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.

项目概要/摘要 美国南部与吸毒相关的艾滋病毒传播比例高于美国其他任何地区 地区，非裔美国人受到的影响尤其严重。吸毒耻辱是一个重大障碍 艾滋病毒预防和护理连续性的每个阶段的参与和保留。与艾滋病相关的耻辱—— 医疗机构中的减少干预措施已显示出积极的成果、可行性和可接受性 美国和全球。然而，这些干预措施很少能解决吸毒耻辱问题。因此，有一个 迫切需要了解吸毒耻辱如何影响艾滋病毒服务的参与和保留 使用毒品的非裔美国人并制定有针对性的干预措施和计划以减少毒品使用 柱头。未能阐明并积极解决吸毒污名将导致污名仍然是吸毒的障碍 为美国重点人群和受艾滋病毒影响最严重的地区提供艾滋病毒服务。 长期目标是开发一种基于证据的药物使用耻辱减少干预措施，该干预措施可以 在艾滋病毒服务中实施，最终减少艾滋病毒预防和护理方面的种族差异 连续体。拟议项目的总体目标是使用混合方法来阐明如何 与毒品相关的耻辱会影响艾滋病毒服务的参与和保留，并利用这些发现来选择、 适应并预先测试基于证据的艾滋病毒耻辱减少干预措施，以解决吸毒耻辱和 其他交叉形式的耻辱。 具体目标是： 目标 1. 进行混合方法研究，以评估和检查人类服务中的吸毒耻辱 吸毒者和诊所工作人员的环境。 目标 2. 选择和调整以证据为依据的艾滋病毒耻辱课程，以减少吸毒耻辱和 歧视并增加/改善对艾滋病毒预防和护理的参与和保留 吸毒者之间的连续体。 目标 3. 预先测试改编后的减少耻辱和歧视课程，以评估初步结果 可接受性和可行性。 这项研究具有创新性，因为它将改变当前有关吸毒耻辱的研究范式 采用以人为本和地位中立的方法。拟议的形成性研究将奠定 为后续研究测试定制药物使用的功效和初步影响奠定基础 减少耻辱干预。这项研究符合 NIH HIV/AIDS 中确定的高度优先领域 研究重点，特别是最终减少艾滋病毒发病率健康差异的研究。