Estimating the population size of persons who inject drugs in New York

估计纽约注射吸毒者的人口规模

基本信息

批准号：
10705455
负责人：
Heather Bradley
金额：
$ 60.51万
依托单位：
EMORY UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-10-01 至 2025-01-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10705455
关键词：
Accident and Emergency department Accounting Achievement Acquired Immunodeficiency Syndrome Acute Hepatitis C Address Admission activity Age Bayesian Modeling Behavior Big Data Big Data to Knowledge Blood Canada Characteristics Collaborations Communicable Diseases Complement County Data Data Set Dependence Development Diagnosis Disease Electronics Epidemic Epidemiologist Epidemiology Estonia Goals HIV Infections HIV/HCV Health Health Services Health Services Accessibility Hepatitis C Hepatitis C virus Heterogeneity Hospital Records Household Imprisonment Individual Infection Infective endocarditis Injecting drug user Injections Inpatients Intervention Joints Leadership Link Measures Methodology Methods Modeling Monitor Needle-Exchange Programs New York Opioid Persons Pharmaceutical Preparations Pharmacotherapy Politics Population Population Sizes Prevention program Probability Process Public Health Reporting Resources Risk Route Services Standardization Stigmatization Surveys System United States National Institutes of Health Work burden of illness data visualization disorder risk drug use behavior experience high risk housing instability improved infection burden injection drug use innovation male opioid epidemic opioid use disorder prevention service preventive intervention remediation research study response sex surveillance data treatment program

项目摘要

ABSTRACT Injection is an increasingly common route of administration for opioids and other drugs in the U.S. Unsafe injection drug use (IDU) behavior threatens recent progress made in reducing HIV and hepatitis C virus (HCV) infections among persons who inject drugs (PWID), which is a major impediment to achieving ambitious national goals for reducing new HIV infections. During the past decade, New York State has experienced growing rates of opioid use disorder and, consequently, increases in IDU-related infectious diseases. New York has strong political will to reduce the burden of these infections among PWID and is the first U.S. state to commit to both “Ending the AIDS Epidemic” and HCV elimination strategies. However, New York, like other states, does not have a current, statewide estimate of how many PWID need infectious disease prevention services. Robust estimates of PWID population sizes are needed in New York and elsewhere to facilitate optimal allocation of scarce resources, measure risk-specific infectious disease burden among PWID, and assess coverage of prevention interventions. We propose to estimate PWID population size and associated risk-specific disease and prevention intervention coverage rates in New York using multiple systems estimation (MSE) with a combination of extant administrative and PWID survey data. MSE is an application of capture- recapture methods that allows estimation of underlying population size using joint probabilities of observing individuals in linked administrative datasets vis-à-vis their receipt of a service or diagnosis. We will apply MSE methods to linked, statewide datasets in New York including claims data, inpatient and emergency room electronic hospital records, drug treatment program data, and infectious disease surveillance data. We will also improve the rigor of MSE methods by addressing potential violations of key statistical assumptions through augmented estimation models, partially informed by survey data currently being collected by the study team. Our Specific Aims are: (1)To estimate PWID population size in New York State using MSE with indications of current IDU behavior from linked administrative datasets, overall and by region, sex, and age; (2) To create refined PWID population size estimates accounting for bias due to unequal probabilities of observing individuals in datasets; (3) To allocate state PWID population size to all 62 counties using a standardization modeling approach; (4) To compute key epidemiologic indicators needed to measure infectious disease risk among PWID: risk-specific HIV and HCV diagnosis rates, syringe service program utilization rates, and number of PWID initiating IDU during past year; (5) To disseminate estimates and methodology using the AIDSVu data visualization platform. The national impact of this work, using New York as a model, will be to establish a robust, replicable method for producing estimates that can guide efforts to improve PWID health and reduce the burden of HIV and HCV in this high-risk, under-studied group.

抽象的在美国，注射是阿片类药物和其他药物越来越常见的给药途径。注射吸毒 (IDU) 行为威胁到最近在减少艾滋病毒和丙型肝炎病毒 (HCV) 方面取得的进展注射吸毒者（PWID）中的感染，这是实现宏伟目标的主要障碍在过去十年中，纽约州经历了减少新发艾滋病毒感染的国家目标。阿片类药物使用障碍的发生率不断上升，从而导致注射吸毒者相关传染病的增加。约克州具有减轻吸毒者感染负担的强烈政治意愿，并且是美国第一个这样做的州致力于“终结艾滋病流行”和消除丙肝病毒战略然而，纽约与其他地区一样。州，目前没有对有多少吸毒者需要传染病预防的可能估计需要对纽约和其他地方的吸毒者人口规模进行可靠估计，以促进服务的发展。稀缺资源的优化分配，衡量吸毒者中特定风险的传染病负担，以及我们建议估计吸毒者人口规模和相关的预防干预措施的覆盖范围。使用多个系统估计纽约的特定风险疾病和预防干预覆盖率 (MSE) 结合了现有的行政和吸毒者调查数据，是捕获的应用。重新捕获方法，允许使用观察的联合概率估计潜在种群规模链接的管理数据集中的个人相对于他们接受的服务或诊断我们将应用 MSE。链接纽约联邦数据集的方法，包括索赔数据、住院和急诊室数据我们还将提供电子医院记录、药物治疗方案数据和传染病监测数据。通过解决可能违反关键统计假设的问题，提高 MSE 方法的严谨性增强估计模型，部分来自研究团队当前收集的调查数据。我们的具体目标是： (1) 使用 MSE 估计纽约州吸毒者人口规模，并表明：来自链接的管理数据集的当前注射吸毒者行为，按地区、性别和年龄分类 (2) 创建；改进的吸毒者人口规模估计，考虑了由于观察概率不平等造成的偏差 (3) 使用标准化将州注射吸毒者人口规模分配给所有 62 个县 (4) 计算衡量传染病风险所需的关键流行病学指标吸毒者中：特定风险的 HIV 和 HCV 诊断率、注射器服务计划利用率和数量过去一年中注射吸毒者发起注射吸毒的人数； (5) 传播使用 AIDSVu 数据的估计值和方法这项工作以纽约为模式，在全国范围内产生的影响将是建立一个可视化平台。强大的、可复制的方法来生成估计值，可以指导改善吸毒者健康和减少吸毒者数量的努力这一高风险、研究不足的群体中艾滋病毒和丙型肝炎病毒的负担。