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Integrating Assisted Partner Services and Phylogenetics for HIV and HCV Prevention

整合辅助合作伙伴服务和系统发育学以预防 HIV 和 HCV

基本信息

批准号：
10208545
负责人：
CAREY FARQUHAR
金额：
$ 15.22万
依托单位：
UNIVERSITY OF WASHINGTON
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-05-15 至 2022-02-28
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10208545
关键词：
2019-nCoV Address Adherence Africa South of the Sahara African Antibodies Award Behavior Biological Assay Blood COVID-19 COVID-19 pandemic Cardiovascular Diseases Caring Cessation of life Clinical Communities Country Data Discrimination Disease Drops Drug usage Economics Enrollment Ensure Food General Population Government HIV HIV Infections HIV Seronegativity HIV Seropositivity HIV risk HIV/HCV Harm Reduction Health Health Services Accessibility Healthcare Systems Hepatitis C Hepatitis C Viremia Hot Spot Individual Infection Injecting drug user Interview Kenya Laboratories Lung diseases Measures Methadone Morbidity - disease rate Natural History Needles Nose Outcome Parents Participant Patient Recruitments Pattern Personal Satisfaction Pharmaceutical Preparations Phylogenetic Analysis Polymerase Chain Reaction Population Population Control Population Density Poverty Prevalence Prevention Public Health Reporting Research Research Infrastructure Risk Risk Factors Sampling Services Ships Site Social Distance Social Network Specimen Swab Symptoms Syringes Target Populations Testing Time Viral Viremia Virus Visit Vulnerable Populations Woman addiction adverse outcome antiretroviral therapy base clinical care cohort comorbidity experience follow-up genome sequencing health care availability health care service high risk housing instability improved infection rate injection drug use innovation intervention program men methadone clinic/center mortality pandemic disease peer prevent recruit respiratory virus response screening seropositive service delivery social social stigma socioeconomics study population transmission process uptake viral transmission

项目摘要

ABSTRACT In sub-Saharan Africa and globally, many persons who inject drugs (PWID) are living with undiagnosed or untreated HIV, experience high levels of poverty, food and housing instability, and discrimination, and have increased risk for health conditions that contribute to worse outcomes from COVID-19. It is also more challenging for PWID to access healthcare when services have been limited by lockdowns and measures to ensure social distancing to prevent spread of respiratory viruses, such as SARS-CoV-2. We propose to recruit and follow a cohort of 500 HIV-positive and 500 HIV-negative PWID and their partners, many of whom also have hepatitis C, to determine whether poorly controlled HIV infection, active drug use and other HIV- and PWID-specific risk factors result in increased likelihood of COVID-19 acquisition, viral transmission, symptomatic disease and poor clinical outcomes (AIM 1). We will also define transmission dynamics through phylogenetic analyses of SAR-CoV-2 sequences from symptomatic PWID (AIM 2) and determine whether HIV care and harm reduction service delivery disruptions are associated with poor compliance to ART and methadone, HIV viremia and other adverse outcomes (AIM 3). Our proposal is innovative in how it reaches PWID and partners using peer educators, employs targeted testing and symptom screening in this high-risk Kenyan population, and defines COVID-19 transmission within and beyond local networks using phylogenetics. Participant recruitment and enrollment will take place in drop-in centers and methadone clinics in Nairobi, Mombasa and Kilifi, Kenya and follow-up visits will occur monthly for 6 months. In addition to collecting interview data and blood for SARS- CoV-2 antibodies, we will ask participants who have symptoms consistent with COVID-19 at any of the 7 visits to self-collect a nasal swab specimen for SARS-CoV-2 polymerase chain reaction (PCR), followed by genome sequencing if positive. Laboratory assays for antibody and viral PCR testing will be conducted in Nairobi and positive specimens will be shipped to Seattle for sequencing and phylogenetic analysis. We anticipate that our results will highlight the need for targeted testing among PWID and inform interventions and programs for HIV and addiction care and treatment across the globe for similar marginalized populations when confronted with COVID-19 and other public health crises.

抽象的在撒哈拉以南非洲和全球范围内，许多注射吸毒者 (PWID) 都生活在未确诊或感染的状态下。未经治疗的艾滋病毒，经历高度贫困、粮食和住房不稳定以及歧视，并且健康状况风险增加，导致 COVID-19 导致更糟糕的结果。也更具挑战性当服务因封锁和确保社交的措施而受到限制时，注射吸毒者能否获得医疗保健保持距离以防止呼吸道病毒（例如 SARS-CoV-2）的传播。我们建议招募并遵循由 500 名 HIV 阳性和 500 名 HIV 阴性吸毒者及其伴侣组成的队列，其中许多人还患有丙型肝炎，确定艾滋病毒感染控制不良、主动吸毒以及其他艾滋病毒和吸毒者特有的风险导致感染 COVID-19、病毒传播、症状性疾病和感染的可能性增加的因素临床结果不佳（AIM 1）。我们还将通过系统发育分析来定义传播动力学来自有症状的吸毒者 (AIM 2) 的 SAR-CoV-2 序列，并确定 HIV 护理和伤害是否减少服务提供中断与抗逆转录病毒疗法和美沙酮、艾滋病毒依从性差有关病毒血症和其他不良后果（AIM 3）。我们的提案在如何影响注射吸毒者和合作伙伴方面具有创新性利用同伴教育者，对肯尼亚高危人群进行有针对性的测试和症状筛查，以及使用系统发育学定义了本地网络内外的 COVID-19 传播。参与者招募登记将在肯尼亚内罗毕、蒙巴萨和基利菲的临时中心和美沙酮诊所进行每月进行一次随访，为期 6 个月。除了收集SARS的采访资料和血液之外—— CoV-2 抗体，我们将询问在 7 次就诊中任何一次出现与 COVID-19 一致症状的参与者自行收集鼻拭子样本进行 SARS-CoV-2 聚合酶链反应 (PCR)，然后进行基因组检测如果阳性则进行测序。抗体和病毒 PCR 检测的实验室分析将在内罗毕和阳性标本将被运往西雅图进行测序和系统发育分析。我们预计我们的结果将强调对吸毒者进行有针对性的检测的必要性，并为艾滋病毒干预措施和计划提供信息以及在全球范围内为类似的边缘化人群提供的成瘾护理和治疗 COVID-19 和其他公共卫生危机。

项目成果

期刊论文数量（12）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Assisted Partner Services for People Who Inject Drugs: Index Characteristics Associated With Untreated HIV in Partners.

DOI：
10.1097/qai.0000000000003062
发表时间：
2022-11-01
期刊：
Journal of acquired immune deficiency syndromes (1999)
影响因子：
0
作者：
通讯作者：

Characteristics associated with HIV and hepatitis C seroprevalence among sexual and injecting partners of HIV positive persons who inject drugs in Nairobi and coastal Kenya.

DOI：
10.1186/s12879-022-07036-8
发表时间：
2022-01-21
期刊：
BMC infectious diseases
影响因子：
3.7
作者：
Sambai BC;Kingston H;Monroe-Wise A;Mbogo L;Juma E;Ludwig-Barron N;Guthrie BL;Bukusi D;Chohan BH;Scott J;Bosire R;Dunbar M;Macharia P;Masyuko S;Sinkele W;Herbeck JT;Farquhar C
通讯作者：
Farquhar C

Prevalence and correlates of violence among sexual and injecting partners of people who inject drugs living with HIV in Kenya: a cross-sectional study.

DOI：
10.1186/s12954-023-00895-7
发表时间：
2023-11-02
期刊：
HARM REDUCTION JOURNAL
影响因子：
4.4
作者：
Aung, Sai Win Kyaw Htet;Kingston, Hanley;Mbogo, Loice W.;Sambai, Betsy;Monroe-Wise, Aliza;Ludwig-Barron, Natasha T.;Bukusi, David;Sinkele, William;Gitau, Esther;Masyuko, Sarah;Herbeck, Joshua T.;Farquhar, Carey;Guthrie, Brandon L.
通讯作者：
Guthrie, Brandon L.

Factors influencing HIV-1 phylogenetic clustering.

影响 HIV-1 系统发育聚类的因素。