Impacts of universal access to HIV/AIDS care among HIV+ injection drug users

艾滋病毒注射吸毒者普遍获得艾滋病毒/艾滋病护理的影响

• 批准号: 7337267
• 负责人: Evan Wood
• 金额: $ 46.39万
• 依托单位: UNIVERSITY OF BRITISH COLUMBIA
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-17 至 2012-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7337267
• 关键词: AIDS prevention; AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; Adherence; Anti-Retroviral Agents; Antiretroviral drug resistance; Antiretroviral resistance; Area; Behavior; Blood specimen; British Columbia; Budgets; Canada; Caring; Charge; Cities; Cohort Studies; Complement; Data; Databases; Development; Disease Progression; Disease Resistance; Drug resistance; Drug usage; Epidemic; Evaluation; Funding; HIV; Health Policy; Healthcare; Healthcare Systems; Highly Active Antiretroviral Therapy; Home environment; Illicit Drugs; Incidence; Injecting drug user; Injection of therapeutic agent; International; Intervention; Knowledge; Laboratories; Law Enforcement; Malaria; Measures; Medical; Modeling; North America; Numbers; Patient Self-Report; Pattern; Peer Review; Persons; Policy Maker; Population; Prevalence; Prevention; Prevention strategy; Process; Province; Public Health; Publications; Purpose; Questionnaires; Research; Research Infrastructure; Research Personnel; Risk Behaviors; Role; Sampling; Scientific Evaluation; Secondary Prevention; Services; Social Work; Syringes; Techniques; Time; Wood material; addiction; antiretroviral therapy; base; cohort; cost; discounting; experience; fighting; improved; member; prevention service; programs; prospective; scale up; transmission process; trend; uptake

DESCRIPTION (provided by applicant): Barriers to appropriate HIV treatment and care for HIV-infected injection drug users (IDU) are a growing concern. International efforts to improve the delivery of highly active antiretroviral therapy (HAART) to IDU, such as the WHO'S 3 by 5 Initiative, are in urgent need of data on how these barriers can be addressed. While there has been much focus on HIV prevention for HIV-negative IDU, there has recently been a growing recognition that breaking the cycle of HIV transmission will require renewed focus on behaviors and prevention needs of HIV-infected IDU. This proposal seeks to fill the information gap existing in North America and elsewhere through the following specific aims: 1. To evaluate the incidence of HIV/AIDS service uptake (e.g., antiretroviral therapy) and factors associated with uptake among IDU 2. To evaluate the incidence of HIV antiretroviral drug resistance among HIV-infected IDU and the role of unique antiretroviral delivery models on the time to antiretroviral resistance 3. To evaluate trends in HIV disease progression and factors such as medical service and secondary prevention service use that may be associated with reduced disease progression among IDU 4. To determine factors associated with persistent HIV risk behaviors (e.g., syringe lending) in a setting with comprehensive evidence-based HIV prevention strategies for HIV-infected IDU. These aims will be met through the development of a new prospective cohort study of HIV-infected IDU in Vancouver, Canada. This setting is unique, since all medical care and antiretrovirals are provided free of charge through a universal healthcare system, allowing the research program to focus on non-financial barriers to care. The cohort will involve serial blood sampling to evaluate antiretroviral resistance patterns, a detailed questionnaire to evaluate illicit drug use and related behaviors, and ongoing administrative linkages to the province's centralized medical care and social service databases to evaluate access to antiretrovirals and access to other HIV/AIDS care and prevention services. By helping to fill a critical information gap, this study has the potential to make a major contribution to public health policies for IDU.

描述(由申请人提供)：对艾滋病毒感染的注射吸毒者(IDU)进行适当的艾滋病毒治疗和护理的障碍日益令人担忧。国际社会为改善向注射吸毒者提供高效抗逆转录病毒疗法(HAART)所作的努力，如世界卫生组织的3×5倡议，迫切需要有关如何克服这些障碍的数据。虽然艾滋病毒阴性注射吸毒者的艾滋病毒预防得到了很大的关注，但最近越来越多的人认识到，打破艾滋病毒传播的循环将需要重新关注感染艾滋病毒的注射吸毒者的行为和预防需求。这项建议旨在通过以下具体目标来填补北美和其他地区存在的信息空白：1.评估艾滋病毒/艾滋病服务接受(例如，抗逆转录病毒治疗)的发生率和与注射吸毒者接受艾滋病毒/艾滋病相关的因素2.评估艾滋病毒感染的注射吸毒者中艾滋病毒抗逆转录病毒药物耐药性的发生率，以及独特的抗逆转录病毒提供模式对抗逆转录病毒耐药性时间的作用3.评估艾滋病毒疾病进展的趋势和可能与IDU中疾病进展减少有关的因素，如医疗服务和二级预防服务的使用。4.确定与持续的艾滋病毒危险行为有关的因素(例如，在为感染艾滋病毒的注射吸毒者制定全面的循证艾滋病毒预防战略的情况下)。这些目标将通过在加拿大温哥华对感染艾滋病毒的注射吸毒者进行一项新的前瞻性队列研究来实现。这种环境是独一无二的，因为所有的医疗保健和抗逆转录病毒药物都是通过全民医疗系统免费提供的，从而使研究计划能够专注于非财政障碍的护理。该队列将涉及评估抗逆转录病毒耐药性模式的连续血液采样、评估非法药物使用和相关行为的详细问卷，以及与该省中央医疗和社会服务数据库的持续行政联系，以评估获得抗逆转录病毒药物的情况以及获得其他艾滋病毒/艾滋病护理和预防服务的情况。通过帮助填补关键的信息空白，这项研究有可能对注射吸毒者的公共卫生政策做出重大贡献。