Optimizing HIV Prevention Among Opioid-Dependent Persons

优化阿片类药物依赖者的艾滋病毒预防

• 批准号: 10425302
• 负责人: MICHAEL COPENHAVER
• 金额: $ 18.95万
• 依托单位: UNIVERSITY OF CONNECTICUT STORRS
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-07-15 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10425302
• 关键词: AIDS prevention; Acquired Immunodeficiency Syndrome; Address; Adherence; Adoption; American; Analgesics; Applications Grants; Behavior Therapy; Behavioral; Caring; Centers for Disease Control and Prevention (U.S.); Characteristics; Clinical; Collaborations; Communicable Diseases; Communities; Complement; Disease Outbreaks; Educational Status; Evidence based intervention; Face; Funding; Future; Goals; Grant; HIV; HIV Infections; HIV risk; Health; Health Personnel; Health Promotion; Health behavior; Impaired cognition; Incubators; Individual; Injectable; Injecting drug user; Institutes; Interdisciplinary Study; International; Intervention; Intervention Trial; K-Series Research Career Programs; Letters; Malaysia; Mentors; Mentorship; National Institute of Drug Abuse; Needle-Exchange Programs; Neurocognitive Deficit; Ohio; Opiate Addiction; Opioid; Patients; Personal Satisfaction; Persons; Pharmaceutical Preparations; Pharmacotherapy; Policies; Positioning Attribute; Prevention; Prevention strategy; Process; Public Health; Research; Research Personnel; Risk Behaviors; Risk Reduction; Rural; Science; Scientist; Series; Structure; Substance abuse problem; Testing; Time; Training; Uganda; Ukraine; United States National Institutes of Health; West Virginia; Work; base; behavioral adherence; biobehavior; career; clinical practice; design; evidence base; experience; global health; high risk; high risk behavior; implementation barriers; implementation science; improved; mHealth; meetings; next generation; opioid agonist therapy; opioid epidemic; opioid use disorder; overdose death; patient oriented; patient oriented research; pre-exposure prophylaxis; prevent; programs; research data dissemination; sex; skills; symposium; therapy development; treatment program; trend

Abstract This revised K24 will enable me to optimize HIV prevention among opioid-dependent persons through three broad and interrelated aims that include: (1) Mentoring a greater number of new patient-oriented researchers via UConn’s Institute for Collaboration on Health, Intervention, and Policy (InCHIP) and the Yale AIDS Program, (2) Expanding my patient-oriented research (POR) program to include several high priority domestic (e.g., rural West Virginia/Ohio) and international settings (e.g., Uganda, Malaysia, and Ukraine), and (3) Engaging in structured training on critical issues surrounding the implementation of evidence-based HIV prevention within clinical settings nationally and internationally that will complement my POR skill set. The volatile opioid epidemic in the U.S. has taken an unimaginable toll, with 2.1 million Americans having an opioid use disorder (OUD) and overdose deaths reaching 70,200 in 2017 alone, representing over a 400% increase in 15 years.1 In parallel, a number of HIV outbreaks among people who inject drugs (PWID)2 reversed a downward trend in this group,1 reflecting the need to more effectively prevent HIV in this group, especially as patients with OUD transition from prescription pain killers to injectable opioids.3 Consequently, the CDC has intensified efforts to reduce the number of new HIV infections by more effectively and efficiently targeting PWID via: 1) reduced HIV risk behaviors, 2) increased adherence and retention in treatment; and 3) promotion of health behaviors that benefit individual and public health. Although drug- and sex-related HIV risk reduction and adherence are behaviors that are readily modifiable, interventions must be carefully designed and situated in a range of patient-oriented settings in the US and internationally.4-8 I am in the process of expanding my POR to focus on better identifying, understanding, and developing strategies at multiple levels to accommodate such patients so that they can derive optimal HIV prevention benefits via the next generation of interventions (e.g., mHealth).9 Such strategies will need to reinforce adherence to PrEP and other biomedical prevention (e.g., opioid agonist therapies [OAT] and syringe services programs [SSP]) alongside behavioral risk reduction. This will be especially important as priority domestic and international communities struggle with their inability to overcome policy factors that limit or restrict access to the full toolkit of HIV prevention (i.e., PrEP, OAT, SSP, behavioral interventions) for PWID. My ongoing (R01DA044867; Gilead ISR-US-19-10641), recently completed (R01DA032290; R01DA022122), and future HIV prevention projects form the basis of my POR and mentoring program as well as future domestic and international research collaborations. Each of the aims will provide a wide range of opportunities for expanding my POR and for my mentees to develop the skill set they need to become the next generation of HIV prevention scientists.

抽象的 经过修订的K24将使我能够通过三个宽度和 相互关联的目的包括：（1）通过UConn的研究所指导更多新的面向患者的研究人员 健康，干预和政策合作（Inchip）和耶鲁大学艾滋病计划，（2）扩大我的以患者为导向的 研究（POR）计划，包括一些高优先级国内（例如，西弗吉尼亚州/俄亥俄州粗糙）和国际环境 （例如，乌干达，马来西亚和乌克兰），以及（3）对周围的关键问题进行结构化培训 在国内和国际上实施基于证据的艾滋病毒预防，这将完成 我的POR技能。美国挥发性的阿片类药物流行造成了难以想象的损失，有210万美国人有 仅在2017年，阿片类药物使用障碍（OUD）和过量死亡人数达到70,200次，占15的400％ 1同时，注射毒品（PWID）2的人中有许多艾滋病毒爆发逆转了下降趋势 组1反映了需要更有效地预防该组HIV的必要 处方止痛药对注射阿片类药物。3因此，CDC启发了减少新数量的努力 通过更有效，有效地靶向PWID的艾滋病毒感染：1）降低艾滋病毒风险行为，2）提高依从性 并保留治疗； 3）促进受益于个人和公共卫生的健康行为。虽然药物和 与性别相关的艾滋病毒风险降低和依从性是容易修改的行为，必须仔细进行干预措施 在美国和国际上设计和位于一系列面向患者的设置。4-8我正在扩展 我专注于更好地识别，理解和制定多个层次的策略以适应这种策略 患者可以通过下一代干预措施（例如MHealth）获得最佳的HIV预防益处。99 这种策略将需要增强对PREP和其他生物医学预防的依从性（例如，阿片类药物激动剂疗法[OAT] 和注射器服务计划[SSP]）以及降低行为风险。这将特别重要，因为优先 国际社区努力无法克服限制或限制访问权限的政策因素 PWID的HIV预防工具包（即Prep，Oat，SSP，行为干预措施）。我正在进行的（R01DA044867; Gilead ISR-US-19-10641），最近完成（R01DA032290; R01DA022122），未来的HIV预防项目构成了基础 我的POR和心理计划以及未来的国内和国际研究合作。每个目标都会 为扩大我的POR和月经的发展提供了广泛的机会，以发展他们所需的技能 下一代艾滋病毒预防科学家。