Southern Ohio Prevents Hepatitis Project (StOPHeP)

 描述（由申请人提供）：本项目的总体目标是在有注射吸毒史（注射吸毒者，PWID）并居住在俄亥俄州南部21个非城市县的年轻人（18-30岁）中开发一种检测、预防、联系护理和治疗丙型肝炎（HCV）的综合方法。我们将通过与目标地区的成瘾治疗提供者，公共卫生机构和注射器交换计划合作来实现这一目标，以识别，测试，参考并将PWID与预防和治疗服务联系起来。目标区域包括俄亥俄州南部的21个郊区（大边缘都市、小都市）和农村（小政治、非核心）县，其中18个县被列为阿巴拉契亚地区。为了制定和实施一项全面的战略来解决俄亥俄州南部HCV的高流行率，我们将1）识别和描述年轻的非城市PWID的人口统计学特征和危险行为以及注射网络，并对他们进行HCV、B型肝炎（HBV）和HIV检测; 2）使用同伴导航器将年轻的非城市PWID与成瘾治疗计划以及初级保健，心理健康和专业治疗联系起来（传染病、肝病），包括通过《平价医疗法案》和扩大的俄亥俄州医疗补助计划与医疗保险挂钩; 3）利用同伴导航员提供关于安全注射实践的教育，以预防肝炎和艾滋病毒;并将PWID与目标社区提供的注射器交换计划挂钩; 4）使用封闭的社交网站（SNS）为未感染的预防组提供同伴促进的支持（预防室）和针对HBV、HCV和/或HIV感染的PWID的联系护理组（治疗室）;可在线和通过智能手机获得;和5）在进入研究的12个月内对研究参与者进行HCV的随访评估和重新检测，以确定新的HCV感染率和成功治疗后的再感染率。由于大多数目标县是 在阿巴拉契亚，该提案将解决该地区特有的医疗保健不公平问题，并将提供数据，作为未来公共卫生倡议的基础，以减少非城市年轻PWID中的HCV感染。

 DESCRIPTION (provided by applicant): The overall goal of this project is to develop an integrated comprehensive approach for detection, prevention, linkage to care and treatment for hepatitis C (HCV) among young adults (18-30 years old) who have a history of injection drug use (people who inject drugs, PWID) and live in 21 non-urban southern Ohio counties. We will accomplish this by collaborating with addiction treatment providers, public health agencies, and syringe exchange programs in the target areas to identify, test, refer and link PWID to prevention and treatment services. The target area includes 21 suburban (large fringe metro, small metro) and rural (micropolitian, non-core) counties in southern Ohio, 18 of which are classified as Appalachian. To develop and implement a comprehensive strategy to address the high prevalence of HCV in southern Ohio, we will 1) identify and describe the demographic characteristics and risk behaviors and injection networks of young non-urban PWID, and test them for HCV, hepatitis B (HBV) and HIV; 2) use Peer Navigators to link young non-urban PWID to addiction treatment programs and to primary care, mental health and specialty treatment (infectious diseases, hepatology), including linkage to health insurance through the Affordable Care Act and expanded Ohio Medicaid; 3) use Peer Navigators to provide education on safe injection practices to prevent hepatitis and HIV; and link PWID to syringe exchange programs as available in target communities; 4) use a closed social networking site (SNS) to provide peer-facilitated support for the uninfected prevention group (Prevention Room) and for the linkage-to-care group for PWID with HBV, HCV and/or HIV infection (Treatment Room); available both online and via smartphone; and 5) perform follow-up assessment and re-testing of study participants for HCV within 12 months of study entry to determine rates of new HCV infection and reinfection after successful treatment. Since the majority of the target counties are in Appalachia, this proposal will address healthcare inequities that are endemic to this region, and will provide data on which to base future public health initiatives to reduce HCV among young non-urban PWID.