Engaging Young People who Inject Drugs into HCV and HIV Care

项目摘要/摘要 背景：最近爆发的人类免疫缺陷病毒(艾滋病毒)和丙型肝炎病毒(丙型肝炎病毒)包括 印第安纳州的这一案例表明，应同时应对这些感染，以改善结果。在……里面 美国大多数新的丙型肝炎病毒感染者是在注射毒品(PWID)的年轻人中。研究 戒毒中心的研究表明，与护理的联系是有问题的。CASE等社会服务支持 管理层有可能改善与护理的联系；然而，人们对其潜在影响知之甚少 关于年轻的PWID的照顾。应聘者：我是一名临床科学家，接受过联合内科的培训 内科/儿科和传染病(ID)。我致力于研究改善健康的策略 向丙型肝炎病毒感染者和艾滋病毒感染者提供护理服务。在哈佛大学贝丝·伊斯雷尔完成ID奖学金后 在女执事医学中心，我加入了波士顿大学医学院的教职，在那里我有 获得了与使用物质的病人打交道的经验。我正在申请一项为期5年的K23奖励，以获得 成为一名独立资助的临床医生研究员所需的技能和经验，具有以下专业知识 设计、实施和分析临床干预措施。研究：我将使用Adapt-ITT框架修改 基于优势的病例管理(SBCM)，一种基于证据的护理干预联系，以解决 在戒毒中心接受丙型肝炎病毒和艾滋病毒检测的18岁至30岁的PWID的需求。然后我会试飞 适应性干预。具体目标是(1)使用深入、定性的访谈来确定促进者 和在艾滋病毒和/或丙型肝炎护理中的联系和保留的障碍；(2)使用目标1的调查结果来使SBCM适应 改善护理中的联系和保留；3)对#年的适应性干预进行可行性研究 为将来的审判做准备。培训：职业发展计划包括以下方面的培训 干预措施、临床试验、先进的统计方法和物质使用研究。BU ID部门， 艾滋病研究中心(CFAR)和NIH资助的成瘾和成瘾早期职业学习 多样性计划提供了丰富的研究环境。导师关系：我的主要导师萨米特博士 在药物使用、艾滋病毒和丙型肝炎方面的专业知识。利纳斯博士，我的共同导师，在丙型肝炎病毒，艾滋病毒和与 关心。顾问是伯恩斯坦博士(定性研究)、霍斯堡博士(丙型肝炎病毒和艾滋病毒)和索伦森博士(物质 使用和艾滋病毒)。当我完成我的K23，我将获得必要的技能，成为一个独立的 临床研究人员，专注于在有物质史的个体中护理丙型肝炎病毒和艾滋病毒的联系 使用。

PROJECT SUMMARY / ABSTRACT Background: Recent human immunodeficiency virus (HIV) and hepatitis C virus (HCV) outbreaks, including the one in Indiana, illustrate that these infections should be addressed simultaneously to improve outcomes. In the United States most of the new HCV infections are among young people who inject drugs (PWID). Studies at detoxification centers have shown that linkage to care is problematic. Social services support such as case management has the potential to improve linkage to care; however, little is known about its potential influence on the care of young PWID. Candidate: I am a clinician scientist trained in combined internal medicine/pediatrics and infectious diseases (ID). I am committed to investigating strategies to improve health care delivery to HCV- and HIV-infected individuals. After completing an ID fellowship at Harvard's Beth Israel Deaconess Medical Center, I joined the faculty at Boston University (BU) School of Medicine, where I have gained experience working with substance using patients. I am applying for a 5-year K23 award to acquire the necessary skills and experience to become an independently funded clinician investigator with expertise to design, implement and analyze clinical interventions. Research: I will use the ADAPT-ITT framework to modify strengths-based case management (SBCM), an evidence-based linkage to care intervention, to address the needs of PWID aged 18 to 30 tested for HCV and HIV at a detoxification center. I will then pilot test the adapted intervention. The specific aims are to (1) To use in-depth, qualitative interviews to identify facilitators and barriers to linkage and retention in HIV and/or HCV care; (2) To use findings from Aim 1 to adapt SBCM to improve linkage and retention in care; 3) To conduct a feasibility study of the adapted intervention in preparation for a future trial. Training: The career development plan includes training in the development of interventions, clinical trials, advanced statistical methods, and substance use research. The BU ID department, the Centers for AIDS Research (CFAR) and the NIH-funded Learning for Early Careers in Addiction and Diversity program provide a rich research environment. Mentorship: My primary mentor, Dr. Samet, has expertise in substance use, HIV and HCV. Dr. Linas, my co-mentor, has expertise in HCV, HIV and linkage to care. Advisors are Drs. Bernstein (qualitative research), Horsburgh (HCV and HIV) and Sorensen (substance use and HIV). At the completion of my K23, I will have gained the skills necessary to become an independent clinician investigator focusing on HCV and HIV linkage to care among individuals with a history of substance use.