Establishing the acceptability and feasibility of using social network-driven recruitment to test for hepatitis C in men who have sex with men.

确定使用社交网络驱动的招募来检测男男性行为者丙型肝炎的可接受性和可行性。

• 批准号: MR/T001127/1
• 负责人: Nina Vora
• 金额: $ 36.56万
• 依托单位: University College London
• 依托单位国家: 英国
• 项目类别: Fellowship
• 财政年份: 2020
• 资助国家: 英国
• 起止时间: 2020 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FT001127%2F1
• 关键词: Establishing; acceptability; feasibility; using; social

The problem: Hepatitis C virus (HCV) is a viral infection that can cause liver failure and liver cancer. We now have well tolerated and effective drugs to clear HCV. But up to 50% of the estimated 210,000 infected people in the UK do not know they are infected. If we find and treat all infected people we can decrease liver disease and stop HCV being spread to others. People who inject drugs (PWID) are the largest affected group in the UK. Most HCV testing strategies target PWID, but since 2000, increasing numbers of men who have sex with men (MSM), especially those with HIV, have been infected sexually with HCV. Their risk factors differ from PWID. More HIV negative MSM are getting HCV now so MSM at risk of HCV infection should be tested when attending sexual health (SH) clinics. But this does not always happen and many MSM do not attend SH clinics. So testing in SH clinics will miss some MSM at risk. Traditional partner notification-testing partners of those diagnosed with HCV- is often impossible to do as often there are many anonymous untraceable partners.The approach: I will develop and pilot a social network driven recruitment (SNDR) intervention to find and offer testing to people who are at risk of HCV but who are not already being tested. Risk of HCV depends on the risk in the people one socialises with as well as has sex with. Social contacts influence behaviour and what is accepted as 'normal', including risky behaviour. More information about testing behaviours in these networks could allow better targeting of testing and a means to reach those not engaged with care. Studies have used a participant (known as a seed) to recruit social (including sexual) peers from their networks (alters) who in turn recruit their alters to reach 'hidden' populations. Adaptations to this method have helped find undiagnosed HIV cases in PWID in Athens. I propose to use SNDR for HCV in MSM in the UK. Seeds will recruit alters at risk of HCV. Each alter will complete a questionnaire about their networks and HCV risk, return a dried blood spot sample for HCV testing and then recruit further alters, creating a 'recruitment chain'. Aim: to explore current testing needs and if this new recruitment strategy of MSM recruiting peers to test for HCV is potentially acceptable, reaches those at risk who are currently not testing and could be tested in a randomised controlled trial (RCT). Participants: Any MSM aged 16+ years and newly diagnosed with HCV at the Mortimer Market Centre (SH/HIV clinic in central London) and their social and sexual contacts with a valid recruitment coupon.Plan of investigation:1. Interview MSM who do not go to SH clinics (recruited from gay saunas) and MSM who have had HCV. I will ask about testing, perception of HCV risk, disclosure of HCV diagnosis and their thoughts on the intervention e.g. number of alters approached. I will also talk to sexual health clinic staff about who they decide to test or not test for HCV and why. 2. Use the interview data to help design a questionnaire exploring HCV risk factors and social (and sexual) networks. The questionnaire will be piloted and refined with MSM. 3. Pilot the SNDR method of recruiting and testing. 4. Evaluate the data to look at the networks among MSM and the risk of hepatitis C infection.This information will provide new insight into the networks of MSM and look for other at risk groups. Participants will be given information about HCV and the results of their HCV test. I will continue to involve patients and the public in the study to make sure its findings reach the public as well as researchers and medical teams. The findings from this feasibility study can be used to plan a randomised controlled trial to determine the efficacy of this strategy. Public health benefits of this randomised controlled trial include better targeted testing and understanding of how HCV spreads.

问题：丙型肝炎病毒是一种病毒感染，可导致肝功能衰竭和肝癌。我们现在有耐受性良好且有效的药物来清除丙型肝炎病毒。但在英国大约21万名感染者中，高达50%的人不知道自己被感染了。如果我们发现并治疗所有感染者，我们就可以减少肝脏疾病，阻止丙型肝炎病毒传播给其他人。注射毒品者(PWID)是英国最大的受影响群体。大多数丙型肝炎病毒检测策略针对的是PWID，但自2000年以来，越来越多的男男性行为者(MSM)，特别是那些携带艾滋病毒的男性，性感染了丙型肝炎病毒。他们的危险因素不同于PWID。现在有更多HIV阴性的男男性接触者感染了丙型肝炎病毒，所以有感染丙型肝炎病毒风险的男男性接触者应该在就诊性健康(SH)诊所时进行检测。但这并不总是发生，许多男男性接触者并不去SH诊所。因此，在SH诊所进行检测将会漏掉一些有风险的MSM。传统的合作伙伴通知--检测确诊为丙型肝炎病毒感染者的伴侣--通常是不可能做到的，因为经常有许多匿名的、无法追踪的合作伙伴。方法：我将开发和试点一种社交网络驱动的招聘(SNDR)干预措施，以发现并为那些有丙型肝炎病毒风险但尚未接受检测的人提供检测。丙型肝炎病毒的风险取决于与之交往和发生性关系的人的风险。社会交往会影响人们的行为和被认为是“正常”的行为，包括危险行为。更多关于在这些网络中测试行为的信息可以使测试更有针对性，并为那些没有参与护理的人提供一种手段。研究使用参与者(称为种子)从他们的社交网络(更改者)招募社交(包括性)同龄人，这些同龄人反过来招募他们的更改者来接触“隐藏的”人群。对这种方法的适应帮助雅典PWID发现了未诊断的艾滋病毒病例。我建议在英国的MSM中使用SNDR来治疗丙型肝炎病毒。种子将招募有感染丙型肝炎病毒风险的变种人。每个Alter将完成一份关于他们的关系网和丙型肝炎病毒风险的问卷，返回一个干血点样本进行丙型肝炎病毒检测，然后招募更多的Alter，从而形成一个“招聘链”。目的：探索当前的检测需求，以及这一新的MSM招募同龄人检测丙型肝炎病毒的招募策略是否潜在地可接受，覆盖到那些目前没有检测并可能在随机对照试验(RCT)中进行检测的高危人群。研究对象：16岁以上在莫蒂默市场中心(伦敦市中心的SH/HIV诊所)新诊断为丙型肝炎的男男性接触者及其持有有效招募优惠券的社会和性接触者。调查计划：1.访谈未去SH诊所的男男性接触者(从同性恋桑拿房招募)和感染丙型肝炎的男男性接触者。我将询问有关检测、对丙型肝炎病毒风险的感知、丙型肝炎病毒诊断的披露以及他们对干预措施的看法，例如，接触的改变数量。我还将与性健康诊所的工作人员讨论他们决定检测或不检测谁的丙型肝炎病毒及其原因。2.使用采访数据帮助设计一份调查问卷，探讨丙型肝炎病毒的风险因素和社会(和性)网络。调查问卷将与男男性接触者一起进行试点和完善。3.试行招考SNDR办法。4.评估数据以了解男男性接触者之间的网络和丙型肝炎感染的风险。这些信息将提供对男男性接触者网络的新见解，并寻找其他高危群体。参与者将获得有关丙型肝炎病毒的信息和他们的丙型肝炎病毒检测结果。我将继续让患者和公众参与这项研究，以确保其结果能够到达公众以及研究人员和医疗团队。这项可行性研究的结果可以用来计划一项随机对照试验，以确定这一策略的有效性。这项随机对照试验的公共健康益处包括更好的针对性测试和对丙型肝炎病毒如何传播的了解。

项目成果

High incidence of Hepatitis C virus infection observed in the PROUD study of HIV pre-exposure prophylaxis.

• DOI: 10.1111/jvh.13297
• 发表时间: 2020-08
• 期刊: Journal of viral hepatitis
• 影响因子: 2.5
• 作者: Desai M;White E;Vora N;Gilson R;Lacey C;Gafos M;Clarke A;Sullivan A;White D;Fox J;Piontkowsky D;McCormack S;Dunn DT
• 通讯作者: Dunn DT

Estimating the effectiveness of routine asymptomatic PCR testing at different frequencies for the detection of SARS-CoV-2 infections.

• DOI: 10.1186/s12916-021-01982-x
• 发表时间: 2021-04-27
• 期刊: BMC medicine
• 影响因子: 9.3
• 作者: Hellewell J;Russell TW;SAFER Investigators and Field Study Team;Crick COVID-19 Consortium;CMMID COVID-19 working group;Beale R;Kelly G;Houlihan C;Nastouli E;Kucharski AJ
• 通讯作者: Kucharski AJ

Detection of SARS-CoV-2 infection by saliva and nasopharyngeal sampling in frontline healthcare workers: An observational cohort study.

• DOI: 10.1371/journal.pone.0280908
• 发表时间: 2023
• 期刊: PLOS ONE
• 影响因子: 3.7
• 作者: Walker, Naomi F. F.;Byrne, Rachel L. L.;Howard, Ashleigh;Nikolaou, Elissavet;Farrar, Madlen;Glynn, Sharon;Cheliotis, Katerina S. S.;Atienzar, Ana I. Cubas I.;Davies, Kelly;Reine, Jesus;Rashid-Gardner, Zalina;German, Esther L. L.;Solorzano, Carla;Blandamer, Tess;Hitchins, Lisa;Myerscough, Christopher;Gessner, Bradford D. D.;Begier, Elizabeth;Collins, Andrea M. M.;Beadsworth, Mike;Todd, Stacy;Hill, Helen;Houlihan, Catherine F. F.;Nastouli, Eleni;Adams, Emily R. R.;Mitsi, Elena;Ferreira, Daniela M. M.
• 通讯作者: Ferreira, Daniela M. M.