The Siyaphambili Substance Use Study: Exploring substance use and its treatment in the context of achieving sustained ART adherence among female sex workers

Siyaphambili 物质使用研究：在女性性工作者实现持续 ART 坚持的背景下探索物质使用及其治疗

• 批准号: 10619245
• 负责人: Justin Knox
• 金额: $ 25.96万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10619245
• 关键词: 18 year old; AIDS prevention; Address; Adherence; Adult; Behavior Therapy; Caring; Case Management; Case Manager; Client; Clinic; Collaborations; Data; Decentralization; Development; Disease; Drug Use Disorder; Economics; Effectiveness; Evaluation; Goals; Grant; HIV; HIV Infections; HIV/TB; Health; Heroin; High Prevalence; Incidence; Infrastructure; International; Intervention; Interview; Logistics; Methodology; Methods; Motivation; NIH Office of AIDS Research; Nurses; Outcome; Pattern; Pharmaceutical Preparations; Pharmacotherapy; Population; Prevention; Public Health; Recreation; Relapse; Reporting; Research; Research Personnel; Research Priority; Risk; Sequential Multiple Assignment Randomized Trial; Site; South Africa; Structure; Time; Violence; Viral; Woman; adaptive intervention; alcohol use disorder; binge drinking; care outcomes; cohort; evidence base; experience; experimental study; female sex worker; illicit drug use; implementation evaluation; implementation intervention; implementation science; implementation strategy; improved; insight; mHealth; mathematical model; polysubstance use; preference; primary outcome; programs; recruit; screening; sex; social stigma; substance use; substance use treatment; success; transmission process; treatment optimization; willingness

Project Summary/Abstract The goal of this project is to increase an understanding of substance use, how it impacts HIV care, and how to address it in a critical population, female sex workers (FSW) aged 18 years and older, in South Africa (SA), using data and infrastructure from an ongoing adaptive intervention, the Siyaphambili trial. Mathematical models suggest that nearly half of the 200,000 annual HIV infections among adults in SA are acquired by FSW, their clients, or partners of their clients and thus treating these unmet needs could result in better health outcomes for women and the population as a whole. Specific Aim 1: Characterize substance use among the FSW living with HIV who participated in the Siyaphambili trial, with a focus on identifying temporal patterns of polysubstance use, using Latent Transition Analysis (LTA), their associated determinants (e.g., violence, stigma, economic vulnerability), and if they modify the effectiveness of the sequentially adaptive strategy to improve HIV care outcomes. Specific Aim 2: Conduct mixed methods formative research on how to deliver substance use treatment for FSW in the context of HIV care through semi-structured interviews with 200 FSW engaged in the Siyaphambili study or in the TB HIV Care (THC) treatment and prevention sex worker program who report any illicit drug use, to ascertain experiences with substances, treatment (e.g. types, relapse), willingness for treatment, and preferences for treatment using a discrete choice experiment. This data will be supplemented by in-depth interviews with 10 implementation partners (e.g., nurses, clinic management) recruited through our partnership with THC. Specific Aim 3: Organize an Implementation Development Workgroup to initiate crosstalk with domestic and international collaborators on substance in FSW to refine emergent implementation strategies for evaluation across contexts. This R21 will allow an additional focus on substance use in the Siyaphambili trial, including bringing on the additional content and methodological expertise needed to achieve the proposed aims. We will also collect primary data to inform the development and implementation of interventions that address substance use among FSW in the context of HIV care, as well as conduct activities that strengthen international collaborations working toward this end. The proposed R21 is aligned with multiple NIH OAR priorities, including reducing HIV incidence (through optimized treatment), has a high likelihood of success by leveraging an existing cohort, and will directly inform an R01 study on the implementation of substance use treatment and HIV care among this key population.

项目摘要/摘要 该项目的目的是增加对药物使用的理解，如何影响艾滋病毒护理以及如何 在关键人群中，南非（SA）的18岁以上的女性性工作者（FSW）使用 持续的自适应干预措施的数据和基础设施，Siyaphambili试验。数学模型 表明，SA中成年人的200,000年艾滋病毒感染中有近一半是FSW获得的 客户或客户的合作伙伴，因此可以满足这些未满足的需求，可能会带来更好的健康状况 妇女和整个人口。特定目的1：表征FSW生活中的物质使用 参加Siyaphambili试验的艾滋病毒，重点是识别使用polysubstance的时间模式， 使用潜在过渡分析（LTA），其相关的决定因素（例如暴力，污名，经济 脆弱性），如果他们改变了依次适应性策略的有效性以改善艾滋病毒护理 结果。特定目的2：进行有关如何提供物质使用的混合方法形成研究 通过半结构化访谈的200 fsw在艾滋病毒护理中对FSW的治疗 Siyaphambili研究或结核病艾滋病毒护理（THC）治疗和预防性工作者计划报告任何报告 非法吸毒，以确定物质，治疗（例如类型，复发）的经历，愿意 治疗和使用离散选择实验的治疗偏好。这些数据将由 通过我们的10个实施合作伙伴（例如护士，诊所管理）的深入访谈 与THC的合作伙伴关系。特定目的3：组织实施开发工作组以启动串扰 与国内和国际合作者在FSW中的实质合作者，以完善紧急实施策略 用于跨环境的评估。该R21将允许在Siyaphambili试验中额外关注使用物质的使用， 包括实现实现拟议目标所需的其他内容和方法论专业知识。 我们还将收集主要数据，以告知处理干预措施的开发和实施 在艾滋病毒护理的背景下，FSW之间的药物使用，并进行加强国际的活动 朝着这一目的的协作。拟议的R21与多个NIH OAR优先级对齐，包括 减少艾滋病毒的发病率（通过优化的治疗），通过利用现有 队列，并将直接告知R01关于实施药物治疗和艾滋病毒护理的研究 在这个关键人群中。