A social network approach for improving medication assisted treatment and HIV prevention and medical care among people who inject drugs in Ukraine

用于改善乌克兰注射吸毒者的药物辅助治疗、艾滋病毒预防和医疗保健的社交网络方法

• 批准号: 10321719
• 负责人: CARL A LATKIN
• 金额: $ 23.47万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-30 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10321719
• 关键词: AIDS prevention; Adherence; Caring; Client; Clinic; Data; Development; Drug usage; Drug user; Economics; Education; Effectiveness; Enrollment; Epidemic; Goals; HIV; HIV Infections; HIV Seropositivity; HIV risk; Health; Health behavior; Incidence; Injecting drug user; International; Intervention; Intervention Studies; Interview; Medical; Methadone; Narcotics; Network-based; Outcome; Overdose; Participant; Patients; Pharmaceutical Preparations; Pharmacotherapy; Pilot Projects; Poverty; Process; Randomized; Randomized Clinical Trials; Recruitment Activity; Relapse; Reporting; Risk Behaviors; Role; Social Network; Support Groups; Surveys; Testing; Training; Ukraine; Viral; Viral Load result; Work; acceptability and feasibility; base; drug testing; experimental group; high risk; illicit drug use; improved; indexing; medication compliance; medication-assisted treatment; member; mortality; novel; novel strategies; opioid epidemic; opioid overdose; opioid use; opioid use disorder; opioid user; peer; prescription opioid; prevent; recruit; seroconversion; transmission process; treatment program; uptake

Project Summary People who inject drugs (PWID) are at high risk for HIV infection and transmission as well as fatal opioid overdoses. The goal of this R34 is to pilot the key components necessary for a larger setting-based randomized clinical trial (RCT) for increasing medication-assisted treatment (MAT) and HIV medical care and medication adherence. In the proposed study, we will recruit 80 index PWID (half HIV seropositive) who have: 1) been on MAT for at least one year, 2) are able to recruit active network members who use drugs, and 3) are willing to promote MAT to these PWID. Based on our pilot data, we anticipate these 80 index participants to be able to recruit approximately 160 network members (two each) for the study intervention. After the baseline assessment of the indexes and network members, the indexes and their respective network members will be randomly assigned to the experimental intervention or the comparison condition. In the experimental intervention, the indexes will be trained on how to work with their network members to promote MAT and HIV care, including ART adherence, for drug network members living with HIV. All study participants will be assessed at 3 months with surveys and drug testing. Outcomes will include MAT uptake among network members, retention on methadone amongst indexes and network members, reduced HIV seroconversions among network members, reduced illicit drug use among all study participants, and linkage to HIV medical care and ART adherence among network participants who are living with HIV. Based on findings from our prior studies, we also anticipate that the health behaviors of the index participants randomized to the experimental group will improve due to their peer education activities. We will conduct qualitative process and outcomes interviews with 10 indexes in the experimental intervention condition and 10 network members. We will also interview 8 MAT and HIV clinic staff members to assess their perspectives on intervention feasibility and acceptably. Given the scope of the opioid epidemic and continued HIV epidemic among PWID, development of novel interventions to increase MAT uptake and retention is critical.

项目摘要 注射药物（PWID）的人患HIV感染和传播以及致命的阿片类药物的风险很高 过量服用。该R34的目标是驾驶基于设置的较大设置所需的关键组件 用于增加药物辅助治疗（MAT）和HIV医疗护理的随机临床试验（RCT）以及 药物依从性。在拟议的研究中，我们将招募80个指数PWID（半HIV血清阳性）： 1）在垫子上至少一年，2）能够招募使用药物的活跃网络成员，3） 愿意将MAT推广到这些PWID。根据我们的试点数据，我们预计这80个指数参与者将会 能够招募大约160个网络成员（每个）进行研究干预。基线之后 评估索引和网络成员，索引及其各自的网络成员将是 随机分配给实验干预或比较条件。在实验中 干预，索引将接受有关如何与网络成员合作以促进MAT和HIV的培训 护理，包括艺术依从性，适用于艾滋病毒的药物网络成员。所有研究参与者都将 通过调查和药物测试在3个月后评估。结果将包括网络中的MAT吸收 成员，在索引和网络成员之间保留美沙酮，减少了HIV血清转化 在网络成员中，所有研究参与者的非法药物使用减少，并与HIV医学联系 感染艾滋病毒的网络参与者之间的护理和艺术依从性。根据我们的发现 先前的研究，我们还预计指数参与者的健康行为随机 由于他们的同伴教育活动，实验组将有所改善。我们将进行定性过程， 结果在实验干预条件下对10个索引和10个网络成员进行了访谈。我们 还将采访8个MAT和HIV诊所工作人员，以评估他们对干预可行性的看法 并且可以接受。鉴于PWID中阿片类药物流行和持续HIV流行的范围， 开发新的干预措施以增加MAT吸收和保留至关重要。