Impacts of universal access to HIV/AIDS care among HIV+ injection drug users

艾滋病毒注射吸毒者普遍获得艾滋病毒/艾滋病护理的影响

• 批准号: 7337267
• 负责人: Evan Wood
• 金额: $ 46.39万
• 依托单位: UNIVERSITY OF BRITISH COLUMBIA
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-17 至 2012-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7337267
• 关键词: AIDS prevention; AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; Adherence; Anti-Retroviral Agents; Antiretroviral drug resistance; Antiretroviral resistance; Area; Behavior; Blood specimen; British Columbia; Budgets; Canada; Caring; Charge; Cities; Cohort Studies; Complement; Data; Databases; Development; Disease Progression; Disease Resistance; Drug resistance; Drug usage; Epidemic; Evaluation; Funding; HIV; Health Policy; Healthcare; Healthcare Systems; Highly Active Antiretroviral Therapy; Home environment; Illicit Drugs; Incidence; Injecting drug user; Injection of therapeutic agent; International; Intervention; Knowledge; Laboratories; Law Enforcement; Malaria; Measures; Medical; Modeling; North America; Numbers; Patient Self-Report; Pattern; Peer Review; Persons; Policy Maker; Population; Prevalence; Prevention; Prevention strategy; Process; Province; Public Health; Publications; Purpose; Questionnaires; Research; Research Infrastructure; Research Personnel; Risk Behaviors; Role; Sampling; Scientific Evaluation; Secondary Prevention; Services; Social Work; Syringes; Techniques; Time; Wood material; addiction; antiretroviral therapy; base; cohort; cost; discounting; experience; fighting; improved; member; prevention service; programs; prospective; scale up; transmission process; trend; uptake

DESCRIPTION (provided by applicant): Barriers to appropriate HIV treatment and care for HIV-infected injection drug users (IDU) are a growing concern. International efforts to improve the delivery of highly active antiretroviral therapy (HAART) to IDU, such as the WHO'S 3 by 5 Initiative, are in urgent need of data on how these barriers can be addressed. While there has been much focus on HIV prevention for HIV-negative IDU, there has recently been a growing recognition that breaking the cycle of HIV transmission will require renewed focus on behaviors and prevention needs of HIV-infected IDU. This proposal seeks to fill the information gap existing in North America and elsewhere through the following specific aims: 1. To evaluate the incidence of HIV/AIDS service uptake (e.g., antiretroviral therapy) and factors associated with uptake among IDU 2. To evaluate the incidence of HIV antiretroviral drug resistance among HIV-infected IDU and the role of unique antiretroviral delivery models on the time to antiretroviral resistance 3. To evaluate trends in HIV disease progression and factors such as medical service and secondary prevention service use that may be associated with reduced disease progression among IDU 4. To determine factors associated with persistent HIV risk behaviors (e.g., syringe lending) in a setting with comprehensive evidence-based HIV prevention strategies for HIV-infected IDU. These aims will be met through the development of a new prospective cohort study of HIV-infected IDU in Vancouver, Canada. This setting is unique, since all medical care and antiretrovirals are provided free of charge through a universal healthcare system, allowing the research program to focus on non-financial barriers to care. The cohort will involve serial blood sampling to evaluate antiretroviral resistance patterns, a detailed questionnaire to evaluate illicit drug use and related behaviors, and ongoing administrative linkages to the province's centralized medical care and social service databases to evaluate access to antiretrovirals and access to other HIV/AIDS care and prevention services. By helping to fill a critical information gap, this study has the potential to make a major contribution to public health policies for IDU.

描述（由申请人提供）：艾滋病毒感染的药物使用者（IDU）适当的HIV治疗和护理的障碍是日益关注的问题。国际努力改善高度活跃的抗逆转录病毒疗法（HAART）向IDU（例如WHO 3乘5计划）迫切需要有关如何解决这些障碍的数据。尽管对HIV阴性IDU的预防艾滋病毒的重点很大，但最近人们越来越认识到打破HIV传播的周期将需要重新关注艾滋病毒感染的IDU的行为和预防需求。该提议旨在通过以下特定目的填补北美和其他地方存在的信息差距：1。评估艾滋病毒/艾滋病服务吸收的发生率（例如，抗逆转录病毒疗法）以及与IDU 2中与吸收相关的因素以及与HIV抗病毒抗体抗药性的发病率相关的因素，以评估HIV抗病毒抗药性的作用，以实现IDU的抗药性，以实现IDU的作用。抗性3。为了评估艾滋病毒疾病进展的趋势和诸如医疗服务和二级预防服务的因素，可能与IDU 4之间的疾病进展降低有关。确定与持续的HIV风险行为相关的因素（例如，在具有全面的基于证据的HIV预防HIV预防HIV感染的IDU的环境中）。 这些目标将通过开发加拿大温哥华的HIV感染IDU的新的前瞻性队列研究来实现。这种环境是独一无二的，因为所有医疗和抗逆转录病毒均通过通用医疗系统免费提供，从而使研究计划可以专注于非金融障碍的护理障碍。该队列将涉及串行血液采样，以评估抗逆转录病毒抗性模式，一份详细的问卷，以评估非法药物使用和相关行为，以及与该省集中的医疗和社会服务数据库的持续行政联系，以评估对抗逆转录病毒的访问以及对其他HIV/AID/AID/AID/AID/AID/AID/AID SARE CARE和PRICENT CARIES CARE和PRICECT的访问。通过帮助填补关键信息差距，这项研究有可能为IDU的公共卫生政策做出重大贡献。