Preventing HIV Transmission by Recently-Infected Drug Users

一半或更多的艾滋病毒传播事件可能发生在高传染性时期(和 通常是高风险行为)，可能在一个人最初感染后持续11个月或更长时间。 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都没有 在这一危险的“近期感染”期间，找到了有效的方法来干预传播。 我们寻求开发有效的干预技术，以防止艾滋病毒在毒品中的传播 用户及其社区成员在最近的感染期内使用 基于注射毒品、性接触和社交网络的接触者追踪方法；社区警报 最近感染者的网络和场所；以及“上”和“下”感染的逻辑 锁链。我们的首要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SEED的成员 网络和人们谁参加他们的场馆。我们将对他们进行急性和近期的检测 感染，并提醒他们他们的网络可能包含高传染性成员 因此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，以 将他们感染的几率降到最低。这也可能减少未经测试的 最近感染的人。社区、网络和场地教育，了解需求和 支持那些最近感染的人的价值应该会减少耻辱。我们的第三个目标是减少 艾滋病毒传播，并开发新的方法来评估“阳性预防”，一般如下 以及我们自己在减少传播方面的成功。我们将使用以下各项的组合来完成此操作： UP访谈和测试，包括病毒载量；系统发育技术；离散事件 模拟建模以评估我们的有效性。

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.