Understanding the role of social networks in methadone maintenance treatment retention and antiretroviral therapy adherence among people who inject drugs in Tanzania

项目摘要 这个指导研究科学家职业发展奖（K 01）应用程序的目的是发展 博士Haneefa Saleem作为一名独立科学家的职业生涯，在社交网络分析和 制定和评估社会网络干预措施，以改善健康成果。PWID具有高 艾滋病毒感染率，特别是在坦桑尼亚，估计有35%的PWID携带艾滋病毒。美沙酮 建议将维持治疗（MMT）作为综合干预方案的一部分， 预防、治疗和护理艾滋病毒感染者。MMT中的保留与改善 抗逆转录病毒治疗（ART）依从性和HIV病毒抑制。MMT中的保留对于链接至关重要 PWID到ART服务，但MMT保留对于PWID来说是一个挑战，他们经常在这种情况下离开治疗 毒品使用水平不断上升的迹象这项研究的目标是适应一个创新的社会网络 动员寻求治疗的PWID的个人社交网络以支持他们继续 并在坦桑尼亚达累斯萨拉姆坚持抗逆转录病毒疗法。本研究的具体目标是：1）定性 研究社交网络如何影响MMT保留和ART坚持PWID通过深入 对10名当前和10名前MMT患者进行访谈; 2）检查个人之间的关系 网络和网络水平的因素和MMT保留和ART坚持使用自我中心和社会计量 从150名HIV阳性MMT患者的横断面调查中产生的网络数据;以及3）适应和 试行一项旨在改善MMT保留率和ART依从性的社交网络干预， HIV阳性MMT患者及其15名社会支持人员评估干预的可接受性， 在坦桑尼亚的可行性。通过提出研究性学习与定向性学习相结合 阅读，课程和指导研究的机会，萨利姆博士将能够实现以下目标 职业发展目标：1）获得社交网络理论基础的专业知识; 2）发展 先进的社会网络分析技能;和3）提高她的实施科学技能，以开发和测试 社交网络干预。为了支持这些目标，萨利姆博士有一个由顶尖专家组成的指导团队， 社会网络理论和分析以及社会网络干预。萨利姆博士的职业发展和 研究计划将为她提供技能和初步数据，以寻求未来的资金，并成功地 成为全球和国内药物使用和艾滋病毒研究的独立研究员。

PROJECT SUMMARY The purpose of this Mentored Research Scientist Career Development Award (K01) application is to develop Dr. Haneefa Saleem’s career as an independent scientist with expertise in social network analysis and the development and evaluation of social network interventions to improve health outcomes. PWID have high rates of HIV, particularly in Tanzania where an estimated 35% of PWID are living with HIV. Methadone maintenance treatment (MMT) is recommended as part of a comprehensive package of interventions for the prevention, treatment, and care of HIV infection among PWID. Retention in MMT is associated with improved antiretroviral therapy (ART) adherence and HIV viral suppression. Retention in MMT is critical for linking PWID to ART services, yet MMT retention is a challenge for PWID who routinely leave treatment in the context of escalating levels of drug use. The goal of this research study is to adapt an innovative social network intervention that mobilizes the personal social networks of treatment-seeking PWID to support them to remain in MMT and adhere to ART in Dar es Salaam, Tanzania. The study’s specific aims are to: 1) qualitatively examine how social networks influence MMT retention and ART adherence among PWID through in-depth interviews with 10 current and 10 former MMT patients; 2) examine the relationship between personal network and network-level factors and MMT retention and ART adherence using egocentric and sociometric network data generated from cross-sectional surveys with 150 HIV-positive MMT patients; and 3) adapt and pilot a social network intervention aimed at improving MMT retention and ART adherence with 15 current HIV-positive MMT patients and 15 of their social support persons to assess intervention acceptability and feasibility in the Tanzanian context. Through the proposed research study and a combination of directed readings, coursework, and mentored research opportunities, Dr. Saleem will be able to achieve the following career development goals: 1) gain expertise in the theoretical underpinnings of social networks; 2) develop advanced social network analysis skills; and 3) enhance her implementation science skills to develop and test social network interventions. To support these goals, Dr. Saleem has a mentoring team of leading experts in social network theory and analysis and social network interventions. Dr. Saleem’s career development and research plan will provide skills and preliminary data for her to pursue future funding and to successfully become an independent researcher in substance use and HIV research both globally and domestically.