Brief Longitudinal Incident Sentinel Surveillance (BLISS) to End the HIV Epidemic among Persons Who Inject Drugs (PWID)

简短的纵向事件哨点监测 (BLISS) 以结束注射吸毒者 (PWID) 中的艾滋病毒流行

• 批准号: 10683947
• 负责人: William McFarland
• 金额: $ 20.57万
• 依托单位: SAN FRANCISCO DEPARTMENT OF PUBLIC HEALTH
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-15 至 2027-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10683947
• 关键词: Adherence; African American; African American population; Awareness; Back; Baseline Surveys; Behavior; Black race; California; Caring; Cellular Phone; Cessation of life; Cities; Communities; County; Data; Data Collection; Disease Outbreaks; Drug usage; Ecological momentary assessment; Enrollment; Epidemic; Epidemiology; Equipment and supply inventories; Event; HIV; HIV Infections; HIV diagnosis; HIV risk; Harm Reduction; Home; Homelessness; Human immunodeficiency virus test; Hybrids; Infection; Injecting drug user; Intervention; Interview; Methods; Outcome; Overdose; Participant; Pattern; Persons; Population; Prevalence; Prevention; Prevention program; Preventive; Questionnaires; Reporting; Risk; Risk Behaviors; Rotation; Sample Size; San Francisco; Sentinel; Sentinel Surveillance; Services; Signal Transduction; Societies; System; Technology; Time; Time trend; cohort; epidemiologic data; epidemiology study; experience; health disparity; high risk; marginalization; men who have sex with men; novel; opioid overdose; outreach; overdose prevention; peer; pre-exposure prophylaxis; programs; recruit; response; starfish sampling; substance use; success; surveillance data; transmission process; uptake

ABSTRACT The endgame for eliminating HIV will become increasingly difficult as transmission persists in populations who are the most marginalized from society, the hardest to reach with prevention programs, and the most challenging to include in epidemiological studies. Although San Francisco appears on track to achieve zero new HIV infections within the next few years, the trajectory among people who inject drugs (PWID) lags behind. The slower rate of decrease in HIV among PWID may be due to lower levels of awareness and uptake of pre-exposure prophylaxis (PrEP). Meanwhile, neighboring Alameda County (home to Oakland) has seen little decrease in the HIV epidemic, and outbreaks occur among PWID who are Black/African American or experiencing homelessness. In addition to HIV, PWID in the US are experiencing a surge in deaths due opioid overdose. To end the HIV epidemic and mitigate other health disparities for PWID, data collection systems need to be more rapid, representative, and responsive to this population at high risk. We therefore propose to create a new epidemiological data collection system for PWID in Alameda and San Francisco counties called Brief Longitudinal Incident Sentinel Surveillance (BLISS). We will recruit 600 PWID (300 each in county) using a novel venue-based / peer-referral hybrid method called Starfish Sampling to accrue a cohort and follow them longitudinally. Following HIV testing and a baseline questionnaire, participants will be enlisted to provide monthly brief responses to 11 sentinel events of high significance to the HIV and substance use epidemics (e.g., PrEP uptake or discontinuation, harm reduction program utilization, overdose experiences). Monthly data will be collected through smart phone and online technologies with in-person options as back up. Selected sentinel events will trigger “deeper dive” data collection through ecological momentary assessments (EMAs). The sample size is geared to detect events occurring at low rates in the community as early warning signals and to obtain sufficient longitudinal data to assess causal factors for HIV risk and preventive behaviors, particularly barriers and facilitators to PrEP use and adherence. BLISS data will help identify and avert outbreaks, micro-target interventions, prioritize those at highest risk, fill unmet care and prevention needs, and end the HIV epidemic.

抽象的 随着传播的持续存在，消除艾滋病毒的最终游戏将变得越来越困难 从社会边缘化最边缘化的人群，预防最难达到 程序，以及在流行病学研究中包括的最大挑战。虽然圣 弗朗西斯科（Francisco）似乎在未来几年内实现零新艾滋病毒感染， 注射毒品（PWID）落后的人的轨迹。降低速度较慢 PWID中的HIV可能是由于意识水平较低和暴露前的吸收 预防（准备）。同时，邻近的阿拉米达县（奥克兰的故乡）几乎没有 艾滋病毒流行病的降低，黑人/非洲的PWID发生爆发 美国或经历无家可归的人。除艾滋病毒外，美国的PWID还经历了 死亡人数激增。结束艾滋病毒流行并减轻其他健康 PWID的差异，数据收集系统需要更快，代表性和 对处于高风险的人群做出反应。因此，我们建议创建一个新的流行病学 Alameda和旧金山县的PWID的数据收集系统称为简报 纵向事件前哨监视（Bliss）。我们将招募600个PWID（每个300个 县）使用一种新颖的基于场地 /同伴推荐的混合方法，称为海星采样到 累积队列并纵向跟随它们。艾滋病毒测试和基线 问卷调查表，参与者将被邀请为11个哨兵提供每月的简短答复 对艾滋病毒和药物使用发作具有很高意义的事件（例如，准备吸收或 中断，减少危害计划利用，过量体验）。每月数据将是 通过智能手机和在线技术收集，并提供面对面选项的备份。 选定的前哨事件将通过生态瞬间触发“更深入的潜水”数据收集 评估（EMAS）。样本量旨在检测以低率发生的事件 社区作为预警信号，并获得足够的纵向数据来评估因果关系 艾滋病毒风险和预防行为的因素，尤其是障碍和促进者准备使用 和坚持。 Bliss数据将有助于识别和避免爆发，微目标干预措施， 优先考虑风险最高的人，满足未满足的护理和预防需求，并结束HIV流行。