Ending HIV: Bringing Integrated Prevention and Treatment Services to People Who Use Drugs Where They Live

终结艾滋病毒：为居住地吸毒者提供综合预防和治疗服务

• 批准号: 10468417
• 负责人: SANDRA Ann SPRINGER
• 金额: $ 117.25万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-06-15 至 2027-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10468417
• 关键词: Address; Affect; Award; Caring; Clinic; Clinical; Clinical Research; Collaborations; Communicable Diseases; Communities; Community Health Aides; Diagnosis; Diagnostic Services; Disease Outbreaks; Drug usage; Drug user; Ensure; Epidemic; Fentanyl; Goals; HIV; HIV Infections; Health Services Accessibility; Hour; Human immunodeficiency virus test; Immigrant; Justice; Medicine; Methods; Modeling; Overdose; Persons; Pharmaceutical Preparations; Pharmacists; Pharmacy facility; Physicians; Prevention; Research; Research Personnel; Retinal blind spot; Risk; Services; Stimulant; Substance Use Disorder; Test Result; Testing; Time; Training; Underrepresented Minority; Uninsured; United States; Vision; Woman; Work Ethic; addiction; antiretroviral therapy; base; career; clinical care; evidence base; experience; member; opioid use disorder; overdose death; pre-exposure prophylaxis; prevention service; rapid diagnosis; response; testing services; treatment planning; treatment services

Project Abstract: The United States (U.S.) Ending the HIV Epidemic (EHE) plan’s primary goal is to reduce the number of new HIV infections by 90% by 2030, but this will not happen unless we develop ways to BRING the evidenced- based services to persons who use drugs (PWUD). Overdose deaths are dramatically increasing in the US, and fentanyl and stimulants are fueling new HIV epidemics. My career and my passion revolve around integration of treatment of opioid use disorder (OUD) and other substance use disorders with HIV treatment and prevention. Through over 20 years of direct clinical care as an infectious disease and addiction medicine physician combined with substantial clinical research expertise involving PWUD living with and at risk of HIV, I know the blind spots in the EHE plan and I can fill them in with this pioneer award. My pioneering award vision is to: 1) train persons who live in the communities affected by high levels of overdose to be community health workers (CHWs) to provide the HIV testing and rapid diagnosis of OUD; 2) create mobile hubs that are pharmacies and clinics on wheels that can be deployed to immediately dispense pre-exposure prophylaxis (PrEP), antiretroviral therapy (ART), and medication treatment for OUD (MOUD) anywhere; 3) develop rapidly deployable mobile rapid response teams (the mobile spokes) comprised of the CHWs and pharmacists with 24 hour access to online clinicians that deploy out from the mobile hubs to where the CHWs identify to bring the medications (PrEP/ART based on the rapid HIV testing results, and MOUD to people who have a diagnosis of OUD) to where people ‘live’; and 4) collaborate with researchers, including modelers, to prioritize where outbreaks of HIV are most likely to occur and provide a collaboration hub for others working in the fields of HIV and substance use disorders to help inform this proposed care model. Through this award, I will also ensure that the mobile rapid response teams continue to follow people and help them retain on the medications and address competing needs to eliminate barriers to accessing services. Thus, the overall idea in this pioneer award is providing low barrier services at multiple access points in line with the EHE plans where we would be BRINGING the testing and treatment plans (MOUD, PrEP/ART) to PWUD and RETAINING them via non- traditional methods where THEY LIVE. Through using trained persons who LIVE in the communities (CHWs) with shared living experiences of their community members who use drugs and are at risk or living with HIV, we can provide the testing and diagnosis services combined with pharmacists to dispense the medications in real-time to people who typically do not have access to our normal clinical or research venues including women, justice-involved persons, immigrants, the uninsured, and underrepresented minorities. I have the experience, the passion, the work ethic and the collaborative team to help end HIV in PWUD through this pioneer award.

项目摘要： 美国（美国）结束艾滋病毒流行（EHE）计划的主要目标是减少新的数量 到2030年，艾滋病毒感染增加了90％，但这不会发生 基于使用毒品的人（PWUD）的服务。在美国，用药过量的死亡人数急剧增加， 芬太尼和兴奋剂正在助长新的HIV发作。我的职业和热情围绕着 阿片类药物使用障碍（OUD）和其他物质使用障碍与HIV治疗的整合 和预防。通过20多年的直接临床护理作为一种传染病和成瘾医学 物理与实质性的临床研究专业知识相结合，涉及与艾滋病毒的风险和有风险的pwud，我 知道EHE计划中的盲点，我可以填写此先锋奖。我的开创性奖 愿景是：1）培训居住在受高水平过量影响社区的社区中的培训人员 卫生工作者（CHW）提供了OUD的HIV测试和快速诊断； 2）创建移动枢纽 可以部署的车轮上的药房和诊所，以立即分配预防前预防 （PREP），抗逆转录病毒疗法（ART）和任何地方的OUD（MOUD）药物治疗； 3）迅速发展 可部署的移动快速响应团队（移动辐条）完成了CHW和药剂师的完成 小时访问从移动枢纽部署到CHW识别的在线临床医生 药物（基于快速HIV测试结果的准备/艺术 OUD）到人们“住的地方”； 4）与包括建模者在内的研究人员合作，优先考虑 艾滋病毒爆发最有可能发生，并为在艾滋病毒领域工作的其他人提供合作枢纽 和物质使用障碍以帮助告知这种建议的护理模型。通过这个奖项，我还将确保 移动快速响应团队继续跟随人们，并帮助他们保留药物和 解决竞争的需求以消除访问服务的障碍。那是这个先驱的总体想法 奖项根据我们将成为的EHE计划，在多个接入点提供低障碍服务 将测试和治疗计划（MOUD，PREP/ART）带来PWUD并通过非 - 保留它们 他们居住的传统方法。通过使用居住在社区（CHW）的受过训练的人 拥有使用毒品并处于危险或艾滋病毒居住的社区成员的共同生活经验， 我们可以提供测试和诊断服务与药剂师结合使用，以将药物分配给 对于通常无法访问我们正常临床或研究场所的人，包括 妇女，涉及正义的人，移民，未投保的人和代表性不足的少数群体。我有 经验，热情，职业道德和协作团队，通过此帮助结束艾滋病毒的艾滋病毒 先锋奖。