Resilience in HIV infected drug users

感染艾滋病毒的吸毒者的复原力

• 批准号: 9857185
• 负责人: Chinazo Cunningham
• 金额: $ 0.02万
• 依托单位: ALBERT EINSTEIN COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-06-01 至 2019-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9857185
• 关键词: Resilience; HIV; infected; drug; users

 DESCRIPTION (provided by applicant): Millions of Americans use illicit opioids or cocaine, which has substantial individual and public health consequences. Because the opioid and cocaine epidemics intersect with the HIV epidemic, it is crucial to fully understand and mitigate the impact that drug use has on HIV disease. Given that adherence to antiretrovirals (ARVs) is a critical predictor of HIV viral load (VL) suppression, research has focused on the association between illicit drug use and medication non-adherence. It is widely accepted that HIV-infected drug users must engage in drug treatment and strive for abstinence to successfully adhere to ARVs and manage their HIV disease. However, drug use disorders are chronic and relapsing conditions, and many drug users are unable to achieve long-term abstinence. Beyond engagement in drug treatment, little is known about which strategies drug users could use to achieve optimal HIV outcomes. In an ongoing NIH-funded study, we surprisingly found that nearly half of active drug users we screened achieved VL suppression despite ongoing drug use. Therefore, using a mixed methods approach that builds on the resilience of HIV-infected drug users, this study will explore factors and behaviors that facilitate achieving VL suppression among active drug users, regardless of their ability to achieve abstinence. Our exploration will be guided by harm reduction and socioecological models. We will leverage our ongoing NIH-funded study to efficiently recruit and screen participants, and extract their medical record data. We will enroll a total of 170 HIV-infected active drug users, including active illicit opioid users with suppressed VL, active illicit opioid users with non-suppressed VL, active cocaine users with suppressed VL, and active cocaine users with non-suppressed VL. We will also enroll 10 experts in the field of HIV and drug use. The 3 study aims are to: 1) Qualitatively explore HIV- infected active drug users' perceptions of how to achieve optimal HIV health outcomes; 2) Develop a quantitative questionnaire to measure factors and behaviors identified in Aim 1 for analyses proposed in Aim 3; and 3) Quantitatively explore factors and behaviors associated with HIV-infected active drug users achieving optimal HIV health outcomes. This study will improve understanding of drug users' resilience, namely how they are able to achieve optimal HIV outcomes even without abstinence. Findings from this study will ultimately be used to inform the development of an intervention to help HIV-infected active drug users achieve VL suppression.

 描述（由申请人提供）：数百万美国人使用非法阿片类药物或可卡因，这对个人和公共健康造成了重大影响。由于阿片类药物和可卡因的流行与艾滋病毒的流行相互交织，因此必须充分了解和减轻吸毒对艾滋病毒疾病的影响。鉴于坚持抗逆转录病毒药物（ARV）是艾滋病毒载量（VL）抑制的关键预测因素，研究重点是非法药物使用和药物不依从性之间的关联。人们普遍认为，感染艾滋病毒的吸毒者必须接受药物治疗，努力戒毒，才能成功地坚持抗逆转录病毒药物并控制其艾滋病毒疾病。然而，吸毒病症是慢性和复发性病症，许多吸毒者无法实现长期戒断。除了参与戒毒治疗外，人们对吸毒者可以使用哪些策略来实现最佳艾滋病毒结果知之甚少。在一项正在进行的NIH资助的研究中，我们惊讶地发现，尽管正在使用药物，但我们筛选的近一半的活跃药物使用者仍实现了VL抑制。因此，使用混合方法的方法，建立在艾滋病毒感染的吸毒者的弹性，本研究将探讨因素和行为，促进实现VL抑制活跃的吸毒者，无论他们的能力，以实现禁欲。我们的探索将以减少危害和社会生态模型为指导。我们将利用我们正在进行的NIH资助的研究来有效地招募和筛选参与者，并提取他们的医疗记录数据。 我们将招募总共170名感染艾滋病毒的活跃吸毒者，包括活跃的非法阿片类药物使用者 VL受抑制的活跃非法阿片类药物使用者、VL未受抑制的活跃可卡因使用者和VL未受抑制的活跃可卡因使用者。我们还将招募10名艾滋病毒和毒品使用领域的专家。3项研究的目的是：1）定性探索HIV感染的活跃吸毒者对如何实现最佳HIV健康结果的看法; 2）开发定量问卷，以测量目标1中确定的因素和行为，用于目标3中提出的分析; 3）定量探索与HIV感染的活跃吸毒者实现最佳HIV健康结果相关的因素和行为。这项研究将增进对吸毒者复原力的了解，即他们如何能够在没有禁欲的情况下实现最佳的艾滋病毒结果。这项研究的结果最终将用于制定干预措施，以帮助感染艾滋病毒的活跃吸毒者实现VL抑制。