as the starting point for this study. The specific ais are: Aim 1: To assess the impact of spatial-, network- and individual-level factors on HIV and HCV incidence among PWID in three Indian cities, selected to reflect diverse HIV/PWID epidemics; Subaim 1a: Use phylogenetic data to characterize HIV/HCV transmission in drug using networks; Aim 2: To assess the social diffusion of behavior change in relation to the HIV care continuum within drug using networks; Aim 3: To develop improved methodology for the application of RDS in PWID populations by overlaying detailed network data on an RDS recruitment process; Subaim 3a: To characterize factors that influence how PWID distribute coupons to members of their networks and the impact of this process on RDS- derived estimates; Subaim 3b: To develop improved RDS recruitment strategies to overcome biases identified in Subaim 3a; Subaim 3c: To determine overlap between the RDS network and phylogenetically-defined clusters to inform the use of RDS for intervention delivery and derivation of population-level estimates; and Aim 4: To establish a platform for future research studies. We will establish a multi-center dynamic cohort across 3 cities with diverse HIV/drug use epidemics in India - Churachandpur, Amritsar and Kanpur. We will characterize the social network of the first 350 participants from the evaluation RDS and recruit those who have injected with these participants in the prior 6 months. We will characterize and recruit eligible network members of new recruits iteratively until no additional new network members are identified (~750 per site; 2250 total). Biometric data, GPS coordinates and network software will facilitate tracking and identifying cross-network linkages. Participants will be followed semi-annually and new network members recruited as identified. Our study is innovative in its ability to track temporal network dynamics, use of novel methodology to characterize sociometric and spatial networks, characterization of network impact on transmission using phylogenetic data, and the social diffusion of health-seeking behaviors related to HIV within PWID networks.

 描述：注射吸毒者（PWID）承受着艾滋病毒和丙型肝炎病毒（HCV）的沉重负担，并且在艾滋病毒护理连续过程中情况更糟。个人、网络和空间因素对艾滋病毒/丙型肝炎病毒风险的相互作用，特别是在资源方面。此外，大多数网络评估都是横向的，并且关注的是自我中心网络。印度是全球阿片类药物使用者人数最多的国家，这些网络对疾病传播和求医行为的影响分别为 20% 和 50%。评估综合护理中心对注射吸毒者艾滋病毒护理连续结果的有效性的试验 在本试验的评估中（2016 年 7 月至 12 月），我们将使用参与者驱动抽样 (RDS) 在 12 个城市收集样本。 - 这将作为本研究的起点： 目标 1：评估空间、网络和个人层面的因素对印度三个城市吸毒者艾滋病毒和丙型肝炎发病率的影响，选择反映这些因素。不同的艾滋病毒/吸毒者流行病；子目标 1a：利用系统发育数据来描述吸毒网络中艾滋病毒/丙型肝炎病毒传播的特征；目标 2：评估吸毒网络中与艾滋病毒护理连续体相关的行为变化的社会扩散；目标 3：通过将详细的网络数据覆盖在 RDS 招募过程中，开发 RDS 在注射吸毒者群体中应用的改进方法；Subaim 3a：描述影响注射吸毒者如何向其网络成员分发优惠券的因素以及该过程对其的影响； RDS 得出的估计；Subaim 3b：制定改进的 RDS 招募策略，以克服 Subaim 3a 中发现的偏差：确定 RDS 网络与 RDS 网络之间的重叠；系统发育定义的聚类，为 RDS 的使用提供干预措施和人口水平估计的推导；目标 4：为未来的研究建立一个平台，我们将在 3 个具有不同 HIV/病毒的城市建立一个多中心动态队列。印度的毒品使用流行病 - Churachandpur、Amritsar 和 Kanpur 我们将从评估 RDS 中描述前 350 名参与者的社交网络，并招募在过去 6 个月内注射过这些参与者的人。我们将迭代地描述和招募新招募的合格网络成员，直到不再确定新的网络成员（每个站点约 750 名；总共 2250 名），生物识别数据、GPS 坐标和网络软件将有助于跟踪和识别跨网络链接。我们的研究每半年进行一次跟踪，并根据确定招募新的网络成员，其创新之处在于跟踪时间网络动态的能力，使用新颖的方法来表征社会计量和空间网络，使用系统发育数据表征网络对传播的影响，以及吸毒者网络中与艾滋病毒相关的寻求健康行为的社会传播。