Opiate Dependence, HIV and Adherence Interventions

描述(由申请人提供)： 这份申请是为了获得以患者为导向的研究事业发展奖(K23)，为桑德拉·斯普林格博士成为一名独立的研究人员做准备。她将通过指导课程作业、来自有成就的研究人员的指导、参与三个重点研究项目和提交学术手稿来实现这一目标。具体地说，她将接受关于设计和实施干预措施的培训，以坚持抗逆转录病毒治疗和药物治疗，以帮助从惩教环境中获释的艾滋病毒+阿片成瘾者。她的研究表明，艾滋病毒+阿片依赖囚犯在监禁期间改善了他们的CD4计数和病毒载量。然而，随着这些人重新吸毒，未能坚持抗逆转录病毒治疗，并导致糟糕的健康结果，这一好处就丧失了。施普林格博士还协助制定了针对HIV+吸毒者的社区依从性干预措施。在她的职业发展过程中，她将获得培训和经验，将获释的艾滋病毒+囚犯与有效的干预措施联系起来。施普林格博士将在她的职业发展奖期间先后进行三个项目。第一项研究包括在一项直接给予抗逆转录病毒治疗(DAART)的随机对照试验中，对影响HIV+吸毒者坚持抗逆转录病毒治疗的因素进行的二次数据分析。第二个项目将评估将艾滋病毒+吸毒者与美沙酮维持方案联系起来并在该环境下提供DAART的可行性。第三个项目将首先将艾滋病毒阳性囚犯在出狱后与丁丙诺啡治疗联系起来，然后进行第二次可行性研究，将他们与丁丙诺啡加DAART联系起来。职业发展计划是一种精心安排的方法，旨在为斯普林格博士提供必要的技能和数据，以开发R01，并在奖项结束时成为一名独立研究员。她的工作将极大地促进艾滋病毒与药物滥用治疗之间的接口，在那里需要经过严格评估的干预措施。

DESCRIPTION (provided by applicant): This application is a request for a Mentored Patient-Oriented Research Career Development Award (K23) to prepare Dr. Sandra Springer to become an independent investigator. She will accomplish this goal through directed coursework, mentoring from accomplished researchers, involvement with three focused research projects and submission of scholarly manuscripts. Specifically, she will receive training in the design and implementation of interventions for adherence to antiretroviral therapy and drug treatment for opiate-addicted HIV+ individuals being released from the correctional setting. Her research has demonstrated that HIV+ prisoners with opiate dependence improve their CD4 count and viral load while incarcerated. This benefit, however, is lost as these individuals relapse to drug use, fail to adhere to antiretroviral therapy and result in poor health outcomes. Dr. Springer has also assisted with development of community-based adherence interventions for HIV+ drug users. During her career development, she will gain training and experience to connect released HIV+ prisoners to effective interventions. Dr. Springer will sequentially conduct three projects during her career development award. The first include secondary data analyses of factors that effect adherence to antiretroviral therapy among HIV+ drug users in a randomized controlled trial of directly administered antiretroviral therapy (DAART). The second project will evaluate the feasibility of linking HIV+ drug users to a methadone maintenance program and providing DAART within that setting. The third project will first link HIV+ prisoners to buprenorphine treatment upon release from prison, followed by a second feasibility study of linking them to buprenorphine plus DAART. The career development plan is a carefully staged approach to provide Dr. Springer with the skills and data necessary to develop an R01 and become an independent investigator by the end of the award. Her work will contribute greatly to the interface between HIV and substance abuse treatment where rigorously evaluated interventions are needed.