Preventing HIV Transmission by Recently-Infected Drug Users

预防最近感染的吸毒者传播艾滋病毒

• 批准号: 9102019
• 负责人: SAMUEL R FRIEDMAN
• 金额: $ 75.98万
• 依托单位: NATIONAL DEVELOPMENT AND RESEARCH INSTITUTES, INC.
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-08-01 至 2019-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9102019
• 关键词: Accounting; Acute; African American; Behavior; Communities; Community Networks; Contact Tracing; Drug Combinations; Drug usage; Drug user; Education; Effectiveness; Epidemic; Evaluation; Event; HIV; HIV Infections; Housing; Incidence; Infection; Injection of therapeutic agent; Intervention; Interview; Location; Logic; Methods; Neighborhoods; Network-based; Persons; Phylogenetic Analysis; Prevention; Probability; Research Design; Risk; Risk Behaviors; Seeds; Sexual Partners; Smallpox; Social Network; Techniques; Technology; Testing; Vaccinated; Vaccination; Viral Load result; Virus; Work; base; disease transmission; effective intervention; follow-up; high risk behavior; member; men who have sex with men; models and simulation; prevent; public health relevance; screening; sex; social; social stigma; success; tool; transmission process

Half or more of HIV transmission events may occur within the period of high infectivity (and often high risk behavior) that can last 11 months or more after a person is initially infected. Unfortunately, neither test-and-treat intervention methods nor Acute HIV Infection projects have found effective ways to intervene against transmission during this risky "recent infection" period. We seek to develop effective intervention techniques against HIV transmission among drug users and their community members during the recent infection period using a combination of drug injection-, sexual- and social-network-based contact tracing methods; community alerts in the networks and venues of recent infectees; and the logic of going "up" and "down" infection chains. Our first Aim is to develop and evaluate ways to locate "seeds," defined as drug users and other people who have recently been infected. Our second Aim targets members of seeds' networks and people who attend their venues. We will test them for acute and for recent infection, and alert them to the probability that their networks contain highly-infectious members so they should reduce their risk and transmission behaviors for the next several months to minimize their chances of getting infected. This may also reduce transmission by untested people with recent infection. Community, network and venue education about the need and value of supporting those with recent infection should reduce stigma. Our third Aim is to reduce HIV transmission and to develop new ways to evaluate "prevention for positives" generally as well as our own success in reducing transmission. We will do this using a combination of follow- up interviews and testing, including of viral loads; phylogenetic techniques; and discrete event simulation modeling to assess our effectiveness.

一半或更多的HIV传播事件可能发生在高感染率之内（和 通常，高风险行为）最初感染了一个人后可以持续11个月或更长时间。 不幸的是，测试和治疗的干预方法和急性HIV感染项目都没有 在这个危险的“最近感染”期间，发现了有效的方法来干预传播。 我们试图开发有效的干预技术，以防止药物之间的艾滋病毒传播 在最近的感染期内，用户及其社区成员结合了 药物注射 - 基于性和社会网络的接触跟踪方法；社区警报 最近感染者的网络和场所；以及“向上”和“下降”感染的逻辑 链。我们的第一个目的是开发和评估定义“种子”的方法，定义为吸毒者 以及最近被感染的其他人。我们的第二个目标是种子成员 网络和参加会场的人。我们将测试它们是否急性 感染，并提醒他们他们的网络包含高感染者的可能性 因此，他们应在接下来的几个月中降低其风险和传播行为 最大程度地减少他们被感染的机会。这也可能会通过未经测试来减少传输 患有最近感染的人。社区，网络和场地教育有关需求和 支持最近感染者的价值应减少污名。我们的第三个目标是减少 艾滋病毒传播并开发新的方法来评估“预防积极因素” 以及我们自己在减少传输方面的成功。我们将使用后续的组合来做到这一点 - 进行访谈和测试，包括病毒负荷；系统发育技术；和离散事件 模拟建模以评估我们的有效性。