A structural HIV prevention intervention targeting high-risk women

针对高危女性的结构性艾滋病毒预防干预措施

• 批准号: 10709073
• 负责人: Susan G. Sherman
• 金额: $ 14.08万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-15 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10709073
• 关键词: AIDS prevention; African American; Baltimore; Behavior; Behavioral; Behavioral Model; COVID testing; COVID-19 point of care; COVID-19 risk; COVID-19 testing; COVID-19 vaccination; Chronic Disease; Cities; Client; Clothing; Collaborations; Communicable Diseases; Communities; Complex; Counseling; Data; Data Analyses; Data Collection; Drug usage; Enabling Factors; Ethnic Origin; Event; Food; HIV; Handwashing; Harm Reduction; Health Personnel; Health Status; High Risk Woman; Homelessness; Hunger; Immunization Programs; Imprisonment; Individual; Infrastructure; Intervention; Interview; Length; Letters; Lung diseases; Manuscripts; Maryland; Measures; Medical; Naloxone; Nature; Participant; Pharmaceutical Preparations; Phase; Policy Maker; Practical Robust Implementation and Sustainability Model; Predictive Factor; RADx Underserved Populations; Race; Research; Research Infrastructure; Running; Seasons; Self Efficacy; Shapes; Social Distance; Surveys; Syringes; Target Populations; Techniques; Testing; Time; Trauma; Trust; Vaccines; Visit; Woman; Work; acceptability and feasibility; adverse outcome; burden of illness; cohort; community partnership; condoms; coronavirus disease; current pandemic; design; experience; female sex worker; follow-up; food insecurity; health belief; health care service utilization; high risk population; implementation process; informant; innovation; marginalized population; outreach; outreach program; phase 1 study; point of care; preventive intervention; programs; reuptake; risk mitigation; service delivery; service providers; sex; sexual violence; social; social stigma; study population; testing services; testing uptake; therapy design; trend; uptake; vaccine acceptance; vaccine distribution

Project Summary Marginalized populations such as women who use drugs (WWUD) have elevated risk of COVID-19 with risk mitigation techniques owing to the social nature of drug use procurement, drug use and sex work. High rates of structural vulnerabilities (e.g., homelessness, hunger, incarceration) in combination with low levels of healthcare utilization are key drivers of this high burden of disease. Through the “C2SPARC” study, we propose expanding the depth of our understanding of drivers of POCT uptake in both research and service delivery contexts. Specifically, we propose adding a 6-month follow-up visit (“C2SPARC visit”) to the CARE study to more robustly examine trends in POCT uptake over time. Secondly, in partnership with a leading harm reduction organization that serves WWUD, we propose designing and implementing POCT on their nighttime mobile outreach van that provides harm reduction (e.g., condoms, naloxone, syringes) and basic necessities (e.g., food, clothing). C2SPARC will employ Andersen’s Behavioral Model (Aim 1), PRISM (Practical, Robust, Implementation, and Sustainability Model) (Aim 2), and the Theoretical Framework of Acceptability (TFA) (Aim 3) to meet the following aims: 1) to examine predisposing (e.g., social - homelessness, food insecurity; individual - drug use, race/ ethnicity, health beliefs) factors as well as enabling (past COVID-19 testing, vaccine uptake) factors that predict uptake of POCT over a six-month period among WWUD (N=250) in Baltimore, Maryland; 2) to collaborate with the SPARC Center to develop and implement POCT on their mobile outreach van that primarily serves WWUD in Baltimore City, Maryland; and to examine the feasibility (e.g., testing uptake) and acceptability (e.g., participant burden, testing self-efficacy) of mobile POCT testing among WWUD (N=250) who are clients of SPARC outreach. C2SPARC is innovative its leverage of the Phase I cohort to evaluate POCT testing uptake longitudinally which will inform the implementation of COVID-testing in the context of a meaningful community partnership. Situating COVID testing in the context of trusted service provider is urgency needed. The study’s impact and sustainability will also be enhanced by a community advisory board (CAB). Study results can be quickly disseminated to policy makers and the target population through products (i.e., fact sheets, manuscripts) and events (i.e., community forums) to inform community-based testing and eventual vaccination programs targeting WWUD and similarly marginalized populations.

项目概要 吸毒女性 (WWUD) 等边缘人群感染 COVID-19 的风险较高 由于毒品采购、毒品使用和性工作的社会性质，采用风险缓解技术。 结构性脆弱性（例如无家可归、饥饿、监禁）发生率高，而结构性脆弱性发生率低 医疗保健利用水平是这种高疾病负担的关键驱动因素。 研究中，我们建议加深对两项研究中 POCT 采用驱动因素的理解 具体来说，我们建议增加 6 个月的后续访问（“C2SPARC 访问”）。 与 CARE 研究一起更强有力地研究 POCT 随时间推移的采用趋势 其次，合作。 与服务于 WWUD 的领先减害组织一起，我们建议设计和实施 在其夜间移动外展车上进行 POCT，以减少伤害（例如避孕套、纳洛酮、 注射器）和基本必需品（例如食物、衣服）。 （目标 1）、PRISM（实用、稳健、实施和可持续性模型）（目标 2）和理论 可接受性框架 (TFA)（目标 3），以满足以下目标：1) 检查诱发因素（例如， 社会 - 无家可归、粮食不安全；个人 - 吸毒、种族/民族、健康信仰）因素 作为预测六个月内 POCT 接受情况的促成因素（过去的 COVID-19 检测、疫苗接种情况） 期间在马里兰州巴尔的摩的 WWUD (N=250) 期间与 SPARC 中心合作开发 并在主要为巴尔的摩市的 WWUD 提供服务的移动外展车上实施 POCT， 马里兰州；并检查可行性（例如，测试的采用率）和可接受性（例如，参与者的负担， SPARC 外展客户 WWUD (N=250) 中的移动 POCT 测试（自我效能测试）。 C2SPARC 创新性地利用 I 期队列来纵向评估 POCT 测试的采用情况 这将为在有意义的社区背​​景下实施新冠病毒检测提供信息 迫切需要在值得信赖的服务提供商的背景下进行新冠病毒检测。 社区咨询委员会（CAB）的研究结果也将增强研究的影响力和可持续性。 可以通过产品（即概况介绍、 手稿）和活动（即社区论坛），为基于社区的测试和最终结果提供信息 针对 WWUD 和类似边缘人群的疫苗接种计划。

项目成果

External resilience in the context of drug use and socio-structural vulnerabilities: a qualitative exploration among women who use drugs and sell sex in Baltimore, Maryland.

• DOI: 10.1186/s12954-022-00678-6
• 发表时间: 2022-08-24
• 期刊: HARM REDUCTION JOURNAL
• 影响因子: 4.4
• 作者: Tomko, Catherine;Nestadt, Danielle Friedman;Weicker, Noelle P.;Rudzinski, Katherine;Underwood, Carol;Kaufman, Michelle R.;Sherman, Susan G.
• 通讯作者: Sherman, Susan G.