The Impact of Stigma on Interpersonal Relationships of Young Adult People who Inject Drugs

耻辱对年轻注射吸毒者人际关系的影响

• 批准号: 10730501
• 负责人: Meghan D Morris
• 金额: $ 8.69万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-06-01 至 2027-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10730501
• 关键词: Action Potentials; Address; Adult; Affect; Behavior; Behavior Therapy; California; Communities; Counseling; Data; Diagnosis; Dimensions; Discrimination; Dissemination and Implementation; Drug usage; Emotional; Epidemiology; Foundations; Friendships; Goals; Health; Health behavior; Healthcare Systems; Hepatitis C; Hepatitis C Prevalence; Hepatitis C Therapy; Hepatitis C virus; Individual; Infectious Disease Epidemiology; Injecting drug user; Interpersonal Relations; Intervention; Intervention Studies; Interview; Link; Maps; Measurement; Measures; Mediating; Nature; Paper; Parents; Partnership Practice; Persons; Population; Prejudice; Prevention; Professional counselor; Qualitative Research; Randomized; Records; Research; Research Personnel; Resources; Role; Safety; San Francisco; Social Discrimination; Social support; Source; Statistical Methods; Stigmatization; Testing; Theory of Change; Training; Trust; United States; Universities; Work; behavior change; community engagement; coping; curative treatments; design; doctoral student; efficacy evaluation; efficacy testing; epidemic virus; experience; health inequalities; high risk; improved; injection drug use; insight; intimate behavior; minority communities; opioid epidemic; parent grant; population health; psychologic; public health intervention; randomized trial; randomized, controlled study; social; social relationships; social stigma; standard of care; substance use; timeline; tool; uptake; young adult

Abstract of Parent Grant: A Randomized Trial to Test the Efficacy of a Partner Navigation Intervention for HCV Treatment among Young Adult People who Inject Drugs (R01DA053325) Globally, more than 3.5 million people are infected with hepatitis C virus (HCV). In the United States, due to the opioid epidemic, HCV cases have increased, especially among adults under 30. However, few young people who inject drugs (PWID ≤30 years old) – who are at the center of the HCV epidemic in the US – are benefiting from curative HCV therapy. A potentially promising, yet untapped avenue for increasing HCV treatment among PWID is the leveraging of their injecting partners to successfully navigate the multiple obstacles between diagnosis and treatment. Our team’s extensive research with dyads identified a potential action-point within injecting partnerships that can be harnessed through behavioral intervention. Quantitative findings identified specific injecting related interpersonal factors (i.e., trust, intimacy, cooperation) associated with increased health and safety for injecting partnerships. Followed by qualitative results that in combination with interpersonal factors, partner involvement (i.e., emotional, tangible, affectionate, and positive social support) enhances a partnership’s ability to coordinate behavior (dyadic capacity). Interpersonal factors with partner involvement was found to overcome barriers to HCV treatment. Building on our extensive foundation of dyadic research and dyadic behavior change theories, we developed the Partner Navigation Intervention a two-session injecting partnership intervention to enhance dyadic capacity for HCV treatment initiation for young adult PWID. The proposed study is a randomized controlled study (RCT) to assess the efficacy and mechanism of action of the first behavioral intervention to increase HCV treatment initiation among young adult PWID. In partnership with our community-based HCV testing organizations (CBOs), we will randomize young adult PWID with recently diagnosed HCV infection (250 partnerships, n=500) and their primary injecting partner to intervention or standard of care. Scalability was core to the design of the two-session intervention. Session 1 expands on standard-of-care HCV infection diagnosis counseling with counselor-led discussion with the HCV positive PWID to identify situational and personal barriers to HCV treatment and identify an injecting partner to aid in their HCV treatment navigation. Session 2 is a dyad session with both the young adult PWID and their injecting partner. A counselor facilitated discussion will develop strategies to respond to the identified HCV treatment initiation barriers and partnerships practice strategies and concretize a plan involving both partners for addressing barriers, including a timeline and potential alternative strategies in treatment navigation. During both sessions the counselor records key information discussed onto a paper handout (Partner Navigation Map) serving as the intervention tool. A community advisory board young adult PWID will guide implementation and dissemination. The proposed study will improve the cure rate in this highly impacted population. Our strategy of enhancing dyadic capacity may be adapted for targeted change of other health behaviors (e.g., HCV prevention) affecting young PWID.

家长补助金摘要：测试合作伙伴导航干预效果的随机试验 用于注射吸毒的年轻成人的 HCV 治疗 (R01DA053325) 在美国，全球有超过 350 万人感染丙型肝炎病毒 (HCV)。 阿片类药物流行，丙型肝炎病毒病例增加，尤其是 30 岁以下的成年人。然而，很少有年轻人 注射吸毒者（注射吸毒者≤30岁）——处于美国HCV流行中心的人——正在受益 来自治愈性 HCV 治疗的一种潜在有前途但尚未开发的途径，用于增加 HCV 治疗。 PWID 是利用他们的注射伙伴成功地克服了之间的多重障碍 我们的团队对二元体进行了广泛的研究，确定了其中的一个潜在的行动点。 注入可以通过行为干预来利用的伙伴关系。 与注射相关的特定人际因素（即信任、亲密、合作）与增加相关 其次是与注射伙伴关系的健康和安全相结合的定性结果。 人际因素、伴侣参与（即情感、有形、深情和积极的社会支持） 增强伙伴关系与合作伙伴协调行为的能力（二元能力）。 研究发现参与可以克服丙型肝炎治疗的障碍。 基于我们广泛的二元研究和二元行为改变理论基础，我们开发了 合作伙伴导航干预 两次注射合作伙伴干预以增强二元关系 年轻成人吸毒者开始 HCV 治疗的能力 本研究是一项随机对照研究。 研究（RCT）评估第一个行为干预措施的功效和作用机制，以增加 与我们基于社区的 HCV 检测合作，在年轻的吸毒者中启动 HCV 治疗。 组织 (CBO) 中，我们将对最近诊断出 HCV 感染的年轻成年吸毒者进行随机分组（250 合作伙伴，n = 500）及其主要注射伙伴进行干预或护理标准可扩展性是核心。 两次会议干预的设计第 1 部分扩展了 HCV 感染标准护理诊断。 由辅导员主导与 HCV 阳性吸毒者进行讨论，以确定情况和个人情况 HCV 治疗的障碍并确定注射伙伴以帮助他们进行 HCV 治疗导航第 2 部分。 是与年轻的注射吸毒者和他们的注射伙伴的二人会议，一名顾问主持了讨论。 将制定策略来应对已确定的丙型肝炎治疗启动障碍和伙伴关系实践 战略并具体化涉及双方的解决障碍的计划，包括时间表和 在两次会议期间，咨询师都会记录治疗导航中的潜在替代策略。 将讨论的信息记录在作为干预工具的纸质讲义（合作伙伴导航图）上。 社区咨询委员会青年吸毒者将指导实施和传播。 研究将提高这一受影响严重的人群的治愈率。 可以针对影响年轻注射吸毒者的其他健康行为（例如丙型肝炎预防）进行有针对性的改变。