Ending transmission of HIV, HCV, and STDs and overdose in rural communities of people who inject drugs (ETHIC)

终止农村社区注射吸毒者的艾滋病毒、丙型肝炎和性病传播以及过量用药（伦理）

• 批准号: 9760229
• 负责人: Wiley Jenkins
• 金额: $ 174.91万
• 依托单位: UNIVERSITY OF CHICAGO
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-08-15 至 2022-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9760229
• 关键词: Affect; Agriculture; Alcohol or Other Drugs use; Area; Caring; Centers for Disease Control and Prevention (U.S.); Characteristics; Client; Clinical Services; Coal Mining; Code; Collaborations; Communicable Diseases; Communities; Country; County; Coupled; Criminal Justice; Data; Death Rate; Demographic Factors; Disease; Disease Outbreaks; Disease Surveillance; Disease model; Distress; Drug Monitoring; Drug Prescriptions; Employment; Ensure; Epidemic; Epidemiologic Factors; Epidemiology; Ethnography; Evidence based intervention; Fentanyl; Funding; Geographic Locations; Geography; HIV; HIV/HCV; Harm Reduction; Health; Health Policy; Health Services Accessibility; Health system; Healthcare Systems; Hepatitis B Virus; Hepatitis C virus; Heroin; Illinois; Indiana; Individual; Infectious Disease Epidemiology; Infrastructure; Injecting drug user; Injections; Location; Methodology; Methods; Midwestern United States; Molecular Epidemiology; Morbidity - disease rate; Naloxone; Needle Sharing; Needle-Exchange Programs; Opiate Addiction; Oral; Outcome; Overdose; Pathway Analysis; Pharmaceutical Preparations; Pharmacotherapy; Phase; Population; Population Surveillance; Prevention; Program Evaluation; Public Health; Reporting; Research; Research Personnel; Resources; Respondent; Risk; Rural; Rural Community; Rural Health; STI prevention; Sampling; Seizures; Service setting; Services; Shares syringes; Sister; Social Network; Structure; Substance Use Disorder; Surveys; Syringes; Testing; United States; Variant; Work; authority; base; care systems; clinical care; disease transmission; disorder prevention; experience; first responder; health care availability; health care service utilization; health seeking behavior; high risk; improved; injection drug use; medication-assisted treatment; member; mortality; multidisciplinary; opioid injection; opioid misuse; opioid use; overdose death; overdose prevention; pre-exposure prophylaxis; predictive modeling; prescription opioid; programs; response; rural area; screening; service coordination; surveillance data; synthetic opioid; telehealth; transmission process

ABSTRACT Outbreaks of HIV and HCV in rural areas of the Midwest have been associated with syringe-sharing among partners injecting nonmedical prescription opioids. Illinois ranks as the third highest state in percentage increase in death rates involving synthetic opiates between 2014-2015. The southernmost 16 counties of Illinois comprise the Illinois Delta Region (IDR) and share many of the characteristics of rural areas that have experienced recent HIV epidemics. A deeper understanding of community characteristics, including transitions from oral to injection opioid use, circumstances for high-risk injection practices, and accessibility to existing and potential health-related resources will be essential to developing models of disease prevention and treatment. Partnering with state and local public health other state agencies, community based programs, local coalitions and healthcare systems, we will take a mixed analytical approach using predictive modeling, GIS analysis, qualitative and survey analysis, network methods, and infectious disease epidemiology to understand geospatial and sociocultural factors impacting health outcomes in people who inject drugs in the IDR. These data will inform evidence-based interventions to strengthen access to disease screening and linkage to care and treatment, expansion of needle exchange and naloxone overdose programs, screening and referral to substance use treatment, and telehealth capacity building for the provision of PrEP, HCV management, and medication-assisted treatment for substance use disorder. UG3 Aim 1. Determine the geographic areas in the rural Illinois Delta Region at greatest risk for opioid misuse and infectious diseases in the IDR based on disease surveillance, healthcare utilization, prescription drug monitoring, arrest and drug seizure, and resource scarcity mapping. UG3 Aim 2. Understand how sociocultural factors impact risk and health seeking behaviors, social networks, and disease transmission of people who inject drugs in high risk geographic areas identified in Aim 1. UG3 Aim 3. Integrate and apply the epidemiological, geospatial, qualitative and network data to inform expanded harm-reduction services and targeted telehealth capacity building for related clinical care. UH3 Aim 1. Expand harm reduction services including syringe services, naloxone overdose prevention, substance use treatment referral, HIV, HCV, HBV and STDs testing and linkage to care through capacity building of existing programs as well as through new local health department based harm reduction units. UH3 Aim 2. Build capacity for HCV management, PrEP, substance use screening, referral, and medication- assisted treatment through telehealth programs targeted at PWID-preferred settings. UH3 Aim 3. Evaluate program implementation based on CDC RE-AIM framework, continued engagement of stakeholders, integration and coordination of services at the state and local level, and sustainability of funding.

抽象的 中西部农村地区艾滋病毒和丙型肝炎病毒的爆发与人们共用注射器有关 注射非医疗处方阿片类药物的伴侣。伊利诺伊州的百分比排名第三 2014 年至 2015 年间，涉及合成阿片剂的死亡率有所上升。最南端16个县 伊利诺伊州由伊利诺伊州三角洲地区 (IDR) 组成，具有许多农村地区的特征 最近经历了艾滋病毒流行。更深入地了解社区特征，包括过渡 从口服阿片类药物到注射阿片类药物的使用、高风险注射做法的情况以及现有和注射阿片类药物的可及性 潜在的健康相关资源对于制定疾病预防和治疗模式至关重要。 与州和地方公共卫生部门、其他州机构、社区项目、地方联盟合作 和医疗保健系统，我们将采用预测建模、GIS 分析的混合分析方法， 定性和调查分析、网络方法和传染病流行病学，以了解 影响 IDR 中注射毒品者健康结果的地理空间和社会文化因素。这些 数据将为循证干预措施提供信息，以加强疾病筛查和护理联系 和治疗、扩大针头交换和纳洛酮过量计划、筛查和转诊 物质使用治疗和远程医疗能力建设，以提供 PrEP、HCV 管理和 物质使用障碍的药物辅助治疗。 UG3 目标 1. 确定伊利诺伊州三角洲农村地区阿片类药物滥用风险最大的地理区域 基于疾病监测、医疗保健利用、处方药的 IDR 中的传染病和传染病 监测、逮捕和缉毒以及资源稀缺测绘。 UG3 目标 2. 了解社会文化因素如何影响风险和寻求健康的行为、社交网络、 目标 1 中确定的高风险地理区域中注射吸毒者的疾病传播情况。 UG3 目标 3. 整合并应用流行病学、地理空间、定性和网络数据来提供信息 扩大减害服务并针对相关临床护理进行有针对性的远程医疗能力建设。 UH3 目标 1. 扩大减少伤害服务，包括注射器服务、纳洛酮过量预防、 物质使用治疗转诊、HIV、HCV、HBV 和 STD 检测以及通过能力与护理联系 建立现有计划以及通过当地卫生部门设立的新的减害单位。 UH3 目标 2. 建设 HCV 管理、PrEP、物质使用筛查、转诊和药物治疗的能力 - 通过针对吸毒者首选环境的远程医疗计划提供辅助治疗。 UH3 目标 3. 根据 CDC RE-AIM 框架评估计划实施情况，持续参与 利益相关者、州和地方层面服务的整合和协调以及资金的可持续性。