Improving measurement of alcohol consumption among HIV-affected youth in sub-Saharan Africa: evaluation and implementation of biomarkers

改进对撒哈拉以南非洲受艾滋病毒影响的青少年饮酒量的测量：生物标志物的评估和实施

• 批准号: 10158010
• 负责人: Jeremy Calvin Kane
• 金额: $ 17.54万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-05-01 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10158010
• 关键词: AIDS prevention; AIDS/HIV problem; Achievement; Address; Adherence; Adolescent; Adolescent and Young Adult; Adoption; Affect; Africa South of the Sahara; Age; Alcohol abuse; Alcohol consumption; Alcohols; Back; Biological Assay; Biological Markers; Body mass index; Caring; Cessation of life; Characteristics; Clinic; Clinical Research; Collaborations; Consumption; Counseling; Country; Data Collection; Detection; Development; Development Plans; Diagnosis; Dissemination and Implementation; Ecological momentary assessment; Effectiveness; Effectiveness of Interventions; Epidemic; Evaluation; Evidence based practice; Feedback; Focus Groups; Follow-Up Studies; Funding; Future; Gender; Glucuronides; Goals; HIV; HIV Infections; Home; Incidence; Income; Infectious Diseases Research; Interview; Knowledge; Lead; Link; Measurement; Measures; Mentors; Mentorship; Methods; Minority; National Institute on Alcohol Abuse and Alcoholism; Outcome; Patient Self-Report; Policy Maker; Population; Prevalence; Procedures; Process; Professional counselor; Protocols documentation; Psychiatric epidemiology; Quality of Care; Religion and Spirituality; Reporting; Research; Research Activity; Research Personnel; Research Training; Resources; Risk; Role; Scientist; Screening Result; Services; Social Desirability; Societies; Strategic Planning; Test Result; Testing; TimeLine; Training; Treatment Efficacy; Treatment outcome; Underserved Population; United States National Institutes of Health; Universities; Urine; Viral; Visit; Work; Youth; Zambia; alcohol abuse therapy; alcohol epidemiology; alcohol intervention; alcohol measurement; alcohol misuse; alcohol risk; alcohol screening; alcohol services; alcohol testing; base; brief intervention; career; career development; catalyst; clinical practice; cost; design; effectiveness evaluation; efficacy study; evidence base; experience; feasibility testing; follow-up; formative assessment; health disparity; high risk sexual behavior; implementation determinants; implementation research; implementation science; implementation strategy; improved; innovation; laboratory experience; multidisciplinary; novel; phosphatidylethanol; point-of-care diagnostics; population based; prevention service; programs; public health relevance; randomized trial; reduced alcohol use; screening; screening and brief intervention; social stigma; stressor; tool; transmission process; treatment services; underage drinking; uptake

HIV-affected adolescents and young adults (AYA) in sub-Saharan Africa (SSA) experience stressors that increase their risk for problematic alcohol use, which in turn can lead to HIV infection or transmission and poor HIV outcomes, including linkage to care and ART adherence. Efforts to address the HIV epidemic among adolescents and young adults in SSA have therefore focused, in part, on treating risky alcohol use. Yet, the vast majority of HIV-affected AYA in SSA who need alcohol services do not receive them, resulting in a substantial treatment gap. A critical barrier to the accurate screening for risky alcohol use among AYA and provision of appropriate treatment is a lack of objective measures for alcohol consumption in HIV care settings, which rely primarily on self-report alone. This K01 mentored research scientist development proposal aims to examine the role of biomarkers in improving alcohol screening and treatment referral among AYA in HIV prevention and treatment clinics. Specifically, the proposal will investigate a urine-based biomarker, ethyl glucuronide (UEtG), which has displayed potential as a point-of-care diagnostic tool among clinic-based populations in the U.S. but has not been investigated as a valid and feasible method within HIV care settings among AYA. Research activities for this proposal will take place in Zambia, a country with one of the highest HIV prevalence estimates in the world. The research will leverage over a decade of HIV research in Zambia by Johns Hopkins University and a longstanding collaboration with Centre for Infectious Disease Research in Zambia (CIDRZ), the local implementing partner. Specific aims of the proposal are to: 1) assess the test characteristics of UEtG among HIV-affected AYA in Zambia; 2) develop a protocol for the use of rapid UEtG dip card testing embedded within AYA HIV prevention and treatment; and 3) pilot the UEtG protocol developed in Aim 2 and refine procedures with a formative evaluation process. Findings will inform implementation strategies that can be tested in a follow-up study. The research is designed to be an integral component of a rigorous training and career development plan focused on HIV/AIDS, alcohol biomarkers, and implementation science. Training will take the form of coursework, lab training, and one-on-one mentorship with an experienced and dedicated team of multidisciplinary mentors and consultants who are widely considered to be experts in their respective fields. The goal of the professional development plan is to facilitate the candidate's transition into an independent investigator in alcohol epidemiology and implementation science with specific expertise in HIV and biomarkers. The proposal is directly in line with Goal 2 (“improve diagnosis and tracking of alcohol misuse”) and Objective 5c (“facilitating dissemination and implementation of evidence-based practices for diagnosing alcohol misuse”) of the NIAAA Strategic plan 2017-2021. The proposal is consistent with NIH high priority HIV research in addressing “health disparities in the incidence of new HIV infections” and “research training of the workforce required to conduct high priority HIV/AIDS or HIV/AIDS-related research.”

撒哈拉以南非洲（SSA）受艾滋病毒影响的青少年和青壮年（AYA）面临的压力是