Resilience in HIV infected drug users

感染艾滋病毒的吸毒者的复原力

• 批准号: 9857185
• 负责人: Chinazo Cunningham
• 金额: $ 0.02万
• 依托单位: ALBERT EINSTEIN COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-06-01 至 2019-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9857185
• 关键词: Resilience; HIV; infected; drug; users

 DESCRIPTION (provided by applicant): Millions of Americans use illicit opioids or cocaine, which has substantial individual and public health consequences. Because the opioid and cocaine epidemics intersect with the HIV epidemic, it is crucial to fully understand and mitigate the impact that drug use has on HIV disease. Given that adherence to antiretrovirals (ARVs) is a critical predictor of HIV viral load (VL) suppression, research has focused on the association between illicit drug use and medication non-adherence. It is widely accepted that HIV-infected drug users must engage in drug treatment and strive for abstinence to successfully adhere to ARVs and manage their HIV disease. However, drug use disorders are chronic and relapsing conditions, and many drug users are unable to achieve long-term abstinence. Beyond engagement in drug treatment, little is known about which strategies drug users could use to achieve optimal HIV outcomes. In an ongoing NIH-funded study, we surprisingly found that nearly half of active drug users we screened achieved VL suppression despite ongoing drug use. Therefore, using a mixed methods approach that builds on the resilience of HIV-infected drug users, this study will explore factors and behaviors that facilitate achieving VL suppression among active drug users, regardless of their ability to achieve abstinence. Our exploration will be guided by harm reduction and socioecological models. We will leverage our ongoing NIH-funded study to efficiently recruit and screen participants, and extract their medical record data. We will enroll a total of 170 HIV-infected active drug users, including active illicit opioid users with suppressed VL, active illicit opioid users with non-suppressed VL, active cocaine users with suppressed VL, and active cocaine users with non-suppressed VL. We will also enroll 10 experts in the field of HIV and drug use. The 3 study aims are to: 1) Qualitatively explore HIV- infected active drug users' perceptions of how to achieve optimal HIV health outcomes; 2) Develop a quantitative questionnaire to measure factors and behaviors identified in Aim 1 for analyses proposed in Aim 3; and 3) Quantitatively explore factors and behaviors associated with HIV-infected active drug users achieving optimal HIV health outcomes. This study will improve understanding of drug users' resilience, namely how they are able to achieve optimal HIV outcomes even without abstinence. Findings from this study will ultimately be used to inform the development of an intervention to help HIV-infected active drug users achieve VL suppression.

 描述（由适用提供）：数百万的美国人使用非法阿片类药物或可卡因，其个人和公共卫生影响很大。由于阿片类药物和可卡因流行与HIV流行相交，因此完全了解和减轻药物使用对HIV疾病的影响至关重要。鉴于遵守抗逆转录病毒（ARV）是HIV病毒载量（VL）抑制的关键预测指标，因此研究集中在非法药物使用和不遵守药物之间的关联上。人们普遍认为，感染HIV的吸毒者必须从事药物治疗，并努力戒酒，以成功地遵守ARV并管理其HIV疾病。但是，药物使用障碍是慢性和复发疾病，许多吸毒者无法实现长期的禁欲。除了参与药物治疗外，对药物使用者可以使用哪些策略来实现最佳艾滋病毒结局的策略知之甚少。在一项正在进行的NIH资助的研究中，我们出人意料地发现，尽管持续使用毒品，我们筛选的几乎一半的活跃吸毒者仍获得了VL抑制。因此，使用一种基于HIV感染的吸毒者的韧性的混合方法，本研究将探讨因素和行为，从而促进活跃的吸毒者之间实现VL抑制的因素和行为，无论其实现戒酒的能力。我们的探索将以减少伤害和社会生态模型为指导。我们将利用我们正在进行的NIH资助的研究有效地招募和筛选参与者，并提取其病历数据。 我们将总共注册170名受HIV的活跃吸毒者，包括活跃的非法阿片类药物使用者 有了被抑制的VL，具有未抑制VL的主动非法Ooid用户，有效的可卡因用户被抑制的VL和活跃的可卡因用户具有非抑制VL。我们还将在艾滋病毒和吸毒领域入学10名专家。这3项研究的目的是：1）定性探索感染HIV感染的吸毒者对如何实现最佳HIV健康结果的看法； 2）制定一份定量问卷，以衡量AIM 1中确定的因素和行为，以进行AIM 3中提出的分析； 3）定量探索与感染HIV的活跃吸毒者相关的因素和行为，从而实现了最佳的HIV健康结果。这项研究将提高人们对吸毒者的韧性的了解，即即使没有禁欲，他们如何能够获得最佳的HIV结果。这项研究的结果最终将用于告知干预措施的开发，以帮助感染HIV的活跃吸毒者实现VL抑制。