Penn Mental Health AIDS Research Center

宾夕法尼亚州心理健康艾滋病研究中心

• 批准号: 10819857
• 负责人: Kelly L Jordan-Sciutto
• 金额: $ 24.38万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-03-15 至 2025-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10819857
• 关键词: AIDS prevention; Accident and Emergency department; Acquired Immunodeficiency Syndrome; Address; Affect; Area; Behavior; COVID-19 pandemic; Caring; Cities; Client; Clinical; Cluster Analysis; Cocaine; Communities; Comprehensive Health Care; Counseling; Coupled; Data; Detection; Development; Diagnosis; Environment; Epidemic; Equipment; Equity; Evaluation; Face; Feedback; Fentanyl; Fright; Funding; Geographic Locations; HIV; HIV diagnosis; Health; Health Personnel; Health Priorities; Health Service Area; Healthcare; Height; Heroin; Human immunodeficiency virus test; Incidence; Injecting drug user; Injections; Integrated Delivery of Health Care; Legal; Link; Mental Health; Methamphetamine; Methodology; Needles; Neighborhoods; Newly Diagnosed; Participant; Patient Education; Perception; Persons; Pharmaceutical Preparations; Philadelphia; Prevention; Provider; Public Health; Recording of previous events; Research; Risk; Service delivery model; Service provision; Services; Site; Social Work; Space-Time Clustering; Surveys; System; Training; Trauma; United States National Institutes of Health; Unsafe Sex; community organizations; community partnership; coronavirus disease; cost; experience; health care service; infection rate; injection drug use; innovation; interest; meetings; operation; outpatient programs; outreach; preference; prescription opioid; prevention service; response; scale up; service organization; service providers; social stigma; substance use treatment; success; testing services; transmission process; treatment center; willingness

Project Summary/Abstract People incidence who inject drugs (PWID) are disproportionately affected by HIV incidence in Philadelphia. The HIV in Philadelphia is growing and returning to pre-COVID pandemic levels.At present, the city health department's Department of HIV Health funds many community and clinical health providers for HIV testing and counseling services, including HIV Service Organizations (HSOs), substance use treatment centers, and emergency departments, which have facilitated the detection of many new cases among PWID in Philadelphia. Despite these successes, increasing infection rates in PWID suggest a need for scaled-up detection and linkage strategies. Reliance on traditional HIV prevention providers may yield missed opportunities for HIV diagnoses, timely linkage-to-care, and cluster detection and response. Leveraging providers in healthcare and social service environments outside of traditional HIV prevention settings in neighborhoods with high rates of IDU may maximize opportunities for expanding efforts for HIV cluster detection and response. The extent to which nonclinical HSO-alternative service providers in these areas understand IDU as a significant contributor to the HIV epidemic, routinely conduct or refer PWID high-quality HIV testing services, and are willing and capable to integrate or scale-up HIV testing services within current clinical operations at their agency is poorly understood. To address these gaps, we propose a 2-year study to conduct the following aims: (Aim 1) Employ persons with lived experiences/histories of IDU to conduct secret shopper methodologies toward understanding the current HIV testing/referral practices in nonclinical HSO-alternative outpatient service facilities (N = 15) in Philadelphia neighborhoods with high IDU; (Aim 2) Deploy surveys with N = 100 PWID living without HIV to evaluate environmental preferences for HIV prevention services in nonclinical HSO-alternative outpatient service facilities in Philadelphia; and (Aim 3) Engage with representatives from secret shopper-evaluated facilities through stakeholder meetings to discuss secret shopper feedback, their perceptions of the HIV epidemic among PWID in their service area, and their capacity for HIV prevention services. The proposed study will facilitate local priorities pertaining to the Diagnose pillar of the Ending the HIV Epidemic Initiative and support the city health department's HIV cluster detection and response strategies. Leveraging HSO-alternative providers' capacities to conduct, refer, and coordinate HIV testing will maximize equitable access to HIV prevention for PWID and opportunities to identify new HIV cases and unidentified clusters missed via traditional HIV testing environments, like HSOs.

项目概要/摘要 人们 发生率 在费城，注射吸毒者 (PWID) 受艾滋病毒发病率的影响尤为严重。艾滋病毒 费城的人口正在增长，并已恢复到新冠疫情大流行前的水平。目前，该市的卫生状况 艾滋病毒健康部资助许多社区和临床卫生服务提供者进行艾滋病毒检测和 咨询服务，包括艾滋病毒服务组织 (HSO)、药物滥用治疗中心和 急诊部门协助发现了费城吸毒者中的许多新病例。 尽管取得了这些成功，但吸毒者感染率的上升表明需要扩大检测和联系 策略。对传统艾滋病毒预防提供者的依赖可能会错失艾滋病毒诊断的机会， 及时联系护理、集群检测和响应。利用医疗保健和社会服务提供商 在注射吸毒者比例高的社区中，传统艾滋病毒预防环境之外的环境可能会 最大限度地扩大艾滋病毒集群检测和应对工作的机会。程度 这些领域的非临床 HSO 替代服务提供商将 IDU 视为对 HIV 流行，定期进行或转介吸毒者高质量的 HIV 检测服务，并且愿意并有能力 在其机构当前的临床操作中整合或扩大艾滋病毒检测服务的情况知之甚少。 为了解决这些差距，我们建议进行一项为期 2 年的研究，以实现以下目标：（目标 1）雇用具有以下能力的人员： 注射吸毒者的生活经历/历史，以实施秘密购物者方法，以了解当前的情况 费城非临床 HSO 替代门诊服务机构 (N = 15) 的 HIV 检测/转诊实践 IDU 高的社区； （目标 2）对 N = 100 名未感染艾滋病毒的吸毒者进行调查以进行评估 非临床 HSO 替代门诊服务设施中 HIV 预防服务的环境偏好 在费城； （目标 3）通过以下方式与秘密购物者评估机构的代表进行接触： 利益相关者会议讨论秘密购物者的反馈以及他们对吸毒者中艾滋病毒流行的看法 他们的服务领域以及艾滋病毒预防服务的能力。拟议的研究将有助于当地 与终止艾滋病流行倡议的诊断支柱相关的优先事项并支持城市健康 部门的艾滋病毒集群检测和应对策略。利用 HSO 替代供应商的能力 进行、转介和协调艾滋病毒检测将最大限度地提高吸毒者和吸毒者获得艾滋病毒预防的公平机会 传统艾滋病毒检测环境错过了识别新艾滋病毒病例和不明群体的机会， 像 HSO 一样。