Estimating the population size of persons who inject drugs in New York

估计纽约注射吸毒者的人口规模

• 批准号: 10347333
• 负责人: Heather Bradley
• 金额: $ 57.62万
• 依托单位: GEORGIA STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-04-01 至 2023-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10347333
• 关键词: Accident and Emergency department; Accounting; Achievement; Acquired Immunodeficiency Syndrome; Acute Hepatitis C; Address; Admission activity; Age; Bayesian Modeling; Behavior; Big Data; Big Data to Knowledge; Blood; Canada; Characteristics; Collaborations; Communicable Diseases; Complement; County; Data; Data Set; Dependence; Development; Diagnosis; Disease; Drug Monitoring; Drug usage; Epidemic; Epidemiologist; Epidemiology; Estonia; Goals; HIV Infections; HIV/HCV; Health; Health Services; Health Services Accessibility; Hepatitis C; Hepatitis C virus; Heterogeneity; Hospital Records; Household; Imprisonment; Individual; Infection; Infective endocarditis; Injecting drug user; Injections; Inpatients; Intervention; Joints; Leadership; Link; Measures; Methodology; Methods; Modeling; Monitor; Needle-Exchange Programs; New York; Opioid; Persons; Pharmaceutical Preparations; Pharmacotherapy; Politics; Population; Population Sizes; Prevention program; Probability; Process; Public Health; Reporting; Resources; Risk; Route; Services; Standardization; Stigmatization; Surveys; System; United States National Institutes of Health; Work; base; burden of illness; data visualization; disorder prevention; disorder risk; drug use behavior; experience; high risk; housing instability; improved; infection burden; injection drug use; innovation; male; opioid epidemic; opioid use disorder; prevention service; preventive intervention; remediation; research study; response; sex; surveillance data; treatment program

ABSTRACT Injection is an increasingly common route of administration for opioids and other drugs in the U.S. Unsafe injection drug use (IDU) behavior threatens recent progress made in reducing HIV and hepatitis C virus (HCV) infections among persons who inject drugs (PWID), which is a major impediment to achieving ambitious national goals for reducing new HIV infections. During the past decade, New York State has experienced growing rates of opioid use disorder and, consequently, increases in IDU-related infectious diseases. New York has strong political will to reduce the burden of these infections among PWID and is the first U.S. state to commit to both “Ending the AIDS Epidemic” and HCV elimination strategies. However, New York, like other states, does not have a current, statewide estimate of how many PWID need infectious disease prevention services. Robust estimates of PWID population sizes are needed in New York and elsewhere to facilitate optimal allocation of scarce resources, measure risk-specific infectious disease burden among PWID, and assess coverage of prevention interventions. We propose to estimate PWID population size and associated risk-specific disease and prevention intervention coverage rates in New York using multiple systems estimation (MSE) with a combination of extant administrative and PWID survey data. MSE is an application of capture- recapture methods that allows estimation of underlying population size using joint probabilities of observing individuals in linked administrative datasets vis-à-vis their receipt of a service or diagnosis. We will apply MSE methods to linked, statewide datasets in New York including claims data, inpatient and emergency room electronic hospital records, drug treatment program data, and infectious disease surveillance data. We will also improve the rigor of MSE methods by addressing potential violations of key statistical assumptions through augmented estimation models, partially informed by survey data currently being collected by the study team. Our Specific Aims are: (1)To estimate PWID population size in New York State using MSE with indications of current IDU behavior from linked administrative datasets, overall and by region, sex, and age; (2) To create refined PWID population size estimates accounting for bias due to unequal probabilities of observing individuals in datasets; (3) To allocate state PWID population size to all 62 counties using a standardization modeling approach; (4) To compute key epidemiologic indicators needed to measure infectious disease risk among PWID: risk-specific HIV and HCV diagnosis rates, syringe service program utilization rates, and number of PWID initiating IDU during past year; (5) To disseminate estimates and methodology using the AIDSVu data visualization platform. The national impact of this work, using New York as a model, will be to establish a robust, replicable method for producing estimates that can guide efforts to improve PWID health and reduce the burden of HIV and HCV in this high-risk, under-studied group.

抽象的 在美国，注射是阿片类药物和其他药物越来越常见的给药途径。 注射吸毒 (IDU) 行为威胁到最近在减少艾滋病毒和丙型肝炎病毒 (HCV) 方面取得的进展 注射吸毒者（PWID）中的感染，这是实现宏伟目标的主要障碍 减少新发艾滋病毒感染的国家目标。在过去的十年中，纽约州经历了 阿片类药物使用障碍的发生率不断上升，从而导致注射吸毒者相关传染病的增加。新的 约克州具有减轻吸毒者感染负担的强烈政治意愿，并且是美国第一个这样做的州 致力于“终结艾滋病流行”和消除丙肝病毒战略。然而，纽约和其他地方一样 各州目前没有全州范围内有多少吸毒者需要预防传染病的估计 服务。纽约和其他地方需要对吸毒者人口规模进行可靠估计，以促进 稀缺资源的优化分配，衡量吸毒者中特定风险的传染病负担，以及 评估预防干预措施的覆盖范围。我们建议估计吸毒者人口规模以及相关的 使用多个系统估计纽约的特定风险疾病和预防干预覆盖率 (MSE) 结合了现有的行政和注射吸毒者调查数据。 MSE 是捕获的应用程序 重新捕获方法，允许使用观察的联合概率估计潜在种群规模 链接的管理数据集中的个人及其接受的服务或诊断。我们将应用MSE 链接纽约全州数据集的方法，包括索赔数据、住院和急诊室数据 电子医院记录、药物治疗方案数据和传染病监测数据。我们还将 通过解决可能违反关键统计假设的问题，提高 MSE 方法的严谨性 增强估计模型，部分来自研究团队当前收集的调查数据。 我们的具体目标是： (1) 使用 MSE 估计纽约州吸毒者人口规模，并表明： 来自关联管理数据集的当前注射吸毒者行为，总体情况以及按地区、性别和年龄划分的情况； (2) 创建 改进的吸毒者人口规模估计，考虑了由于观察概率不平等而造成的偏差 数据集中的个人； (3) 使用标准化将州注射吸毒者人口规模分配给所有 62 个县 建模方法； (4) 计算衡量传染病风险所需的关键流行病学指标 吸毒者中：特定风险的 HIV 和 HCV 诊断率、注射器服务计划利用率和数量 过去一年中吸毒者发起注射吸毒的人数； (5) 传播使用 AIDSVu 数据的估计值和方法 可视化平台。这项工作以纽约为模式，对全国的影响将是建立一个 强大的、可复制的方法来产生估计值，可以指导改善吸毒者健康和减少吸毒者数量的努力 这一高风险、研究不足的群体中艾滋病毒和丙型肝炎病毒的负担。