Rapid Response to Incident HIV Infection through Social Network Strategies and Molecular Epidemiology to Inform Partner Services

通过社交网络策略和分子流行病学快速响应艾滋病毒感染事件，为合作伙伴服务提供信息

• 批准号: 10460005
• 负责人: Ann Dennis
• 金额: $ 77.24万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-07-01 至 2027-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10460005
• 关键词: AIDS prevention; Acute; Address; Advocate; Anti-Retroviral Agents; Area; Behavior; Behavioral; Biological; Caring; Centers for Disease Control and Prevention (U.S.); Cluster Analysis; Collaborations; Contact Tracing; County; Data; Detection; Development; Diagnosis; Drug usage; Ensure; Epidemic; Epidemiology; Evaluation; Friends; Genetic; Goals; HIV; HIV Infections; HIV Seropositivity; HIV diagnosis; Human immunodeficiency virus test; Incidence; Individual; Infection; Intervention; Investigation; Knowledge; Link; Logistics; Methods; Molecular Epidemiology; Names; Network-based; North Carolina; Outcome; Pathway Analysis; Persons; Pharmaceutical Preparations; Prevention; Prophylactic treatment; Public Health; Reporting; Research; Resources; Risk; Rural; Sequence Analysis; Services; Sexual Partners; Sexual and Gender Minorities; Social Network; Social support; Source; South Carolina; Testing; United States; Viral; Virus; black men who have sex with men; case finding; community engagement; community involvement; design; distrust; effectiveness evaluation; effectiveness outcome; evidence base; experience; gender minority group; high risk; hybrid type 1 design; implementation outcomes; implementation strategy; improved; indexing; innovation; member; metropolitan; multidisciplinary; next generation; peer; post intervention; pre-exposure prophylaxis; prevention service; recruit; response; rural area; rural counties; service engagement; service intervention; service utilization; sex; social; social contact; social stigma; standard of care; success; tool; transgender women; transgender women who have sex with men; transmission process; treatment services; uptake; urban area

PROJECT SUMMARY The objective of the proposed research is to improve the response to incident HIV infection by engaging the networks of Black men who have sex with men (BMSM) and transgender women (TGW) through a combination of Partner Services, social network recruitment, and HIV genetic cluster detection. Despite marked advances in HIV treatment and prevention, HIV incidence has not substantially declined among BMSM/TGW in the Southern United States (US), highlighting the need for innovative methods to detect and respond to ongoing HIV transmission. While Partner Services can be highly effective, case finding remains limited even for persons diagnosed soon after HIV acquisition (acute or recent infections). Partner Services can also be limited in investigations across jurisdictional boundaries and in rural areas. We hypothesize that leveraging the social networks (social contacts rather than only drug sharing or sexual partners) of networks with recent HIV transmission will lead to improved engagement in HIV services (prevention or care). However, such strategies must be responsive to the barriers and facilitators to engagement in these services including a better understanding of social support networks. This project involves a multidisciplinary team including robust public health partnerships and active community engagement to address HIV prevention needs and build on existing resources. We will develop and implement an enhanced social network strategy (eSNS) for networks of BMSM/TGW with new HIV diagnoses, including acute incident infection, in the high-burden Charlotte region (Mecklenburg County, North Carolina), situated on the border of South Carolina. Both areas are priority regions in the Ending the Epidemic (EHE) initiative. In the eSNS intervention, new diagnoses will receive rapid response Partner Services for elicitation of social and sexual contacts; selected contacts will be recruited and coached to recruit their peers to engage in HIV services. Aim 1 will employ regional genetic and contact network analysis of incident and prevalent HIV in North and South Carolina, to evaluate important connections (bridging) between states and between urban and rural areas. This granular data (contact, spatial, genetic) will expand epidemiological understanding of the epidemic to inform development of the eSNS and enhance local EHE strategies. To further inform eSNS development, Aim 2 will use a mixed methods approach to examine the barriers and facilitators of engaging BMSM/TGW members of networks with recent HIV transmission. Aim 3 will then evaluate the eSNS with effectiveness and implementation outcomes. Effectiveness outcomes (increase in testing, pre-exposure prophylaxis referral, and HIV care engagement) will be evaluated with regression point displacement design comparing outcomes pre/post intervention in Charlotte and in comparison, with the Raleigh region receiving standard of care partner services. Overall, the results of this project will lead to critical information to guide new strategies in Partner Services and in EHE responses to increase HIV care and prevention engagement among BMSM/TGW in the Southern US.

项目摘要 拟议研究的目的是通过参与 与男人发生性关系（BMSM）和变性妇女（TGW）的黑人网络 合作伙伴服务，社交网络招聘和HIV遗传群集检测的结合。尽管 艾滋病毒治疗和预防的明显进步，艾滋病毒发病率并未大大下降 美国南部（美国）的BMSM/TGW，强调了需要创新方法检测和 响应正在进行的艾滋病毒传播。虽然合作伙伴服务可能非常有效，但案件发现仍然存在 即使在艾滋病毒收购后不久被诊断出的人（急性或最近感染）也有限。合作伙伴服务 在司法管辖区和农村地区的调查中也可能受到限制。我们假设这一点 利用网络的社交网络（社交联系，而不是药物共享或性伴侣） 随着最近的艾滋病毒传播，将改善参与艾滋病毒服务（预防或护理）。然而， 这些策略必须对障碍和促进者的参与做出反应，包括 更好地了解社会支持网络。该项目涉及一个多学科团队 公共卫生合作伙伴关系和积极的社区参与，以满足艾滋病毒预防需求并基于 现有资源。我们将为网络开发并实施增强的社交网络策略（ESN） 在高负荷夏洛特地区，具有新的HIV诊断的BMSM/TGW，包括急性事件感染 （北卡罗来纳州梅克伦堡县），位于南卡罗来纳州的边界。这两个领域都是优先区域 在结束流行病（EHE）倡议中。在ESN干预中，新诊断将得到快速 响应合作伙伴服务以促进社会和性接触；选定的联系人将被招募，并且 指导招募同龄人从事艾滋病毒服务。 AIM 1将采用区域遗传和接触 北卡罗来纳州和南卡罗来纳州的事件和普遍艾滋病毒的网络分析，以评估重要的联系 （桥接）在州之间以及城市和农村地区之间。这种粒状数据（接触，空间，遗传）将 扩大对流行病的流行病学理解，以告知ESN的发展并增强本地 EHE策略。为了进一步通知ESNS开发，AIM 2将使用混合方法来检查 与最近的HIV传播相关的BMSM/TGW成员的障碍和促进者。目的 3然后将以有效性和实施结果评估ESN。有效性结果 （测试增加，暴露前预防转诊和HIV护理参与）将与 回归点位移设计比较夏洛特和夏洛特的前/干预后的结果 比较，罗利地区获得了护理合作伙伴服务标准。总体而言，结果 项目将导致关键信息指导合作伙伴服务的新策略以及对 在美国南部增加BMSM/TGW之间的艾滋病毒护理和预防参与。