Increasing representation of black communities in SARS-CoV-2 serosurveys by understanding barriers and motivations for participation

通过了解参与的障碍和动机，增加黑人社区在 SARS-CoV-2 血清调查中的代表性

• 批准号: 10843497
• 负责人: Heather Bradley
• 金额: $ 24.96万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-06-01 至 2024-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10843497
• 关键词: 2019-nCoV; Accident and Emergency department; Accounting; Achievement; Acquired Immunodeficiency Syndrome; Acute Hepatitis C; Address; Admission activity; Age; Bayesian Modeling; Behavior; Big Data; Big Data to Knowledge; Blood; Canada; Characteristics; Collaborations; Communicable Diseases; Communities; Complement; County; Data; Data Set; Dependence; Development; Diagnosis; Disease; Electronics; Epidemic; Epidemiologist; Epidemiology; Estonia; Goals; HIV Infections; HIV/HCV; Health; Health Services; Health Services Accessibility; Hepatitis C; Hepatitis C virus; Heterogeneity; Hospital Records; Household; Imprisonment; Individual; Infection; Infective endocarditis; Injecting drug user; Injections; Inpatients; Intervention; Joints; Leadership; Link; Measures; Methodology; Methods; Modeling; Monitor; Motivation; Needle-Exchange Programs; New York; Opioid; Persons; Pharmaceutical Preparations; Pharmacotherapy; Politics; Population; Population Sizes; Prevention program; Probability; Process; Public Health; Reporting; Resources; Risk; Route; Services; Standardization; Stigmatization; Surveys; System; United States National Institutes of Health; Work; burden of illness; data visualization; disorder risk; drug use behavior; experience; high risk; housing instability; improved; infection burden; injection drug use; innovation; male; opioid epidemic; opioid use disorder; prevention service; preventive intervention; remediation; research study; response; serosurvey; sex; surveillance data; treatment program

ABSTRACT Injection is an increasingly common route of administration for opioids and other drugs in the U.S. Unsafe injection drug use (IDU) behavior threatens recent progress made in reducing HIV and hepatitis C virus (HCV) infections among persons who inject drugs (PWID), which is a major impediment to achieving ambitious national goals for reducing new HIV infections. During the past decade, New York State has experienced growing rates of opioid use disorder and, consequently, increases in IDU-related infectious diseases. New York has strong political will to reduce the burden of these infections among PWID and is the first U.S. state to commit to both “Ending the AIDS Epidemic” and HCV elimination strategies. However, New York, like other states, does not have a current, statewide estimate of how many PWID need infectious disease prevention services. Robust estimates of PWID population sizes are needed in New York and elsewhere to facilitate optimal allocation of scarce resources, measure risk-specific infectious disease burden among PWID, and assess coverage of prevention interventions. We propose to estimate PWID population size and associated risk-specific disease and prevention intervention coverage rates in New York using multiple systems estimation (MSE) with a combination of extant administrative and PWID survey data. MSE is an application of capture- recapture methods that allows estimation of underlying population size using joint probabilities of observing individuals in linked administrative datasets vis-à-vis their receipt of a service or diagnosis. We will apply MSE methods to linked, statewide datasets in New York including claims data, inpatient and emergency room electronic hospital records, drug treatment program data, and infectious disease surveillance data. We will also improve the rigor of MSE methods by addressing potential violations of key statistical assumptions through augmented estimation models, partially informed by survey data currently being collected by the study team. Our Specific Aims are: (1)To estimate PWID population size in New York State using MSE with indications of current IDU behavior from linked administrative datasets, overall and by region, sex, and age; (2) To create refined PWID population size estimates accounting for bias due to unequal probabilities of observing individuals in datasets; (3) To allocate state PWID population size to all 62 counties using a standardization modeling approach; (4) To compute key epidemiologic indicators needed to measure infectious disease risk among PWID: risk-specific HIV and HCV diagnosis rates, syringe service program utilization rates, and number of PWID initiating IDU during past year; (5) To disseminate estimates and methodology using the AIDSVu data visualization platform. The national impact of this work, using New York as a model, will be to establish a robust, replicable method for producing estimates that can guide efforts to improve PWID health and reduce the burden of HIV and HCV in this high-risk, under-studied group.

抽象的 注射是美国阿片类药物和其他药物的越来越普遍的行政途径 注射药物使用（IDU）行为威胁着减少艾滋病毒和丙型肝炎病毒（HCV）方面取得的最新进展 注射毒品（PWID）的人中的感染，这是实现雄心勃勃的主要障碍 减少新艾滋病毒感染的国家目标。在过去的十年中，纽约州经历了 阿片类药物使用障碍率的增长，因此增加了与IDU相关的传染病。新的 约克有强大的政治意愿减少PWID中这些感染的燃烧，并且是美国第一个国家 致力于“结束艾滋病流行病”和HCV消除策略。但是，纽约，像其他 各国没有目前的全州估计值，即有多少PWID需要预防传染病 服务。在纽约和其他地方需要对PWID人口规模的强大估计来促进 稀缺资源的最佳分配，衡量特定风险的传染病在PWID中燃烧，以及 评估预防干预措施的覆盖范围。我们建议估计PWID人口规模和相关 纽约风险特异性疾病和预防干预范围使用多个系统估算 （MSE）结合了额外的管理和PWID调查数据。 MSE是捕获的应用 - 重新捕获方法，允许使用观察的共同可能性估算潜在的人口规模 链接的管理数据集中的个人相对于他们的服务或诊断。我们将申请MSE 纽约链接的，全州数据集的方法，包括索赔数据，住院和急诊室 电子医院记录，药物治疗计划数据和传染病监测数据。我们也会 通过解决潜在的违反关键统计假设的行为，改善MSE方法的严格 增强估计模型，部分由研究团队目前收集的调查数据告知。 我们的具体目的是：（1）使用MSE估算纽约州的PWID人口规模 当前的IDU行为来自链接的行政数据集，整体和区域，性别和年龄； （2）创建 精致的PWID人口规模估计值是由于观察不平等的可能性而导致的偏见 数据集中的个人； （3）使用标准化将状态PWID人口规模分配给所有62个县 建模方法； （4）计算衡量传染病风险所需的关键流行病学指标 在PWID中：特定风险的艾滋病毒和HCV诊断率，注射器服务计划利用率和数量 PWID在过去一年中启动IDU； （5）使用AIDSVU数据传播估计和方法 可视化平台。这项工作的国家影响以纽约为典范，将是建立一个 强大的可复制方法，用于产生估算值，以指导努力改善PWID健康并减少 在这个高风险，研究不足的群体中，艾滋病毒和HCV的伯恩。