Impacts of universal access to HIV/AIDS care among HIV+ injection drug users

艾滋病毒注射吸毒者普遍获得艾滋病毒/艾滋病护理的影响

• 批准号: 7892660
• 负责人: Evan Wood
• 金额: $ 28.85万
• 依托单位: UNIVERSITY OF BRITISH COLUMBIA
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-17 至 2012-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7892660
• 关键词: AIDS prevention; AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; Adherence; Anti-Retroviral Agents; Antiretroviral drug resistance; Antiretroviral resistance; Area; Behavior; Blood specimen; British Columbia; Budgets; Canada; Caring; Charge; Cities; Cohort Studies; Complement; Data; Databases; Development; Disease Progression; Drug resistance; Drug usage; Epidemic; Evaluation; Funding; HIV; Health Policy; Healthcare; Healthcare Systems; Highly Active Antiretroviral Therapy; Home environment; Illicit Drugs; Incidence; Injecting drug user; Injection of therapeutic agent; International; Intervention; Knowledge; Laboratories; Law Enforcement; Malaria; Measures; Medical; Modeling; North America; Patient Self-Report; Pattern; Peer Review; Persons; Policy Maker; Population; Prevalence; Prevention; Prevention strategy; Process; Province; Public Health; Publications; Questionnaires; Research; Research Infrastructure; Research Personnel; Risk Behaviors; Role; Sampling; Scientific Evaluation; Secondary Prevention; Services; Social Work; Syringes; Techniques; Time; Wood material; addiction; antiretroviral therapy; base; cohort; cost; discounting; evidence base; experience; fighting; improved; meetings; member; population based; prevention service; programs; prospective; scale up; transmission process; trend; uptake

Barriers to appropriate HIV treatment and care for HIV-infected injection drug users (IDU) are a growing concern. International efforts to improve the delivery of highly active antiretroviral therapy (HAART) toIDU, such as the WHO'S 3 by 5 Initiative, are in urgent need of data on how these barriers can be addressed. While there has been much focus on HIV prevention for HIV-negative IDU, there has recently been a growing recognition that breaking the cycle of HIV transmission will require renewed focus on behaviors and prevention needs of HIV-infected IDU. This proposal seeks to fill the information gap existing in North America and elsewhere through the following specific aims: 1. To evaluate the incidence of HIV/AIDS service uptake (e.g., antiretroviral therapy) and factors associated with uptake among IDU 2. To evaluate the incidence of HIV antiretroviral drug resistance among HIV-infected IDU and the role of unique antiretroviral delivery models on the time to antiretroviral resistance 3. To evaluate trends in HIV disease progression and factors such as medical service and secondary prevention service use that may be associated with reduced disease progression among IDU 4. To determine factors associated with persistent HIV risk behaviors (e.g., syringe lending) in a setting with comprehensive evidence-based HIV prevention strategies for HIV-infected IDU These aims will be met through the development of a new prospective cohort study of HIV-infected IDU in Vancouver, Canada. This setting is unique, since all medical care and antiretrovirals are provided free of charge through a universal healthcare system, allowing the research program to focus on non-financial barriers to care. The cohort will involve serial blood sampling to evaluate antiretroviral resistance patterns, a detailed questionnaire to evaluate illicit drug use and related behaviors, and ongoing administrative linkages to the province's centralized medical care and social service databases to evaluate access to antiretrovirals and access to other HIV/AIDS care and prevention services. By helping to fill a critical information gap, this study has the potential to make a major contribution to public health policies forIDU.

艾滋病毒感染药物使用者（IDU）的适当艾滋病毒治疗和护理的障碍是不断增长的 忧虑。国际努力改善高度活跃的抗逆转录病毒疗法（HAART）TOIDU的努力， 例如WHO是3乘5的计划，迫切需要有关如何解决这些障碍的数据。 尽管对HIV阴性IDU的预防艾滋病毒预防有很大的关注，但最近有一个 越来越认识到打破艾滋病毒传播周期将需要重新关注行为和 艾滋病毒感染的IDU的预防需求。该建议旨在填补北部现有的信息差距 通过以下特定目的，美国和其他地方： 1。评估艾滋病毒/艾滋病服务摄取的发病率（例如抗逆转录病毒疗法）和相关因素 在IDU中吸收 2。评估HIV感染的IDU中HIV抗逆转录病毒耐药性的发生率和 抗逆转录病毒抗性的独特抗逆转录病毒输送模型 3。评估艾滋病毒疾病进展的趋势和医疗服务和次要的因素 预防服务的使用可能与IDU疾病进展减少有关 4。确定与持续的HIV风险行为（例如，注射器贷款）相关的因素 艾滋病毒感染的IDU的全面基于证据的艾滋病毒预防策略 这些目标将通过开发一项针对HIV感染IDU的新的前瞻性队列研究来实现 加拿大温哥华。此设置是独一无二的，因为所有医疗和抗逆转录病毒均免费提供 通过通用医疗保健系统收费，使研究计划可以专注于非金融 护理障碍。该队列将涉及串行血液采样以评估抗逆转录病毒抗性模式，A 详细的调查表评估非法药物使用和相关行为以及持续的行政联系 到该省的集中医疗和社会服务数据库，以评估对抗逆转录病毒的访问 并获得其他艾滋病毒/艾滋病护理和预防服务。通过帮助填补关键信息差距，这 研究有可能为Foridu做出重大贡献。