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

了解社交网络在坦桑尼亚注射吸毒者美沙酮维持治疗保留和抗逆转录病毒治疗依从性中的作用

• 批准号: 10451521
• 负责人: Haneefa Tasleem Saleem
• 金额: $ 18.32万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-08-15 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10451521
• 关键词: Africa South of the Sahara; Age; Caring; Characteristics; Clinic; Communities; Community Outreach; Cross-Sectional Studies; Data; Development; Dose; Drug usage; Enrollment; Evaluation; Family; Friends; Funding; Future; Gender; General Population; Goals; HIV; HIV Infections; HIV Seropositivity; HIV risk; Health; Hospitals; Individual; Injecting drug user; Intervention; Interview; K-Series Research Career Programs; Link; Measures; Medical; Mentors; Modeling; Outcome; Pathway Analysis; Patients; Persons; Pharmaceutical Preparations; Positioning Attribute; Prevalence; Prevention; Program Sustainability; Provider; Qualitative Research; Questionnaires; Randomized Controlled Trials; Reading; Recording of previous events; Records; Recovery; Research; Research Personnel; Resource-limited setting; Respondent; Role; Scientist; Services; Sexual abuse; Social Network; Social support; Surveys; Tanzania; Testing; Trust; United States National Institutes of Health; Viral; Woman; Work; acceptability and feasibility; antiretroviral therapy; barrier to care; base; career; career development; design; drug maintenance; implementation science; improved; informant; innovation; intervention cost; medication compliance; medication-assisted treatment; member; methadone treatment; mortality risk; non-drug; patient population; programs; research and development; research study; skills; social influence; social metrics; social structure; sociodemographics; substance use; theories; therapy adherence; treatment services

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.

项目总结 本次导师研究科学家职业发展奖(K01)申请的目的是开发 Haneefa Saleem博士作为一名独立科学家的职业生涯，他在社交网络分析和 制定和评估社会网络干预措施，以改善健康结果。PWID高 艾滋病毒感染率，特别是在坦桑尼亚，那里估计有35%的残疾人携带艾滋病毒。美沙酮 建议将维持治疗(MMT)作为综合干预措施的一部分 PWID人群HIV感染的预防、治疗和护理。MMT中的保留与改善有关 坚持抗逆转录病毒疗法(ART)和抑制艾滋病毒病毒。在MMT中的保留率对链接至关重要 PWID到ART服务，然而MMT保留对于PWID来说是一个挑战，他们经常在背景下离开治疗 毒品使用水平不断上升的可能性。本研究性研究的目标是适应创新的社交网络 动员寻求治疗的PWID的个人社交网络以支持他们留下来的干预措施 在MMT，并在坦桑尼亚的达累斯萨拉姆坚持艺术。这项研究的具体目的是：1)定性 深入研究社交网络如何影响PWID患者的MMT保留和ART依从性 访谈10名现役和10名曾患MMT的患者；2)检查个人与 使用自我中心和社会测量的网络和网络水平因素与MMT保持和艺术依从性 对150名艾滋病毒阳性的MMT患者进行横断面调查所产生的网络数据；以及3)适应和 试点社交网络干预，旨在提高MMT保留率和ART依从性 HIV阳性的MMT患者及其15名社会支持人员评估干预的可接受性和 在坦桑尼亚的情况下的可行性。通过提出的研究性学习和指导性研究相结合 阅读、课程作业和有指导的研究机会，Saleem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方面的专业知识；2)发展 高级社交网络分析技能；以及3)增强实施科学技能，以开发和测试 社交网络干预。为了支持这些目标，Saleem博士有一个由领先专家组成的指导团队 社会网络理论与分析及社会网络干预。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，以便她寻求未来的资金并成功 成为全球和国内物质使用和艾滋病毒研究的独立研究员。