Epidemiologic Studies of HMPXV Infection among PWID in the US-Mexico Border Region to Inform Prevention Responses

美墨边境地区吸毒者 HMPXV 感染的流行病学研究，为预防措施提供信息

• 批准号: 10674322
• 负责人: STEFFANIE A. STRATHDEE
• 金额: $ 38万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-04-01 至 2025-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10674322
• 关键词: 2019-nCoV; Abscess; Address; Adult; Affect; Africa; Animals; Anus; Behavior; Blood specimen; California; Centers for Disease Control and Prevention (U.S.); Central America; Communicable Diseases; Contact Tracing; Country; Crowding; Detection; Development; Diagnosis; Disease Outbreaks; Epidemic; Epidemiologist; Epidemiology; Equipment; Evolution; Face; Funding; General Population; HIV; HIV Infections; Health system; Hepatitis A Virus; Hepatitis C virus; Homelessness; Human; Immunosuppression; Imprisonment; Incidence; Individual; Infection; Infrastructure; Injecting drug user; Injections; Institutes; International; Intervention; Interviewer; Investigation; Latin America; Latinx; Leisures; Lesion; Letters; Location; Masks; Mediating; Mexico; Migrant; Molecular; Monkeypox virus; Mutation; National Institute of Drug Abuse; National Institute on Minority Health and Health Disparities; Oral; Participant; Persons; Pharmaceutical Preparations; Physicians; Policies; Population; Prevalence; Prevention; Primary Prevention; Recording of previous events; Reporting; Risk Factors; Rocky Mountain Spotted Fever; Rodent; Scientist; Secondary Prevention; Serology; Serology test; Sexual Partners; Sexually Transmitted Diseases; Shigella; South America; Structural Models; Substance Use Disorder; Surveys; Swab; Syphilis; Testing; Tuberculosis; Ulcer; Vaccination; Variant; Vesicle; Virus; Vulnerable Populations; Work; base; cohort; cost; epidemiology study; experience; follow-up; health disparity; high risk; housing instability; injection drug use; male; men who have sex with men; pandemic disease; pandemic preparedness; pathogen; preventive intervention; public health emergency; response; sex; substance use; transmission process

In response to NOT-OD-22-159, this project will leverage an ongoing cohort of people who inject drugs (PWID) in the U.S.-Mexico border region to study the epidemiology of monkeypox virus (HMPXV) to inform prevention interventions to diagnose and treat HMPXV and curtail transmission. Although it is well known that PWID face numerous health disparities including higher rates of HIV, HCV and sexually transmitted infections (STIs) than the general population, experts are concerned that the ongoing outbreak of HMPXV, which is the largest international outbreak recorded since this virus first emerged in the 1970’s, will soon disproportionately affect people experiencing homelessness (PEH), which includes a high proportion of PWID. Our team includes epidemiologists, prevention interventionists, molecular virologists and infectious disease physicians to address these aims: Aim 1. To determine the prevalence and correlates of subclinical and symptomatic HMPXV infection among PWID in the San Diego/Tijuana (SD/TJ) border region to inform the development of prevention interventions. H1. PWID who are unstably housed (H1.1), Latinx (H1.2) or living with HIV and not receiving ART (H1.3) will be significantly more likely to test positive for HMPXV infection. Aim 2. To estimate incidence and risk factors of HMPXV infection among PWID over a one-year period. H2.1 PWID who report recently having abscesses associated with injection drug use, STIs or open sores will be more likely to acquire HMPXV during follow-up. H2.2. PWID who report engaging in sex work and those with higher numbers of sex partners will be more likely to acquire HMPXV during follow-up. Aim 3. To determine network features associated with cross-border transmission of HMPXV among PWID. H3.1 Cross-border drug tourism between SD and TJ (by participants & their network contacts) will be associated with HMPXV infection. H3.2. Network-level risk factors such as total number of contacts and number of contacts who are MSM, sex workers, unstably housed, or have a history of incarceration will be independently associated with HMPXV infection after controlling for individual-level risk factors. Aim 4: To conduct phylogenomic characterization of circulating HMPXV variants in the SD/TJ region including mutation signatures (e.g., APOBEC3). H4.1 Circulating HMPXV will have a single origin (lineage B.1) followed by local dispersal. We will leverage the binational infrastructure of our NIDA- funded binational cohort of PWID, and support from a new pandemic preparedness institute at UCSD to conduct HMPXV PCR testing and sequencing on swabs collected from any suspect lesions/vesicles as well as oral and anal swabs. Serologic HMPXV testing will be done in-kind by the CDC. Findings will inform potential interventions and policies, including whether PWID and/or PEH should be recommended for routine vaccination and whether subsequent interventions to increase HMPXV testing, vaccination and treatment in this vulnerable population should be network or venue-based, following NIMHD’s conceptual model for structural interventions.

为了响应Not-OD-22-159，该项目将利用持续的注射毒品的人群（PWID） 在美国 - 墨西哥边境地区，研究猴蛋白实病毒（HMPXV）的流行病学，以告知预防 诊断和治疗HMPXV和减少传输的干预措施。虽然众所周知，pwid脸 许多健康差异，包括更高的艾滋病毒，HCV和性传播感染率（性传播感染） 一般人群，专家担心HMPXV的爆发是最大的 自该病毒首次在1970年代首次出现以来，国际爆发记录了，很快将不成比例地影响 遇到无家可归者（PEH）的人们，其中包括很大一部分的PWID。我们的团队包括 流行病学家，预防干预主义者，分子病毒学家和传染病医生解决 这些目的：目标1。确定亚临床和有症状的HMPXV的患病率和相关性 圣地亚哥/蒂华纳（SD/TJ）边境地区的PWID感染，以告知预防的发展 干预措施。 H1。不稳定地容纳（H1.1），Latinx（H1.2）或艾滋病毒而没有接受的PWID ART（H1.3）将更有可能检验HMPXV感染阳性。目标2。估计事件 在一年内，PWID中HMPXV感染的危险因素。 H2.1最近报告的PWID 具有与注射药物使用相关的脓肿，性传播疾病或开放性疮会更有可能获取HMPXV 在随访期间。 H2.2。报告报告性工作的人和有更多性伴侣的人 随访期间，将更有可能获取HMPXV。目标3。确定与 HMPXV在PWID中的跨境传播。 H3.1 SD和TJ之间的跨境吸毒旅游（作者： 参与者及其网络联系）将与HMPXV感染有关。 H3.2。网络级风险因素 例如，MSM，性工作者，不稳定的住所的联系总数和联系人数量 具有继承史将与HMPXV感染独立相关 个人级别的风险因素。 AIM 4：进行循环HMPXV变体的系统基础表征 SD/TJ区域包括突变特征（例如APOBEC3）。 H4.1循环HMPXV将有一个 起源（血统b.1），然后是局部分散。我们将利用NIDA-的二元基础设施 资助PWID的二进制组，以及UCSD的新大流行准备机构的支持 对从任何可疑病变/囊泡收集的拭子进行HMPXV PCR测试和测序 口服和肛门拭子。 CDC将在实物中进行血清学HMPXV测试。调查结果将为潜力提供信息 干预措施和政策，包括是否应该建议使用PWID和/或PEH进行例行 疫苗接种以及随后的干预措施是否增加了HMPXV测试，疫苗接种和治疗 遵循NIMHD的概念模型 结构干预措施。