Investigator Development Core

研究者开发核心

基本信息

批准号：
10309107
负责人：
Brooke E.E. Montgomery
金额：
$ 17.97万
依托单位：
UNIV OF ARKANSAS FOR MED SCIS
依托单位国家：
美国
项目类别：
财政年份：
2007
资助国家：
美国
起止时间：
2007-09-30 至 2022-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10309107
关键词：
Address Adherence Advocate African American Arkansas COVID-19 COVID-19 disparity COVID-19 mortality COVID-19 outbreak COVID-19 prevention Caring Case Study Cessation of life Characteristics Clinical Services Code Communities County Criminal Justice Data Data Set Development Disease Outbreaks Ecosystem Epidemic Epidemiology Ethnic Origin Evaluation Foundations Funding Future Geographic Locations Goals HIV HIV Infections HIV risk Health Healthcare High Prevalence Imprisonment Incidence Individual Intervention Jail Location Mental disorders Modeling Morality Morbidity - disease rate New York Pharmaceutical Preparations Play Population Poverty Prevalence Prisons Public Health Quarantine Race Recommendation Recording of previous events Research Research Personnel Resources Risk Risk Factors Role Rotation Rural Rural Community Science Sexual Partners Sexually Transmitted Diseases Site Socioeconomic Status Statistical Models Structure System Tenofovir Testing Time Treatment Efficacy United States National Institutes of Health United States Public Health Service Woman Wood material base combat coronavirus disease data repository efficacy testing emtricitabine ethnic minority population evidence base exhaustion experience geographic population health disparity health service use high risk high risk men improved indexing infection rate low socioeconomic status member men men who have sex with men minority health mortality novel open label pandemic disease pre-exposure prophylaxis prison population racial and ethnic rural area rural counties rural underserved rurality sex social socioeconomic disparity socioeconomics substance use substance user trait underserved area underserved rural area uptake urban setting vision science

项目摘要

Abstract Criminal justice (CJ) involved individuals have extremely high prevalence of risk factors associated with HIV infection including poverty, substance use, transactional sex, high numbers of sex partners, high prevalence of sexually transmitted infections and mental illness. African Americans (AA) are at disproportionate risk for both incarceration and HIV infections. A growing body of evidence highlights the efficacy of a once daily medication, emtricitabine/tenofovir, also known as pre-exposure prophylaxis (PrEP), in reducing HIV acquisition. However, structural and social barriers can undermine optimal PrEP uptake, adherence, and retention in care and must be addressed especially among those with recent CJ experience. Our proposed study is directly aligned with NIMHD Science Visioning to advance intervention approaches to improve minority health or to reduce health disparities. Our proposed study will: provide a novel exploration of facilitators and barriers to PrEP; allow us to target hard to reach populations, including MSM and substance users (both of which are top funding priority groups for the National Institutes of Health) who experience intersecting markers of HIV risk; and inform regional, and possibly national, intervention approaches to combat the overlapping epidemic of HIV and incarceration: The specific aims of the project are: Aim 1: Perform a qualitative assessment of facilitators and barriers to PrEP uptake among high-risk jail detainees, systems and interactor levels; Aim 2: Develop the PrEP-LINK intervention and perform an open label evaluation with high-risk individuals being discharged from the Pulaski County Jail; Aim 3: Conduct a pilot RCT of the PrEP-LINK intervention among high-risk men and women being released from the Pulaski County Jail. Results will inform a subsequent multi-site RCT to test efficacy of the intervention in improving PrEP uptake, adherence, and retention in care among men with CJ-experience.

抽象的涉及刑事司法 (CJ) 的个人与艾滋病毒相关的危险因素患病率极高感染，包括贫困、药物滥用、性交易、性伴侣数量多、感染率高性传播感染和精神疾病。非裔美国人 (AA) 面临着不成比例的风险监禁和艾滋病毒感染。越来越多的证据强调了每日一次药物的功效，恩曲他滨/替诺福韦，也称为暴露前预防 (PrEP)，可减少 HIV 感染。然而，结构性和社会障碍可能会破坏 PrEP 的最佳吸收、坚持和护理保留，因此必须尤其是那些最近有 CJ 经验的人。我们提出的研究直接与 NIMHD 科学愿景推进干预方法，以改善少数族裔健康或降低健康水平差异。我们提出的研究将：对 PrEP 的促进因素和障碍进行新颖的探索；让我们能够针对难以接触到的人群，包括男男性行为者和药物使用者（两者都是资助的首要优先事项）美国国立卫生研究院 (National Institutes of Health) 的群体）经历了艾滋病毒风险交叉标记；并告知区域性的、可能是国家性的干预措施，以对抗艾滋病毒和艾滋病毒的重叠流行监禁：该项目的具体目标是：目标 1：对协调员进行定性评估高风险监狱被拘留者、系统和互动者级别采用 PrEP 的障碍；目标 2：制定 PrEP-LINK 干预措施并对高危人群进行开放标签评估从普拉斯基县监狱释放；目标 3：进行 PrEP-LINK 试点随机对照试验对从普拉斯基县监狱释放的高危男性和女性进行干预。结果将为随后的多中心随机对照试验提供信息，以测试干预措施在改善 PrEP 吸收、依从性、以及具有 CJ 经验的男性的护理保留率。