Preventing HIV Transmission by Recently-Infected Drug Users

预防最近感染的吸毒者传播艾滋病毒

• 批准号: 8448960
• 负责人: SAMUEL R FRIEDMAN
• 金额: $ 76.75万
• 依托单位: NATIONAL DEVELOPMENT AND RESEARCH INSTITUTES, INC.
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-08-01 至 2017-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8448960
• 关键词: Acute; Behavior; Communities; Community Networks; Contact Tracing; Drug Combinations; Drug user; Education; Effectiveness; Event; HIV; HIV Infections; Infection; Injection of therapeutic agent; Intervention; Interview; Logic; Methods; Network-based; Persons; Phylogenetic Analysis; Prevention; Probability; Risk; Seeds; Social Network; Stigmata; Techniques; Testing; Viral Load result; effective intervention; follow-up; high risk behavior; member; models and simulation; prevent; social stigma; success; transmission process

Half or more of HIV transmission events may occur within the period of high infectivity (and often high risk behavior) that can last 11 months or more after a person is initially infected. Unfortunately, neither test-and-treat intervention methods nor Acute HIV Infection projects have found effective ways to intervene against transmission during this risky "recent infection" period. We seek to develop effective intervention techniques against HIV transmission among drug users and their community members during the recent infection period using a combination of drug injection-, sexual- and social-network-based contact tracing methods; community alerts in the networks and venues of recent infectees; and the logic of going "up" and "down" infection chains. Our first Aim is to develop and evaluate ways to locate "seeds," defined as drug users and other people who have recently been infected. Our second Aim targets members of seeds' networks and people who attend their venues. We will test them for acute and for recent infection, and alert them to the probability that their networks contain highly-infectious members so they should reduce their risk and transmission behaviors for the next several months to minimize their chances of getting infected. This may also reduce transmission by untested people with recent infection. Community, network and venue education about the need and value of supporting those with recent infection should reduce stigma. Our third Aim is to reduce HIV transmission and to develop new ways to evaluate "prevention for positives" generally as well as our own success in reducing transmission. We will do this using a combination of follow- up interviews and testing, including of viral loads; phylogenetic techniques; and discrete event simulation modeling to assess our effectiveness.

一半或更多的艾滋病毒传播事件可能发生在高传染性时期（以及 通常是高风险行为），在一个人最初感染后可能会持续 11 个月或更长时间。 不幸的是，无论是检测与治疗干预方法还是急性艾滋病毒感染项目都没有 找到了在这个危险的“近期感染”时期干预传播的有效方法。 我们寻求开发有效的干预技术来阻止艾滋病毒在吸毒者之间的传播 用户及其社区成员在最近的感染期间使用以下组合 基于毒品注射、性行为和社交网络的接触者追踪方法；社区警报 最近感染者的网络和场所；以及“上”“下”感染的逻辑 链。我们的首要目标是开发和评估定位“种子”（定义为吸毒者）的方法 以及最近被感染的其他人。我们的第二个目标是种子成员 网络和参加其场地的人员。我们将对他们进行急性和近期的测试 感染，并提醒他们网络中可能存在高传染性成员 因此他们应该在接下来的几个月里减少风险和传播行为 尽量减少他们被感染的机会。这也可能减少未经测试的传播 最近感染过的人。有关需求和的社区、网络和场所教育 支持近期感染者的价值应该可以减少耻辱感。我们的第三个目标是减少 艾滋病毒传播并开发新方法来评估“阳性预防”，一般为 以及我们自己在减少传播方面取得的成功。我们将使用以下组合来做到这一点： 加强访谈和测试，包括病毒载量；系统发育技术；和离散事件 模拟建模来评估我们的有效性。