ART diversion in Rakai, Uganda

乌干达拉凯的艺术改道

• 批准号: 10259664
• 负责人: CAITLIN E KENNEDY
• 金额: $ 21.7万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-09 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10259664
• 关键词: Address; Adherence; Affect; Africa South of the Sahara; Anti-Retroviral Agents; Behavior; Characteristics; Clinic; Cohort Studies; Communities; Complex; Data; Development; Dimensions; Disease Progression; Drug Prescriptions; Drug resistance; Drug usage; Fishes; Florida; Focus Groups; Frequencies; Friends; Future; HIV; Health Personnel; Health Sciences; High Prevalence; Household; Individual; Infrastructure; Intervention; Interview; Measures; Methods; Participant; Patients; Pharmaceutical Preparations; Population; Population Study; Prevalence; Publishing; Recreational Drugs; Reporting; Research; Running; Sampling; Series; Social Network; Source; South Africa; Support Groups; Surveys; Techniques; Therapeutic; Therapeutic Uses; Time; Treatment outcome; Trust; Uganda; Viral; acceptability and feasibility; aged; antiretroviral therapy; barrier to care; base; compliance behavior; cost; innovation; medication compliance; novel; patient mobility; peer; population based; programs; sex; social stigma; success; transmission process; treatment adherence; virology

Summary Drug sharing is commonly reported for other prescription medications, but to date, no studies have examined antiretroviral drug diversion (buying, selling, borrowing, or lending) for therapeutic use among people living with HIV. We previously conducted qualitative interviews with people living with HIV in high-prevalence fishing communities (hotspots) along Lake Victoria in the Rakai region, Uganda. Participants reported frequent, short- term sharing of antiretroviral treatment (ART) with coworkers/friends that was motivated by the desire to keep taking drugs despite challenges to regular clinic attendance and adherence. However, we do not know how common ART diversion is at the population-level, who is most likely to divert antiretroviral drugs, or whether ART diversion affects HIV treatment outcomes such as HIV viral suppression. We therefore propose a mixed methods study to better understand ART diversion and whether it can be leveraged to reach and support sub-optimally adherent, hard-to-reach individuals living with HIV. The study will be conducted through the Rakai Community Cohort Study, a population-based cohort study conducted among all residents aged 15-49 in 40 communities in southcentral Uganda. Aim 1 will measure the prevalence, distribution, and factors associated with ART diversion in this representative sample. Aim 2 will assess the association between ART diversion and HIV viral suppression. Aim 3 will explore acceptability and feasibility of a novel intervention among ART-sharing dyads that builds upon these existing networks of social trust to reach sub-optimally adherent, hard-to-reach HIV patients.

概括 据报道，其他处方药的药物共享很常见，但迄今为止，还没有研究检验过 抗逆转录病毒药物转移（购买、出售、借用或借出）用于艾滋病患者的治疗用途 艾滋病病毒。我们之前对高流行渔业中的艾滋病毒感染者进行了定性访谈 乌干达拉凯地区维多利亚湖沿岸的社区（热点）。参与者报告频繁、短暂 与同事/朋友分享抗逆转录病毒治疗 (ART) 的术语，其动机是希望保留 尽管定期就诊和依从性存在挑战，但仍服用药物。然而我们不知道如何 常见的 ART 转移是在人群层面，谁最有可能转移抗逆转录病毒药物，或者是否接受 ART 转移会影响艾滋病毒治疗结果，例如艾滋病毒病毒抑制。因此我们提出了一种混合方法 研究以更好地了解 ART 转移以及是否可以利用它来达到和支持次优效果 坚持不懈、难以接触到的艾滋病毒感染者。该研究将通过 Rakai 社区进行 队列研究，一项以人群为基础的队列研究，对 40 个社区 15-49 岁的所有居民进行 乌干达中南部。目标 1 将衡量与 ART 转移相关的流行率、分布和因素 在这个代表性样本中。目标 2 将评估 ART 转移与 HIV 病毒之间的关联 抑制。目标 3 将探索 ART 共享二人组之间新颖干预措施的可接受性和可行性 建立在这些现有的社会信任网络的基础上，以达到次优依从性、难以接触到的艾滋病毒感染者 患者。