Feasibility of Pharmacy-Based HIV Interventions among IDUs: Ha Giang, Vietnam

对注射吸毒者进行基于药物的艾滋病毒干预的可行性：越南河江

• 批准号: 7797624
• 负责人: Nancy Pielemeier
• 金额: $ 19.28万
• 依托单位: ABT ASSOCIATES, INC.
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-01-01 至 2011-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7797624
• 关键词: AIDS prevention; Adopted; Attitude; Blood; Caring; Censuses; Characteristics; Communities; Country; Data; Data Collection; Drug usage; Elements; Environment; Epidemic; Feasibility Studies; HIV; Health Services; India; Injecting drug user; Injection of therapeutic agent; International; Intervention; Intervention Trial; Interview; Law Enforcement; Learning; Legal; Link; Location; Methodology; Methods; Needles; Outcome Measure; Pharmaceutical Services; Pharmacists; Pharmacy facility; Policies; Policy Maker; Population; Preparation; Public Health; Randomized; Research Personnel; Risk; Russia; Sampling; Services; Site; Sterility; Surveys; Syringes; Testing; Training; Vietnam; Virus; Work; World Health Organization; base; control trial; disease transmission; effective intervention; informant; innovation; multi-site trial; public health relevance; response; scale up; social; transmission process; willingness; AIDS prevention; Adopted; Attitude; Blood; Caring; Censuses; Characteristics; Communities; Country; Data; Data Collection; Drug usage; Elements; Environment; Epidemic; Feasibility Studies; HIV; Health Services; India; Injecting drug user; Injection of therapeutic agent; International; Intervention; Intervention Trial; Interview; Law Enforcement; Learning; Legal; Link; Location; Methodology; Methods; Needles; Outcome Measure; Pharmaceutical Services; Pharmacists; Pharmacy facility; Policies; Policy Maker; Population; Preparation; Public Health; Randomized; Research Personnel; Risk; Russia; Sampling; Services; Site; Sterility; Surveys; Syringes; Testing; Training; Vietnam; Virus; Work; World Health Organization; base; control trial; disease transmission; effective intervention; informant; innovation; multi-site trial; public health relevance; response; scale up; social; transmission process; willingness

DESCRIPTION (provided by applicant): Transmission of HIV and other blood borne viruses among injection drug users (IDUs) has been linked to restrictions on syringe access. Conversely, strategies that have expanded syringe access through pharmacies have been shown to reduce injection-related HIV risk. The best of these work with pharmacists to increase their willingness to serve as agents of public health, encouraging them to provide not just more syringes but expanded HIV- and substance abuse-related services to the IDUs who patronize their pharmacies. But to date no comprehensive studies have been undertaken to understand what elements of pharmacist training and which services are most critical in reducing the risks for disease transmission. A multi-site intervention trial to fill this gap could have a significant impact in locations in which injection-related HIV transmission poses significant burdens. Before such a trial can begin, however, appropriate sites need to be identified. This application is one of five linked R21 applications- two from the U. S. and one each from India, Russia, and Vietnam - for possible study sites to explore the feasibility of a trial of pharmacy-based interventions. Each site has information about the local injection-related HIV epidemic and the extent to which IDUs already use pharmacies to obtain syringes. At this point, more information is needed to understand the local culture of pharmacies and pharmacists, their willingness to participate in such a trial, and the local barriers to developing and implementing an intervention. Additionally, determining the receptiveness of IDU syringe customers to participating in such a trial and the influences of the social and political contexts are also needed to help determine feasibility of a multi-site trial. This application from Abt Associates Inc. for Ha Giang town, Vietnam proposes to a two-year scope of work that adopts the methodology of Rapid Policy Assessment and Response (RPAR) projects to learn, based on qualitative interviews and quantitative surveys, from pharmacists, the IDUs they serve, local public health and law enforcement officials enough to develop an intervention that can be tested in a variety of local contexts in U.S. and international sites. Qualitative interviews will be conducted with all key informant groups and quantitative surveys will be done with a sample of IDUs and a census of pharmacy mangers to better determine the interventions and outcome measures to be used in the intervention trial. This exploratory study has three major aims: (1) to assess current pharmacy services and how these services can be expanded to include HIV related services for IDUs who purchase or otherwise access syringes in pharmacies; (2) to assess barriers to IDU and pharmacy staff participation in HIV prevention and treatment interventions targeted to IDU customers, including pharmacists' attitudes, and possible interference from law enforcement, political leaders, and policy makers; and (3) to identify potential local sites for a randomized community controlled trial. There are important methodological and contextual advantages of conducting feasibility studies in a diverse set of domestic and international sites. PUBLIC HEALTH RELEVANCE: This project is highly relevant to public health in that it will help to develop innovative, replicable, and sustainable HIV prevention and care interventions for injection drug users. In many developing and transitional countries there are growing HIV epidemics that are concentrated among IDUs but there are few scaled-up interventions to reach this important population. The interventions to be developed through project will utilize pharmacies, which are the most widespread settings for health services in the world.

描述（由申请人提供）：注射吸毒者中艾滋病毒和其他血液传播病毒的传播（IDU）与注射器通道的限制有关。相反，已证明通过药房扩大注射器访问的策略已被证明可以降低与注射相关的艾滋病毒风险。这些与药剂师合作中最好的工作是提高他们作为公共卫生的代理人的意愿，鼓励他们不仅提供更多的注射器，而且向光顾其药房的IDU提供了与艾滋病毒和药物滥用相关的服务。但是迄今为止，尚未进行全面的研究来了解哪些药剂训练的要素以及哪些服务对于降低疾病传播的风险至关重要。填补此空白的多站点干预试验可能会在注射相关的艾滋病毒传播造成巨大负担的位置产生重大影响。但是，在开始进行此类试验之前，需要确定适当的站点。该申请是五个链接的R21应用程序之一 - 来自美国的两项申请中的两项，一项来自印度，俄罗斯和越南 - 可能的研究地点探索了基于药房的干预措施试验的可行性。每个站点都有有关局部注射相关的HIV流行的信息，以及IDUS已经使用药房获取注射器的程度。在这一点上，需要更多信息来了解药房和药剂师的当地文化，他们参加此类试验的意愿以及开发和实施干预措施的当地障碍。此外，还需要确定IDU注射器客户参加此类试验的接受度以及社会和政治背景的影响，以帮助确定多站点试验的可行性。越南为Ha Giang Town提供的ABT Associates Inc.的这一申请提议为期两年的工作范围，采用了快速政策评估和回应（RPAR）项目的方法，根据定性访谈和定量调查，从药剂师那里进行的，从药剂师那里，IDU，IDU，当地的公共卫生和执法人员在本地进行介入的介入室内培训及其务必进行介入的情况下，以培养了一项介入。定性访谈将与所有主要线人组进行，并将使用IDU和药房经理人口普查进行定量调查，以更好地确定干预试验中要使用的干预措施和结果指标。这项探索性研究具有三个主要目的：（1）评估当前的药房服务以及如何扩展这些服务，以包括在药房购买或以其他方式访问注射器的IDU相关服务； （2）评估针对IDU客户的IDU和药房人员参与艾滋病毒预防和治疗干预措施的障碍，包括药剂师的态度，以及执法人员，政治领导人和政策制定者的干扰； （3）为随机社区对照试验确定潜在的本地站点。在各种国内和国际地点进行可行性研究的方法论和背景优势是重要的。公共卫生相关性：该项目与公共卫生高度相关，因为它将为注射吸毒者开发创新，可复制和可持续的HIV预防和护理干预措施。在许多发展中国家和过渡国家中，越来越多的艾滋病毒流行病集中在IDU中，但几乎没有扩大干预措施来达到这一重要人群。通过项目制定的干预措施将利用药房，这是世界上最广泛的卫生服务环境。