Yuva Sath: A peer-led intervention to support substance use treatment and HIV prevention among young people who inject drugs in India

Yuva Sath：一项由同伴主导的干预措施，旨在支持印度注射吸毒年轻人的药物滥用治疗和艾滋病毒预防

• 批准号: 10698376
• 负责人: Lakshmi Ganapathi
• 金额: $ 19.35万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-15 至 2028-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10698376
• 关键词: AIDS prevention; Address; Age Years; Automobile Driving; Award; Behavior Therapy; Behavioral Medicine; Caring; Cellular Phone; Childhood; Cities; Clinical; Collection; Communicable Diseases; Counseling; Data; Development; Drops; Effectiveness; Epidemic; Evaluation; Evidence based intervention; Fellowship; Focus Groups; Future; Goals; Government; HIV; HIV Infections; HIV Seropositivity; HIV risk; Heroin; Human immunodeficiency virus test; Hybrids; Incidence; India; Individual; Injecting drug user; Injections; Intervention; Intervention Studies; Lead; Life; Medicine; Mentored Patient-Oriented Research Career Development Award; Mentors; Modeling; Modification; National Institute of Drug Abuse; Needle-Exchange Programs; Needles; Nongovernmental Organizations; Outcome; Participant; Patients; Peer Pressure; Persons; Physicians; Policies; Prevalence; Problem Solving; Provider; Public Health; Randomized; Randomized, Controlled Trials; Research; Research Infrastructure; Research Personnel; Retrospective cohort; Risk Behaviors; Services; Signal Transduction; Specific qualifier value; Statistical Methods; Statistical Study; Subgroup; Testing; Time; Training; Transportation; United States National Institutes of Health; Vulnerable Populations; Work; Youth; acceptability and feasibility; addiction; antiretroviral therapy; career development; condoms; disorder prevention; effectiveness trial; experience; flexibility; high risk; high risk behavior; implementation intervention; implementation science; improved; innovation; integrated care; medical schools; medication for opioid use disorder; multidisciplinary; novel; opioid injection; opioid use disorder; outreach; patient oriented research; peer; peer support; person centered; pre-exposure prophylaxis; preference; prescription opioid; prevention service; preventive intervention; primary outcome; psychosocial; public health priorities; reduced substance use; risk perception; scale up; secondary analysis; secondary outcome; skills; sociodemographics; substance use; substance use treatment; testing uptake; therapy adherence; therapy design; therapy development; treatment as usual; uptake

7. PROJECT SUMMARY/ABSTRACT India’s HIV epidemic is being fueled by an alarming rise in injection of opioids. Young people who inject drugs (YPWID; 18-29 years of age) are poorly engaged in treatment for opioid use disorder and HIV prevention services and bear a disproportionate burden of new HIV infections. Increasing engagement in treatment for opioid use disorder and uptake of HIV prevention services among YPWID is an urgent public health priority. YRGCARE, an Indian non-governmental organization, has established Integrated Care Centers in 8 cities to deliver medications for opioid use disorder (MOUD) and other HIV prevention services, including HIV testing, clean needles, and condoms to people who inject drugs. YPWID initiating MOUD at Integrated Care Centers engage poorly in treatment due to diverse barriers that also limit uptake of HIV prevention services. YPWID under-engaged in MOUD have high risk behaviors, low HIV testing, and high HIV seroconversion. Few interventions exist to support substance use treatment and HIV prevention among Indian YPWID. Dr. Ganapathi is a pediatric infectious diseases physician who aspires to lead rigorous research to address this gap. Building upon her HIV research fellowship training and unique clinical background, she will utilize this Mentored Patient-Oriented Research Career Development (K23) Award to: 1) develop expertise in behavioral intervention development, 2) gain skills in advanced statistical methods and study design for intervention research, and 3) develop an understanding of the principles of implementation science. Dr. Ganapathi will develop and pilot “Yuva Sath”, a brief, peer-led behavioral intervention to support MOUD engagement and uptake of HIV prevention services among YPWID who have initiated MOUD at Integrated Care Centers but are under-engaged in treatment. Informed by empirical principles used in successful youth- tailored interventions, Yuva Sath will be developmentally tailored, leverage peer support, and employ convenient mobile phone delivery. Development of Yuva Sath will entail adapting “Life-Steps”, an empirically supported problem-solving intervention originally developed to support antiretroviral therapy adherence. Intervention development will be informed by: 1) analysis of existing quantitative data collected from a retrospective cohort of YPWID initiating MOUD across 8 Integrated Care Centers, and 2) collection of qualitative data to understand YPWID preferences for intervention content and delivery. Dr. Ganapathi will then conduct a pilot randomized controlled trial of Yuva Sath, compared to usual care, among YPWID at a single Integrated Care Center in Aizawl city in Northeast India, to inform a future fully powered effectiveness trial. Leveraging research infrastructure at Harvard Medical School and YRGCARE, Dr. Ganapathi will be mentored by a multidisciplinary team, with expertise in behavioral medicine, infectious diseases, and addiction medicine, led by Drs. O’Cleirigh, Solomon, and Mayer. By developing a novel HIV prevention intervention for YPWID, this work has potential to impact public health while facilitating her transition to independence.

7。项目摘要/摘要 印度的艾滋病毒流行正在激发阿片类药物注射震撼。注射年轻人 药物（YPWID; 18-29岁）的治疗不佳，治疗阿片类药物使用障碍和预防HIV 服务并带有不成比例的新艾滋病毒感染。增加参与治疗 在YPWID中，OPIOED使用障碍和对HIV预防服务的吸收是紧急的公共卫生优先事项。 印度非政府组织Yrgcare已在8个城市建立了综合护理中心 为阿片类药物使用障碍（MOUD）和其他艾滋病毒预防服务提供药物，包括艾滋病毒 测试，清洁针和给注入毒品的人进行测试。 YPWID在集成护理中启动MOUD 由于潜在的障碍也限制了艾滋病毒预防服务的吸收，因此中心参与治疗。 在MOUD中的YPWID参与不足具有高风险行为，低HIV测试和高HIV血清转化。很少 目前存在干预措施，以支持印度YPWID中的药物治疗和预防HIV。 Ganapathi博士是一种儿科传染病，渴望领导严格的研究以解决 这个差距。在她的艾滋病毒研究奖学金培训和独特的临床背景的基础上，她将利用这一点 指导的面向患者的研究职业发展（K23）授予：1）发展行为方面的专业知识 干预开发，2）获得高级统计方法和研究设计的技能 研究，以及3）对实施科学原理的理解。 Ganapathi博士将开发并试行“ Yuva Sath”，这是一项简短的，由同行领导的行为干预措施，以支持MOUD 在Integrated发起Moud的YPWID之间的参与和吸收艾滋病毒预防服务 护理中心，但在治疗方面不足。由成功青年中使用的经验原则所告知 - 量身定制的干预措施，Yuva Sath将被量身定制，利用同伴支持，并采用 方便的手机交付。 Yuva Sath的发展将需要改编“生命步骤”，这是一个经验上的 最初为支持抗逆转录病毒疗法的依从性而开发的支持解决问题的干预措施。 干预开发将通过以下方式告知：1）分析从A 回顾性YPWID在8个综合护理中心启动MOUD和2）收集 定性数据以了解干预内容和交付的YPWID偏好。加纳帕蒂博士将 与通常的护理相比，在一个单一的YPWID中，进行YUVA SATH的飞行员随机对照试验 印度东北部Aizawl City的综合护理中心，以告知未来的全力有效性试验。 利用哈佛医学院和YRGCARE的研究基础设施，Ganapathi博士将是 由一个多学科团队指导，具有行为医学，传染病和成瘾方面的专业知识 医学，由博士领导。奥克利格，所罗门和梅耶。通过开发一种新型的HIV预防干预措施 YPWID，这项工作有可能影响公共卫生，同时支持她向独立过渡。