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. 项目概要/摘要 印度的艾滋病毒流行因注射阿片类药物的年轻人数量惊人增加而加剧。 药物滥用者（YPWID；18-29 岁）在治疗阿片类药物使用障碍和艾滋病毒预防方面表现不佳 服务并承担新的艾滋病毒感染的不成比例的负担。 阿片类药物使用障碍和 YPWID 接受艾滋病毒预防服务是一项紧迫的公共卫生优先事项。 印度非政府组织YRGCARE在8个城市设立综合护理中心 提供治疗阿片类药物使用障碍 (MOUD) 的药物和其他艾滋病毒预防服务，包括艾滋病毒 为在 Integrated Care 发起 MOUD 的 YPWID 患者提供检测、清洁针头和安全套。 由于各种障碍也限制了艾滋病毒预防服务的采用，各中心在治疗方面表现不佳。 参与 MOUD 不足的 YPWID 具有高风险行为、低 HIV 检测和高 HIV 血清转化率。 现有干预措施支持印度 YPWID 的药物滥用治疗和艾滋病毒预防。 Ganapathi 博士是一名儿科传染病医生，他渴望领导严格的研究来解决 基于她的艾滋病毒研究奖学金培训和独特的临床背景，她将利用这一差距。 指导以患者为导向的研究职业发展 (K23) 奖项旨在：1) 发展行为方面的专业知识 干预措施的开发，2) 获得先进统计方法和干预研究设计的技能 研究，3) 加深对实施科学原理的理解。 Ganapathi 博士将开发并试点“Yuva Sath”，这是一项简短的、同行主导的行为干预措施，以支持 MOUD 已在综合中心发起 MOUD 的 YPWID 参与和接受艾滋病毒预防服务 护理中心但对成功青年使用的经验原则的参与不足。 量身定制的干预措施，尤瓦·萨斯 (Yuva Sath) 将根据发展情况量身定制，利用同伴支持，并雇用 Yuva Sath 的开发将需要采用“Life-Steps”，这是一种经验性的方法。 支持解决问题的干预措施最初是为了支持抗逆转录病毒治疗的依从性而开发的。 干预措施的制定将通过以下方式进行：1）对从某个机构收集的现有定量数据进行分析。 YPWID 在 8 个综合护理中心发起 MOUD 的回顾性队列，以及 2) 收集 Ganapathi 博士随后将提供定性数据，以了解 YPWID 对干预内容和实施方式的偏好。 在 YPWID 中进行一项 Yuva Sath 试验随机对照试验，与常规护理相比，一次 印度东北部艾藻尔市的综合护理中心，为未来的全动力有效性试验提供信息。 Ganapathi 博士将利用哈佛医学院和 YRGCARE 的研究基础设施 由多学科团队指导，具有行为医学、传染病和成瘾方面的专业知识 由 O’Cleirigh、Solomon 和 Mayer 博士领导的药物开发了一种新型艾滋病毒预防干预措施。 YPWID，这项工作有可能影响公共健康，同时促进她向独立过渡。