Prison Interventions and HIV Prevention Collaboration

监狱干预和艾滋病毒预防合作

• 批准号: 8510613
• 负责人: FREDERICK LEWIS ALTICE
• 金额: $ 38.17万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-01 至 2015-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8510613
• 关键词: AIDS prevention; AIDS/HIV problem; Address; Area; Behavior; Behavior Therapy; Chronic; Collaborations; Communicable Diseases; Communities; Comorbidity; Country; Criminal Justice; Data; Detection; Drug Addiction; Drug usage; Drug user; Epidemic; Evaluation; Evidence based intervention; Future; Grant; HIV; HIV risk; Harm Reduction; Health; Hepatitis B Virus; Hepatitis C virus; High Prevalence; Holistic Health; Housing; Imprisonment; Incidence; Individual; Infection; Injection of therapeutic agent; Intervention; Intervention Studies; Kazakhstan; Knowledge; Link; Mental disorders; Modeling; Morbidity - disease rate; Needs Assessment; North America; Opioid Rotation; Outcome; Phase; Play; Policy Research; Prevalence; Prisoner; Prisons; Recording of previous events; Recovery; Research; Research Activity; Research Infrastructure; Research Personnel; Research Priority; Risk; Risk Behaviors; Risk-Taking; Role; Sentinel; Sexual Partners; Sexual Transmission; Site; Substance Use Disorder; Substance abuse problem; Surveys; System; Testing; Tuberculosis; USSR; Ukraine; Viral hepatitis; Work; base; burden of illness; community setting; evaluation/testing; evidence base; experience; health care delivery; high risk; implementation research; injection drug use; innovation; meetings; mortality; programs; success; therapy development; transmission process

DESCRIPTION (provided by applicant): Injection drug use (IDU) has greatly contributed to an explosive and volatile HIV epidemic in states of the former Soviet Union (FSU) - especially in Ukraine. This region, for reasons similar in North America, incarceration of drug users is among the highest in the world. As a result, there is a concentration of HIV/AIDS and other infectious diseases (HBV, HCV, TB, STIs) within the criminal justice system (CJS). In many FSU countries, high-risk sexual and injection behaviors within prisons have resulted in significant intra-prison HIV transmission. The CJS is therefore a sentinel place not only to detect and treat HIV among drug users and their sexual partners, but to adapt and implement evidence-based interventions that are effective in decreasing HIV-related morbidity and mortality. In this application, we propose to create an innovative and new collaborative research program in Ukraine called PRIDE (Prison-related Research, Intervention Development and Evaluation), which addresses research and implementation issues in the FSU region associated with HIV, substance abuse and the CJS. PRIDE creates an infrastructure for research that involves both researchers and the CJS partners and includes collaborators from Ukraine, Kazakhstan and Georgia. The synergy between researchers and CJS partners allows an open dialogue and opportunity to incorporate implementation research using the Plan-Do-Study-Act (PDSA) that is likely to yield the most effective outcomes. Phase I provides a menu of surveillance activities that can be selected for research activities within the Ukraine CJS. Differing methodological strategies are available to answer different questions, including burden of infectious diseases and co-morbidity among prisoners, HIV risk behaviors and HIV transmission within prison, pre-release needs of prisoners with HIV, drug dependence and/or TB. Phase II reviews all surveillance and needs assessment activities and to select from a number of evidence-based interventions that should be adapted and pilot-tested among prisoners. Though not known a priori, the menu of options includes alternatives to incarceration, behavioral interventions such as the Holistic Health Recovery Program (HHRP), opioid substitution therapy (OST) administered either during incarceration or as a pre- or post-release intervention, prison-release interventions adapted from nationally-recognized models created by Yale investigators or others worthy of exploration and agreed upon through PRIDE. Phase III involves adaptation and pilot testing of selected interventions. Results from these pilots are to be used for further research, including application for new grants. The likelihood of success for PRIDE is based upon: 1) over 20 years of innovative research at the interface of substance abuse, HIV/AIDS and the CJS; 2) an extensive research history between Yale and Ukraine; and 3) conducting research in Ukraine where the burden of disease is great and its central role in FSU activities is considerable.

描述（由申请人提供）：注射吸毒（IDU）在很大程度上导致了前苏联（FSU）国家的爆炸性和不稳定的艾滋病毒流行，特别是在乌克兰。由于与北美类似的原因，该区域是世界上监禁吸毒者最多的区域之一。因此，艾滋病毒/艾滋病和其他传染病（乙型肝炎病毒、丙型肝炎病毒、结核病、性传播感染）集中在刑事司法系统内。在许多前苏联国家，监狱内的高风险性行为和注射行为导致了严重的监狱内艾滋病毒传播。因此，该中心不仅是检测和治疗吸毒者及其性伴侣中的艾滋病毒的前哨站，而且是调整和实施有效降低艾滋病毒相关发病率和死亡率的循证干预措施的前哨站。在此应用程序中，我们建议在乌克兰创建一个创新的和新的合作研究计划，称为PRIDE（监狱相关的研究，干预发展和评估），它解决了与艾滋病毒，药物滥用和CJS相关的FSU地区的研究和实施问题。PRIDE创建了一个研究基础设施，涉及研究人员和CJS合作伙伴，包括来自乌克兰，哈萨克斯坦和格鲁吉亚的合作者。研究人员和CJS合作伙伴之间的协同作用允许开放的对话和机会，将实施研究使用计划做研究法（PDSA），这可能会产生最有效的结果。第一阶段提供了一份监测活动清单，可供乌克兰科学研究中心内的研究活动选择。不同的方法战略可用于回答不同的问题，包括囚犯中的传染病和共病负担、艾滋病毒风险行为和监狱内的艾滋病毒传播、感染艾滋病毒的囚犯的释放前需求、药物依赖和/或结核病。第二阶段审查所有监测和需求评估活动，并从若干循证干预措施中选择应在囚犯中加以调整和试行的干预措施。虽然没有先验知识，但选项菜单包括监禁的替代方案，行为干预措施，如整体健康恢复计划（HHRP），阿片类药物替代疗法（OST）在监禁期间或作为释放前或释放后的干预措施，监狱释放干预措施改编自耶鲁大学研究人员或其他值得探索并通过PRIDE达成一致的国家认可的模型。第三阶段涉及选定干预措施的适应和试点测试。这些试点的结果将用于进一步的研究，包括申请新的赠款。骄傲成功的可能性是基于：1）在药物滥用，艾滋病毒/艾滋病和CJS接口超过20年的创新研究; 2）耶鲁大学和乌克兰之间的广泛研究历史;和3）在乌克兰进行研究，那里的疾病负担很大，其在前苏联活动中的核心作用是相当大的。