PrEP and MOUD Rapid Access for Persons who Inject Drugs: the CHORUS+ Study

注射毒品者的 PrEP 和 MOUD 快速获取：CHORUS 研究

基本信息

批准号：
10682181
负责人：
Sabrina A Assoumou
金额：
$ 95.29万
依托单位：
BOSTON MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-09-01 至 2028-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10682181
关键词：
AIDS prevention Acceleration Address Adherence Adopted Adoption Affect Automobile Driving Behavior Therapy Behavioral Biometry Blood Boston Buprenorphine Caring Cellular Phone Clinic Clinical Laboratory Improvement Amendments Communicable Diseases Communities Control Groups County Data Diphosphates Dose Drug user Dryness Effectiveness Enrollment Epidemic Evaluation Evidence based intervention Foundations Future Goals HIV HIV risk Home Human Human immunodeficiency virus test Immunologic Deficiency Syndromes Individual Infection Injecting drug user Intervention Laboratories Measures Medical Medical center Methadone Methods Mission Modeling National Institute of Drug Abuse Opioid Outcome Overdose Participant Patients Persons Pharmaceutical Preparations Pharmacy facility Phase Pilot Projects Population Populations at Risk Prevention strategy Privacy Public Health Qualitative Methods Qualitative Research Randomized Randomized, Controlled Trials Recommendation Records Recovery Research Research Methodology Self Efficacy Self Perception Site Social Behavior Spottings Substance Use Disorder Tenofovir Testing Training Treatment Efficacy United States National Institutes of Health Venous blood sampling Walking acceptability and feasibility addiction arm care fragmentation cocaine use contextual factors efficacy evaluation evidence base experimental study heroin use improved improved outcome informant interest long term recovery medication for opioid use disorder mortality motivational enhancement therapy motivational intervention multidisciplinary novel opioid epidemic opioid overdose opioid use disorder outreach participant interview peer peer coaching peer recovery pilot test point of care pre-exposure prophylaxis prevent primary outcome process evaluation programs rapid test rapid testing recruit response scale up secondary outcome self testing skills social stigma substance use syndemic theories therapy development treatment as usual trial design uptake

AIDS prevention Acceleration Address Adherence Adopted Adoption Affect Automobile Driving Behavior Therapy Behavioral Biometry Blood Boston Buprenorphine Caring Cellular Phone Clinic Clinical Laboratory Improvement Amendments Communicable Diseases Communities Control Groups County Data Diphosphates Dose Drug user Dryness Effectiveness Enrollment Epidemic Evaluation Evidence based intervention Foundations Future Goals HIV HIV risk Home Human Human immunodeficiency virus test Immunologic Deficiency Syndromes Individual Infection Injecting drug user Intervention Laboratories Measures Medical Medical center Methadone Methods Mission Modeling National Institute of Drug Abuse Opioid Outcome Overdose Participant Patients Persons Pharmaceutical Preparations Pharmacy facility Phase Pilot Projects Population Populations at Risk Prevention strategy Privacy Public Health Qualitative Methods Qualitative Research Randomized Randomized, Controlled Trials Recommendation Records Recovery Research Research Methodology Self Efficacy Self Perception Site Social Behavior Spottings Substance Use Disorder Tenofovir Testing Training Treatment Efficacy United States National Institutes of Health Venous blood sampling Walking acceptability and feasibility addiction arm care fragmentation cocaine use contextual factors efficacy evaluation evidence base experimental study heroin use improved improved outcome informant interest long term recovery medication for opioid use disorder mortality motivational enhancement therapy motivational intervention multidisciplinary novel opioid epidemic opioid overdose opioid use disorder outreach participant interview peer peer coaching peer recovery pilot test point of care pre-exposure prophylaxis prevent primary outcome process evaluation programs rapid test rapid testing recruit response scale up secondary outcome self testing skills social stigma substance use syndemic theories therapy development treatment as usual trial design uptake

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项目摘要

PROJECT SUMMARY / ABSTRACT The US opioid overdose epidemic has been accompanied by an increase in human immunodeficiency (HIV) among persons who inject drugs. The co-occurrence of HIV and opioid use disorder (OUD) suggests that a comprehensive approach to OUD and its infectious complications has the potential to improve outcomes. HIV pre-exposure prophylaxis (PrEP) and medication for opioid use disorder (MOUD) are evidence-based approaches that are recommended for persons who inject drugs. Unfortunately, these measures have not been widely adopted in real-world settings or accessed by persons at-risk. Foundation for the Proposal: The CHORUS intervention (Comprehensive HIV and Opioid use disorder Response to the Unaddressed Syndemic) is informed by preliminary research, including: (a) quantitative and qualitative research with persons with substance use disorder, (b) a randomized controlled trial of a peer-delivered motivational intervention demonstrating effectiveness in reducing heroin and/or cocaine use, and (c) preliminary studies demonstrating the feasibility and acceptability of peer-delivered motivational interventions in non-traditional settings. During the CHORUS pilot phase, we uncovered that PrEP was initiated late in the intervention. Therefore, we are attempting to accelerate PrEP initiation by providing HIV self-testing (CHORUS +) at baseline. The CHORUS+ intervention includes HIV self-testing, rapid initiation of PrEP and MOUD, and a 6-month peer recovery coach to support adherence to these medications. Conceptual Model: CHORUS+ is a theory-based, peer-delivered, mobile phone-supported intervention focused on enhancing uptake and adherence to HIV PrEP (primary outcome), and receipt of MOUD (secondary outcome) among persons who inject opioids. CHORUS+ aims to improve behavioral skills and self-efficacy while addressing structural barriers. Summary: The current proposal seeks to determine the efficacy of a novel intervention to increase the uptake of evidence-based measures to prevent HIV and treat opioid use disorder. We will compare the CHORUS+ intervention to usual care (passive referral) among persons who inject opioids (aim 1). In addition, we will examine study implementation to facilitate potential future dissemination using a mixed-methods process evaluation of CHORUS+ (aim 2). The study will be performed at Boston Medical Center’s Faster Paths clinic, a low-barrier substance use disorder bridge clinic, and through Victory Programs, which utilizes a mobile outreach van. The proposed intervention will recruit from non-traditional settings in order to reach participants who might not be comfortable in office- based clinics. This project specifically addresses NIDA’s mission of developing effective socio-behavioral interventions to increase uptake of HIV prevention strategies, and accelerating the adoption of evidence-based interventions to address substance use and its infectious complications.

项目摘要 /摘要美国阿片类药物过量流行是通过人类免疫缺陷（HIV）实现的在注射毒品的人中。艾滋病毒和阿片类药物使用障碍（OUD）的同时出现表明 OUD及其感染并发症的全面方法有可能改善结果。艾滋病病毒预防前预防（PREP）和阿片类药物使用障碍药物（MOUD）是基于证据的建议注入毒品的人推荐的方法。不幸的是，这些措施还没有我们在现实环境中广泛采用或被处于危险的人访问。提案基金会：合唱干预（综合艾滋病毒和阿片类药物使用障碍对未解决的联合学的反应）由初步研究所告知，包括：（a）与患者的定量和定性研究药物使用障碍，（b）一项同伴分配动机干预的随机对照试验证明在减少海洛因和/或可卡因使用方面的有效性，以及（c）初步研究证明在非传统环境中，同行分配的动机干预措施的可行性和可接受性。期间合唱飞行员阶段，我们发现了在干预措施后期开始的PREP。因此，我们是试图通过在基线时提供艾滋病毒自我测试（合唱 +）来加速准备启动。合唱+ 干预包括艾滋病毒自我测试，准备和穆德的快速倡议，以及一个6个月的同行恢复教练支持遵守这些药物。概念模型：合唱+是一个基于理论的，同行分配的，手机支持的干预措施着重于增强摄取和遵守HIV Prep（主要结果），并在注射阿片类药物的人中收到MOUD（次要结果）。合唱+的目标提高行为能力和自我效能，同时解决结构性障碍。摘要：当前建议试图确定新干预的效率，以增加基于证据的措施的吸收预防艾滋病毒并治疗阿片类药物使用障碍。我们将将合唱+干预与通常的护理（被动）进行比较转介）在注射阿片类药物的人中（AIM 1）。此外，我们将研究研究实施使用合唱+的混合方法评估促进潜在的未来传播（AIM 2）。这研究将在波士顿医疗中心更快的路径诊所进行，这是一种低性疾病桥梁诊所，并通过胜利计划，该计划利用移动外展货车。拟议的干预措施将从非传统环境中招募，以吸引可能在办公室不舒服的参与者 - 基于诊所。该项目专门针对NIDA的使命，发展有效的社会行为采取干预措施以增加艾滋病毒预防策略的吸收，并加速采用基于证据的解决药物使用及其感染并发症的干预措施。