Preventing HIV Transmission by Recently-Infected Drug Users

一半或一半以上的艾滋病毒传播事件可能发生在高传染性时期（以及 通常是高风险行为），可以持续11个月或更长时间后，一个人最初感染。 不幸的是，无论是检测和治疗干预方法还是急性艾滋病毒感染项目， 在这一危险的“近期感染”时期，找到了有效的干预传播的方法。 我们致力发展有效的干预技术，以防止吸毒人士感染爱滋病病毒。 用户及其社区成员在最近的感染期间使用的组合， 基于毒品注射、性和社交网络的接触者追踪方法; 最近感染者的网络和场所;以及“上升”和“下降”感染的逻辑 店我们的第一个目标是开发和评估定位“种子”的方法，“种子”被定义为吸毒者 以及其他最近被感染的人我们的第二个目标是种子组织的成员。 网络和参加他们场地的人。我们会检测他们的急性和近期 感染，并提醒他们，他们的网络包含高传染性成员的可能性 所以他们应该在接下来的几个月里减少他们的风险和传播行为， 最大限度地减少感染的机会。这也可能减少未经测试的传播 最近感染的人。社区、网络和场地教育， 支持新近感染者的价值应减少耻辱感。我们的第三个目标是减少 艾滋病毒的传播，并制定新的方法来评估“预防阳性”一般， 以及我们在减少传播方面的成功。我们将使用以下组合来实现这一点- 进行访谈和测试，包括病毒载量;系统发育技术;和离散事件 模拟模型来评估我们的有效性。

Half or more of HIV transmission events may occur within the period of high infectivity (and often high risk behavior) that can last 11 months or more after a person is initially infected. Unfortunately, neither test-and-treat intervention methods nor Acute HIV Infection projects have found effective ways to intervene against transmission during this risky "recent infection" period. We seek to develop effective intervention techniques against HIV transmission among drug users and their community members during the recent infection period using a combination of drug injection-, sexual- and social-network-based contact tracing methods; community alerts in the networks and venues of recent infectees; and the logic of going "up" and "down" infection chains. Our first Aim is to develop and evaluate ways to locate "seeds," defined as drug users and other people who have recently been infected. Our second Aim targets members of seeds' networks and people who attend their venues. We will test them for acute and for recent infection, and alert them to the probability that their networks contain highly-infectious members so they should reduce their risk and transmission behaviors for the next several months to minimize their chances of getting infected. This may also reduce transmission by untested people with recent infection. Community, network and venue education about the need and value of supporting those with recent infection should reduce stigma. Our third Aim is to reduce HIV transmission and to develop new ways to evaluate "prevention for positives" generally as well as our own success in reducing transmission. We will do this using a combination of follow- up interviews and testing, including of viral loads; phylogenetic techniques; and discrete event simulation modeling to assess our effectiveness.