Understanding the role of social networks in methadone maintenance treatment retention and antiretroviral therapy adherence among people who inject drugs in Tanzania

了解社交网络在坦桑尼亚注射吸毒者美沙酮维持治疗保留和抗逆转录病毒治疗依从性中的作用

• 批准号: 10451521
• 负责人: Haneefa Tasleem Saleem
• 金额: $ 18.32万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-08-15 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10451521
• 关键词: Africa South of the Sahara; Age; Caring; Characteristics; Clinic; Communities; Community Outreach; Cross-Sectional Studies; Data; Development; Dose; Drug usage; Enrollment; Evaluation; Family; Friends; Funding; Future; Gender; General Population; Goals; HIV; HIV Infections; HIV Seropositivity; HIV risk; Health; Hospitals; Individual; Injecting drug user; Intervention; Interview; K-Series Research Career Programs; Link; Measures; Medical; Mentors; Modeling; Outcome; Pathway Analysis; Patients; Persons; Pharmaceutical Preparations; Positioning Attribute; Prevalence; Prevention; Program Sustainability; Provider; Qualitative Research; Questionnaires; Randomized Controlled Trials; Reading; Recording of previous events; Records; Recovery; Research; Research Personnel; Resource-limited setting; Respondent; Role; Scientist; Services; Sexual abuse; Social Network; Social support; Surveys; Tanzania; Testing; Trust; United States National Institutes of Health; Viral; Woman; Work; acceptability and feasibility; antiretroviral therapy; barrier to care; base; career; career development; design; drug maintenance; implementation science; improved; informant; innovation; intervention cost; medication compliance; medication-assisted treatment; member; methadone treatment; mortality risk; non-drug; patient population; programs; research and development; research study; skills; social influence; social metrics; social structure; sociodemographics; substance use; theories; therapy adherence; treatment services

PROJECT SUMMARY The purpose of this Mentored Research Scientist Career Development Award (K01) application is to develop Dr. Haneefa Saleem’s career as an independent scientist with expertise in social network analysis and the development and evaluation of social network interventions to improve health outcomes. PWID have high rates of HIV, particularly in Tanzania where an estimated 35% of PWID are living with HIV. Methadone maintenance treatment (MMT) is recommended as part of a comprehensive package of interventions for the prevention, treatment, and care of HIV infection among PWID. Retention in MMT is associated with improved antiretroviral therapy (ART) adherence and HIV viral suppression. Retention in MMT is critical for linking PWID to ART services, yet MMT retention is a challenge for PWID who routinely leave treatment in the context of escalating levels of drug use. The goal of this research study is to adapt an innovative social network intervention that mobilizes the personal social networks of treatment-seeking PWID to support them to remain in MMT and adhere to ART in Dar es Salaam, Tanzania. The study’s specific aims are to: 1) qualitatively examine how social networks influence MMT retention and ART adherence among PWID through in-depth interviews with 10 current and 10 former MMT patients; 2) examine the relationship between personal network and network-level factors and MMT retention and ART adherence using egocentric and sociometric network data generated from cross-sectional surveys with 150 HIV-positive MMT patients; and 3) adapt and pilot a social network intervention aimed at improving MMT retention and ART adherence with 15 current HIV-positive MMT patients and 15 of their social support persons to assess intervention acceptability and feasibility in the Tanzanian context. Through the proposed research study and a combination of directed readings, coursework, and mentored research opportunities, Dr. Saleem will be able to achieve the following career development goals: 1) gain expertise in the theoretical underpinnings of social networks; 2) develop advanced social network analysis skills; and 3) enhance her implementation science skills to develop and test social network interventions. To support these goals, Dr. Saleem has a mentoring team of leading experts in social network theory and analysis and social network interventions. Dr. Saleem’s career development and research plan will provide skills and preliminary data for her to pursue future funding and to successfully become an independent researcher in substance use and HIV research both globally and domestically.

项目概要 导师研究科学家职业发展奖（K01）申请的目的是开发 Haneefa Saleem 博士作为独立科学家的职业生涯，在社交网络分析和 开发和评估社交网络干预措施以改善吸毒者的健康结果具有很高的效果。 艾滋病毒感染率，特别是在坦桑尼亚，估计有 35% 的吸毒者感染了美沙酮。 建议将维持治疗（MMT）作为一揽子综合干预措施的一部分 注射吸毒者中 HIV 感染的预防、治疗和护理与 MMT 的保留率提高有关。 抗逆转录病毒治疗 (ART) 依从性和 HIV 病毒抑制在 MMT 中的保留对于联系至关重要。 注射吸毒者接受 ART 服务，但保留 MMT 对于注射吸毒者来说是一个挑战，因为他们通常会放弃治疗 这项研究的目标是适应创新的社交网络。 动员寻求治疗的注射吸毒者的个人社交网络来支持他们留下来的干预措施 在坦桑尼亚达累斯萨拉姆学习 MMT 并坚持 ART 该研究的具体目标是：1) 定性。 通过深入研究社交网络如何影响吸毒者中 MMT 的保留和 ART 的坚持 采访 10 名现任和 10 名前 MMT 患者 2) 检查个人之间的关系； 使用自我中心和社会计量学的网络和网络层面因素以及 MMT 保留和 ART 依从性 对 150 名 HIV 阳性 MMT 患者进行横断面调查生成的网络数据；3) 适应和 试点一项社交网络干预措施，旨在提高 MMT 保留率和 ART 依从性，目前有 15 个 HIV 阳性 MMT 患者及其 15 名社会支持人员评估干预措施的可接受性和 通过拟议的研究和定向研究的结合。 阅读材料、课程作业和指导研究机会，萨利姆博士将能够实现以下目标 职业发展目标：1) 获得社交网络理论基础方面的专业知识；2) 发展 高级社交网络分析技能；3) 增强她的科学实施技能以进行开发和测试 为了支持这些目标，萨利姆博士拥有一支由领先专家组成的指导团队。 社交网络理论与分析以及萨利姆博士的职业发展和社交网络干预。 研究计划将为她提供技能和初步数据，以便她寻求未来的资助并成功 成为全球和国内物质使用和艾滋病毒研究的独立研究员。