Integrating Assisted Partner Services and Phylogenetics for HIV and HCV Prevention

整合辅助合作伙伴服务和系统发育学以预防 HIV 和 HCV

• 批准号: 10086117
• 负责人: CAREY FARQUHAR
• 金额: $ 7.16万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-05-15 至 2022-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10086117
• 关键词: AIDS prevention; Adult; Affect; Africa; Africa South of the Sahara; Area; Behavioral; Blood; Cameroon; Caring; Clinic; Clinical; Collection; Contact Tracing; Counseling; Data; Disease Progression; Drug usage; Enrollment; Epidemic; Europe; Exposure Notifications; Exposure to; Family; Female; Future; General Population; Genes; HIV; HIV Infections; HIV Seropositivity; HIV diagnosis; HIV/HCV; Health; Hepatitis C; Hepatitis C Transmission; Hepatitis C co-infection; Hepatitis C virus; Hospitals; Human immunodeficiency virus test; Improve Access; Individual; Infection; Injecting drug user; Investments; Kenya; Laboratory Research; Link; Methods; Molecular Epidemiology; Mozambique; Needle Sharing; Needles; Paper; Participant; Partner Notification; Persons; Pharmaceutical Preparations; Phylogenetic Analysis; Population; Prevalence; Prevention; Prevention program; Public Health; Research; Risk; Risk Behaviors; Risk Factors; Role; Services; Sexual Partners; Sexual Transmission; Shapes; Slum; Spottings; Syringes; Testing; Time; United States; Universities; Viral; Viral Load result; Virus; Washington; addiction; base; case finding; co-infection; epidemiologic data; experience; high risk; high risk behavior; indexing; innovation; intravenous drug use; multidisciplinary; peer; pol genes; prevent; programs; public health intervention; recruit; screening; service delivery; sociodemographics; success; testing services; trait; transmission process; treatment program

ABSTRACT To contain the HIV epidemic in Kenya and other parts of sub-Saharan Africa, innovative strategies for identifying and treating HIV-infected persons who inject drugs (PWID) are critically important. It is also essential that factors contributing to onward transmission are better understood if prevention and treatment programs are to be brought to scale for key affected populations. The study will be co-led by Dr. Carey Farquhar and Dr. Joshua Herbeck and is a collaborative effort between the University of Washington, Kenyatta National Hospital, the University of Kwa-Zulu-Natal, Kenya Ministry of Health and a local NGO, Support for Addiction Prevention and Treatment in Africa (SAPTA). The study will determine whether assisting HIV-infected PWID to notify their partners can be a successful strategy for HIV testing and linkage to care, and whether assisted partner notification services (APS) can be leveraged to identify individuals at high risk for hepatitis C (HCV). The primary objective is to determine how many needle-sharing and sexual partners per HIV-infected PWID accessing HIV testing services can be tested, diagnosed HIV- or HCV-positive, linked to appropriate services, and engaged in care at 3 months post-testing. To achieve this, health advisors experienced in APS will recruit and enroll 1000 HIV-infected participants at 3 needle-syringe program clinics in the Mathare slum area of Nairobi. Together with peer educators from SAPTA, study health advisors will inform partners of the exposure to HIV and HCV and arrange for testing at the clinic or another venue. This strategy has not been used among PWID for HIV or HCV, however, it has recently been shown to be acceptable and feasible in the general population in Kenya. Our second and third aims leverage the ability of APS to identify new HIV and HCV cases and use phylogenetics to characterize modes of transmission and risk factors for ongoing HIV and HCV transmission in this key population. Blood spots will be collected on filter paper from 1000 HIV-infected and 1000 HCV-infected PWID in the network and HIV and HCV will be sequenced at the University of KwaZulu-Natal research laboratory. This type of molecular epidemiology approach has not been used in this population for HIV or HCV and holds great promise when combined with collection of sociodemographic and behavioral data for defining population level factors contributing significantly to onward transmission of these two viruses. We anticipate that our results will shape the success of future prevention efforts in Kenya and sub-Saharan Africa by enabling public health programs to target high-risk clusters, and this will in turn pave the way for more in-depth research on effective screening and service delivery PWID.

抽象的 为了遏制肯尼亚和撒哈拉以南非洲其他地区的艾滋病毒流行，识别的创新策略 并治疗注射药物（PWID）的艾滋病毒感染者至关重要。因素也至关重要 如果要预防和治疗计划，可以更好地理解有助于继续传播 为关键受影响的人群进行扩展。该研究将由凯里·法夸（Carey Farquhar）博士和约书亚（Joshua）博士共同领导。 赫伯克（Herbeck 肯尼亚卫生部和当地非政府组织Kwa-Zulu-Natal大学，支持预防成瘾和 非洲的治疗（SAPTA）。该研究将确定是否协助感染HIV的PWID通知其 合作伙伴可以成为艾滋病毒测试和与护理联系的成功策略，以及是否协助合作伙伴 可以利用通知服务（AP）来识别乙型肝炎（HCV）高风险的个体。主要 目的是确定每个HIV感染的PWID访问HIV的针头共享和性伴侣 可以对测试服务进行测试，诊断为HIV或HCV阳性，与适当的服务相关，并参与 测试后三个月的护理。为了实现这一目标，APS经验丰富的健康顾问将招募和注册1000 内罗毕Mathare贫民窟地区的3个针触及计划诊所的HIV感染参与者。一起 来自SAPTA的同伴教育工作者，研究健康顾问将向合作伙伴告知艾滋病毒和HCV的暴露以及 安排在诊所或其他场所进行测试。该策略尚未用于HIV或HCV的PWID中 但是，最近在肯尼亚的一般人群中已证明它是可以接受的和可行的。我们的 第二和第三的目的是利用AP识别新的HIV和HCV病例的能力，并使用系统发育学对 表征该关键人群中持续的HIV和HCV传播的传播模式和风险因素。 将在网络中的1000 HIV感染和1000 HCV感染的PWID的滤纸上收集血斑 HIV和HCV将在夸祖鲁 - 纳塔尔大学研究实验室进行测序。这类 分子流行病学方法尚未用于HIV或HCV，并保持着巨大的希望 当结合收集社会人口统计学和行为数据以定义人口级别的因素时 这两种病毒的继续传播显着贡献。我们预计我们的结果将会成型 未来在肯尼亚和撒哈拉以南非洲未来预防努力的成功，使公共卫生计划能够 针对高风险集群，这反过来将为有效筛查和更深入的研究铺平道路 服务交付PWID。