PS07-003, Minority HIV/AIDS Research Initiative

PS07-003，少数民族艾滋病毒/艾滋病研究计划

• 批准号: 7497070
• 负责人: Silvia Amesty
• 金额: $ 22.52万
• 依托单位: NEW YORK ACADEMY OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-30 至 2011-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7497070
• 关键词: PS07; 003; Minority; HIV; AIDS

DESCRIPTION (provided by applicant): Summary The purpose of this community-based evaluation study is to pilot test the feasibility of expanding pharmacy services to include provision of HIV testing referrals and services to injection drug users (IDUs) who purchase syringes in pharmacies in the Harlem community of New York City. In 2001, New York State pharmacies were allowed to register to sell syringes without a prescription through the Expanded Syringe Access Demonstration Program (ESAP), a public health policy targeted to IDUs to reduce syringe sharing and subsequent HIV transmission. This proposed evaluation study is based on two observations: black and Hispanic IDUs are disproportionately affected by HIV, and some pharmacists support ESAP and consider their work to include public health practice. Given our research team's extensive research in evaluating pharmacy syringe access, we believe that extending services, such as HIV testing, is a logical next step in the effort to help reduce racial disparities in HIV. Thus, the specific aims are: (1) to pilot test the feasibility of 10 ESAP-registered pharmacies in the delivery of HIV testing referrals to local HIV testing sites among IDU-syringe customers; and (2) to evaluate the feasibility of offering and performing HIV counseling and testing to IDU syringe-purchasing customers in 2 additional pilot pharmacies. To accomplish these aims, 10 pharmacies from the Harlem community will be randomly selected from 100 ESAP-registered pharmacies in the Harlem area. In collaboration with community members and local pharmacists, the research team will utilize a previously developed training module for pharmacists and pharmacy staff on the availability of HIV testing services, and how to engage/offer referrals to IDU syringe customers. IDUs who receive services from the pilot pharmacies will be asked to participate in a brief structured survey administered at the pharmacy by research staff. Among approximately 362 IDUs, we will compare those who have used the HIV testing referral vs. those who did not with respect to demographics, drug and sexual risk behaviors, perceptions and attitudes toward HIV testing, prior HIV testing, and previous HIV-positive diagnosis (Aim 1). We will also select and train pharmacy staff at 2 additional pilot pharmacies to perform HIV counseling and testing on-site (Aim 2); among IDUs who are offered on-site testing (N=82), we will administer a brief structured survey to compare those who agree to be tested vs. those who refuse with respect to similar factors described in Aim 1. Finally, semi-structured questionnaires will be administered to all pharmacy staff to qualitatively ascertain the impact of expanded services on customer base, daily business flow, and attitudes and perceptions of HIV testing services (referrals or on-site) among IDUs. Descriptive statistics and logistic regression will be used to analyze quantitative IDU data and standard qualitative techniques will be used to analyze pharmacy staff data. This proposed research is highly significant in that it aims to explore new venues for HIV testing that can reach high risk black and Hispanic communities in New York City. Due to a recently implemented expanded syringe access program allowing pharmacies to sell syringes without a prescription, a natural next step is to explore linking additional services, namely HIV testing referrals and on-site HIV testing services, with syringe sales to IDUs. If successful, this model can be duplicated not only through-out other high risk neighborhoods in New York, but in several other states with similar pharmacy access programs (e.g, New Jersey, California, Connecticut, Minnesota, Rhode Island, and Maine).

描述（由申请人提供）：总结这项基于社区的评估研究的目的是试点测试扩大药房服务的可行性，包括提供艾滋病毒测试转介和向注射药物使用者（IDU）提供纽约市哈林社区药房的注射器（IDU）。 2001年，纽约州药房被允许注册以通过扩展的注射器访问示范计划（ESAP）出售注射器，这是一项针对IDU的公共卫生政策，旨在减少注射器共享和随后的HIV传播。这项拟议的评估研究基于两个观察结果：黑人和西班牙裔IDU受艾滋病毒的影响不成比例，一些药剂师支持ESAP，并认为他们的工作包括公共卫生实践。鉴于我们的研究团队在评估药房注射器访问方面的广泛研究，我们认为扩展服务（例如HIV测试）是努力帮助减少艾滋病毒种族差异的逻辑下一步。因此，具体的目的是：（1）试点测试10家ESAP注册药房在将IDU-SRINGE客户中当地HIV测试站点转介给本地HIV测试站点的可行性； （2）评估在另外两家试点药房中为IDU注射器提供艾滋病毒咨询和测试的可行性。为了实现这些目标，将从哈林地区的100家ESAP注册药房中随机选择了10家来自哈林社区的药房。与社区成员和当地药剂师合作，研究团队将利用先前开发的培训模块，供药剂师和药房人员提供艾滋病毒测试服务的可用性，以及如何向IDU注射器客户进行参与/提供推荐。从研究人员通过研究人员在药房管理的简短结构化调查中，将要求从飞行员药房获得服务的IDU。在大约362个IDU中，我们将比较那些使用HIV测试转诊的人，而不是在人口统计学，药物和性风险行为，对HIV检测，先前的HIV检测以及以前的HIV阳性诊断的人口和性风险行为，感知和态度（AIM 1）。我们还将在另外两家试点药房中选择和培训药房人员，以在现场进行艾滋病毒咨询和测试（AIM 2）；在提供现场测试（n = 82）的IDU中，我们将进行简短的结构化调查，以比较那些同意接受测试的人与拒绝AIM 1中所述的类似因素的人进行比较。最后，半结构化的问卷将对所有药房进行管理，以定性地测试客户对客户群，每日业务的影响，以及访问者的访问，或者访问的范围，或者访问客户的范围，以及访问者的影响，或者访问了每日业务的影响，或者访问者的访问效果，或现场）iDus。描述性统计和逻辑回归将用于分析定量IDU数据，标准定性技术将用于分析药房数据。这项拟议的研究非常重要，因为它旨在探索可以达到纽约市黑人和西班牙裔社区高风险的艾滋病毒测试场所。由于最近实施的扩展注射器访问计划，允许药房在没有处方的情况下出售注射器，因此下一步是探索链接其他服务，即HIV测试转介和现场HIV测试服务，并将注射器销售给IDUS。如果成功的话，该模型不仅可以在纽约的其他高风险社区中复制，而且可以在其他几个具有类似药房访问计划的州（例如，新泽西州，加利福尼亚州，康涅狄格州，明尼苏达州，罗德岛州和缅因州）复制。