A social network approach for improving medication assisted treatment and HIV prevention and medical care among people who inject drugs in Ukraine

用于改善乌克兰注射吸毒者的药物辅助治疗、艾滋病毒预防和医疗保健的社交网络方法

• 批准号: 10676829
• 负责人: CARL A LATKIN
• 金额: $ 13.69万
• 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: 2021-09-30 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10676829
• 关键词: AIDS prevention; Adherence; Caring; Client; Clinic; Data; Development; Drug usage; Drug user; Economics; Education; Educational Activities; Effectiveness; Enrollment; Epidemic; Goals; HIV; HIV Infections; HIV Seropositivity; HIV risk; Health; Health behavior; Incidence; Injecting drug user; International; Intervention; Intervention Studies; Interview; Medical; Methadone; Narcotics Anonymous; Network-based; Outcome; Participant; Patients; Persons; Pharmaceutical Preparations; Pharmacotherapy; Pilot Projects; Poverty; Process; Randomized; Recruitment Activity; Relapse; Reporting; Risk Behaviors; Role; Social Network; Support Groups; Surveys; Testing; Training; Ukraine; Viral; Viral Load result; Work; acceptability and feasibility; drug testing; experimental group; high risk; illicit drug use; improved; indexing; medication compliance; medication for opioid use disorder; medication-assisted treatment; member; mortality; novel; novel strategies; opioid epidemic; opioid overdose; opioid use; opioid user; overdose death; peer; prevent; randomized, clinical trials; recruit; seroconversion; transmission process; treatment program; uptake

Project Summary People who inject drugs (PWID) are at high risk for HIV infection and transmission as well as fatal opioid overdoses. The goal of this R34 is to pilot the key components necessary for a larger setting-based randomized clinical trial (RCT) for increasing medication-assisted treatment (MAT) and HIV medical care and medication adherence. In the proposed study, we will recruit 80 index PWID (half HIV seropositive) who have: 1) been on MAT for at least one year, 2) are able to recruit active network members who use drugs, and 3) are willing to promote MAT to these PWID. Based on our pilot data, we anticipate these 80 index participants to be able to recruit approximately 160 network members (two each) for the study intervention. After the baseline assessment of the indexes and network members, the indexes and their respective network members will be randomly assigned to the experimental intervention or the comparison condition. In the experimental intervention, the indexes will be trained on how to work with their network members to promote MAT and HIV care, including ART adherence, for drug network members living with HIV. All study participants will be assessed at 3 months with surveys and drug testing. Outcomes will include MAT uptake among network members, retention on methadone amongst indexes and network members, reduced HIV seroconversions among network members, reduced illicit drug use among all study participants, and linkage to HIV medical care and ART adherence among network participants who are living with HIV. Based on findings from our prior studies, we also anticipate that the health behaviors of the index participants randomized to the experimental group will improve due to their peer education activities. We will conduct qualitative process and outcomes interviews with 10 indexes in the experimental intervention condition and 10 network members. We will also interview 8 MAT and HIV clinic staff members to assess their perspectives on intervention feasibility and acceptably. Given the scope of the opioid epidemic and continued HIV epidemic among PWID, development of novel interventions to increase MAT uptake and retention is critical.

项目概要 注射吸毒者 (PWID) 感染和传播艾滋病毒以及致命的阿片类药物的风险很高 服药过量。 R34 的目标是试验更大的基于设置的必要关键组件 增加药物辅助治疗 (MAT) 和艾滋病毒医疗护理的随机临床试验 (RCT) 用药依从性。在拟议的研究中，我们将招募 80 名指数注射吸毒者（一半 HIV 血清阳性），他们具有： 1) 参加 MAT 至少一年，2) 能够招募使用毒品的活跃网络成员，并且 3) 愿意向这些注射吸毒者推广 MAT。根据我们的试点数据，我们预计这 80 个指数参与者将 能够招募大约 160 名网络成员（每人两名）进行研究干预。基线之后 对指数和网络成员的评估、指数及其各自的网络成员将 随机分配到实验干预或比较条件。在实验中 干预后，索引将接受如何与其网络成员合作以促进 MAT 和艾滋病毒的培训 为感染艾滋病毒的毒品网络成员提供护理，包括坚持抗逆转录病毒治疗。所有研究参与者都将 3 个月时通过调查和药物测试进行评估。成果将包括网络中 MAT 的采用 成员、索引和网络成员中保留美沙酮、减少 HIV 血清转化 网络成员中的非法药物使用减少，以及与艾滋病毒医疗的联系 感染艾滋病毒的网络参与者的护理和抗逆转录病毒疗法的依从性。根据我们的调查结果 在之前的研究中，我们还预计指数参与者的健康行为被随机分配到 实验组将由于同伴教育活动而得到改善。我们将进行定性流程和 结果对实验干预条件下的10个指标和10个网络成员进行访谈。我们 还将采访 8 名 MAT 和 HIV 诊所工作人员，以评估他们对干预可行性的看法 并且可以接受。鉴于阿片类药物流行的范围和吸毒者中艾滋病毒持续流行， 开发新的干预措施以增加 MAT 的吸收和保留至关重要。