Implementation of Rapid HIV Testing and Linkage to HIV Treatment or Prevention Among Vulnerable Populations in Tennessee

在田纳西州弱势群体中实施快速艾滋病毒检测并将其与艾滋病毒治疗或预防联系起来

• 批准号: 10460100
• 负责人: Carolyn Audet
• 金额: $ 135.88万
• 依托单位: VANDERBILT UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10460100
• 关键词: Implementation; Rapid; HIV; Testing; Linkage

Project Summary Human Immunodeficiency Virus (HIV) infection remains a significant public health problem in the United States (US). It is estimated that almost 15% of the 1.17 million people living with HIV (PLWH) in the US are unaware of their HIV status. And despite the existence of highly effective HIV treatment (antiretroviral therapy, ART), only 65% of people living with diagnosed HIV have achieved viral suppression. Similarly, among HIV-negative people eligible for PrEP, only 18% have used PrEP. These gaps between evidence and practice are deepened in the US South, where the opioid crisis has further increased the risk for acquiring HIV in this region. In order to achieve US Ending the HIV Epidemic (EHE) goals, implementation research, particularly in the US South, is needed to close the gap between evidence-based interventions and practice in the HIV neutral continuum of care. Thus, our overarching goal is to support and evaluate the implementation of a sustainable HIV health service model for rapid HIV testing and linkage to HIV treatment (ART) or prevention (PrEP) in Tennessee (TN), a state located in the US South. Our Core Project will focus on implementation and evaluation of rapid HIV testing and linkage to ART from the Shelby County Health Department, the highest volume HIV testing facility in Memphis, TN (a southern US city which ranks 4th among all US Metropolitan Statistical Areas for HIV incidence) to several nearby Ryan White-funded HIV care clinics. Our Collaborative Project will focus on implementation and evaluation of rapid HIV testing and linkage to local PrEP providers from: 1) Street Works, a Community Based Organization (CBO) providing a Syringe Service Program (SSP) to the Nashville community and 2) A Betor Way, a CBO providing a SSP to the Memphis community. We are uniquely positioned to perform the work we propose for three important reasons. First, we plan to leverage an established collaboration with implementation and community partners in Memphis and Nashville including colleagues from St. Jude Children’s Research Hospital, University of Memphis, Shelby County Health Department, Street Works, and A Betor Way. Second, we will leverage resources available at the TN Center for AIDS Research, Vanderbilt Center for Health Services Research, and the Meharry-Vanderbilt Alliance/Community Engaged Research Core. Thirdly, the investigators involved in this proposal possess the expertise in HIV clinical care and prevention, implementation science, and public health practice necessary to complete the proposed work. The proposed study will support the implementation of a contextually appropriate rapid HIV testing and linkage to HIV treatment (ART) or prevention (PrEP) in Memphis and Nashville, TN. The results will inform future scaling of these models to additional HIV testing, care, prevention sites across TN, a geographic area at the epicenter of important US HIV disparities. Importantly, our work will support the Memphis and Nashville communities in reaching their local EHE goals through leveraging of our unique academic, public health, and community-based partnerships.

项目摘要 在美国，人类免疫缺陷病毒（HIV）感染仍然是一个重大的公共卫生问题 （我们）。据估计，在美国有117万艾滋病毒（PLWH）的人中，近15％不知道 他们的艾滋病毒状况。尽管存在高效的HIV治疗（抗逆转录病毒疗法，ART），但 只有65％的患有诊断为艾滋病毒的患者已获得病毒抑制。同样，在HIV阴性中 有资格获得准备的人，只有18％的人使用了Prep。证据与实践之间的这些差距得到了加深 在美国南部，阿片类药物危机进一步增加了在该地区获取艾滋病毒的风险。为了 为了实现我们结束艾滋病毒流行（EHE）的目标，实施研究，尤其是在美国南部，是 需要在HIV中性连续体中缩小基于证据的干预措施和实践之间的差距 关心。这就是我们的总体目标是支持和评估可持续艾滋病毒健康的实施 田纳西州快速艾滋病毒测试和与HIV治疗（ART）或预防（PREP）联系的服务模型 （TN），位于美国南部的一个州。我们的核心项目将着重于快速实施和评估 艾滋病毒测试和与谢尔比县卫生部门的艺术联系，最高的艾滋病毒测试 田纳西州孟菲斯的设施（美国南部城市，在美国大都会统计领域中排名第四 发病率），瑞安·怀特（Ryan）白人资助的艾滋病毒护理诊所（HIV Care Clinics）。我们的协作项目将重点放在 快速艾滋病毒测试和与本地预备提供者的链接的实施和评估：1）街头工程，一个 基于社区的组织（CBO）为纳什维尔社区提供注射器服务计划（SSP） 2）Betor Way，CBO为孟菲斯社区提供SSP。我们是独特的位置 我们提出的工作是出于三个重要原因。首先，我们计划利用已建立的 与孟菲斯和纳什维尔的实施和社区合作伙伴合作，包括来自 圣裘德儿童研究医院，孟菲斯大学，谢尔比县卫生系，街 作品和betor的方式。其次，我们将利用TN艾滋病研究中心可用的资源 范德比尔特卫生服务研究中心和Meharry-Vanderbilt联盟/社区 参与研究核心。第三，参与该提案的调查人员拥有艾滋病毒专业知识 完成临床护理和预防，实施科学以及完成公共卫生实践 建议的工作。拟议的研究将支持实施上下文适当的快速 孟菲斯和田纳西州纳什维尔的HIV测试和与HIV治疗（ART）或预防（PREP）的联系。这 结果将为这些模型的未来扩展提供给其他艾滋病毒测试，护理，预防地点， 美国重要艾滋病毒差异的地理区域。重要的是，我们的工作将支持 孟菲斯和纳什维尔社区通过利用我们的独特 学术，公共卫生和基于社区的伙伴关系。