Quantifying health policy impacts on substance use and treatment among women with and at risk for HIV: a longitudinal multilevel analysis using the Women's Interagency HIV Study

量化卫生政策对感染艾滋病毒和有感染艾滋病毒风险的妇女的药物使用和治疗的影响:利用妇女机构间艾滋病毒研究进行纵向多层次分析

基本信息

项目摘要

PROJECT SUMMARY/ABSTRACT Substance use (SU), including hazardous alcohol use, is common among women with HIV in the United States (US) and rates exceed those of the general female population. Substance-using women with HIV are less likely to initiate and adhere to antiretroviral medications, which has important implications for morbidity, mortality, and HIV transmission. Drug and alcohol treatment mitigates these effects, but is underutilized. In addition, high-dose opioid pain therapy is prevalent among people with HIV, increasing their risk of prescription drug misuse. Marijuana may serve as an alternative for opioid-based pain management, but marijuana's effect on HIV clinical outcomes is unclear. Several policy initiatives have the potential to influence SU and drug and alcohol treatment in the US by: 1) curbing inappropriate prescribing practices for pain management (e.g., prescription drug monitoring programs [PDMPs]); 2) increasing access to drug and alcohol treatment (e.g., health parity laws [HPLs]); and 3) legalizing marijuana use for medical purposes (e.g., medical marijuana laws [MMLs]). Yet, little is known about how these health policies impact women with HIV. Studies suggest that these policies have benefits (e.g., HPLs associated with drug treatment). Others found negative or unintended consequences (e.g., MMLs associated with more alcohol, but less opioid use). This K01 leverages participant- level data from the NIH-funded Women's Interagency HIV Study by integrating cohort data with contextual data (e.g., Prescription Drug Abuse Policy System) capturing the policy and health care access environments where these women live. The proposed study will use a longitudinal, multilevel design to generate evidence on how health policies impact SU and drug and alcohol treatment among women with and without HIV in the US, and elucidate the pathways through which health policies shape HIV viral suppression among women with HIV. The specific aims are: Aim 1. Assess relationships between PDMPs and prescribed and non-prescribed opioid use over time, examining the modifying role of HIV status and race. Aim 2. Assess relationships between HPLs, access to drug and alcohol treatment, and treatment utilization over time, examining the modifying role of HIV status, health insurance, and patterns of SU. Aim 3: Assess relationships between MMLs, access to legalized marijuana, and marijuana use and hazardous drinking, examining the modifying role of HIV status and patterns of SU. Aim 4: Among women with HIV, assess the impact of PDMPS, HPLs, and MMLs on HIV viral suppression, examining the mediating or modifying role of SU and drug and alcohol treatment. To accomplish these aims the applicant will receive training in: 1) the epidemiology of SU, 2) empirical policy analysis, and 3) advanced longitudinal multilevel analysis, under the direction of University of North Carolina at Chapel Hill faculty Drs. Vivian Go, Adaora Adimora, Mark Holmes, and Daniel Bauer. These analyses will to inform future policy and structural interventions by generating causal evidence on how policies influence SU and alcohol and drug treatment over time among US women with and at risk of HIV.
项目总结/摘要 物质使用(SU),包括危险的酒精使用,在美国感染艾滋病毒的妇女中很常见。 美国各州和比率超过一般女性人口。感染艾滋病毒的使用药物的妇女 不太可能开始和坚持使用抗逆转录病毒药物,这对发病率有重要影响, 死亡率和艾滋病毒传播。药物和酒精治疗减轻了这些影响,但未得到充分利用。在 此外,高剂量阿片类药物疼痛治疗在艾滋病毒感染者中很普遍,增加了他们的处方风险。 滥用药物大麻可能作为阿片类药物疼痛管理的替代品,但大麻的作用 艾滋病临床结果尚不清楚。一些政策举措有可能影响SU和药物, 美国的酒精治疗通过:1)抑制用于疼痛管理的不适当的处方实践(例如, 处方药监测计划[PDMP]); 2)增加获得药物和酒精治疗的机会(例如, 健康平等法[HPLs]);以及3)将大麻用于医疗目的合法化(例如,医用大麻法律 [MML])。然而,人们对这些卫生政策如何影响感染艾滋病毒的妇女知之甚少。研究表明 这些策略具有益处(例如,与药物治疗相关的HPL)。其他人发现负面或意外 后果(例如,MML与更多的酒精相关,但阿片类药物使用较少)。此K 01利用参与者- 通过整合队列数据和背景数据, (e.g.,处方药滥用政策系统),捕捉政策和卫生保健准入环境, 这些女人活着。拟议的研究将使用纵向,多水平设计,以产生证据,说明如何 卫生政策影响美国感染和不感染艾滋病毒的妇女的SU和药物及酒精治疗, 阐明卫生政策在感染艾滋病毒的妇女中形成艾滋病毒抑制的途径。 具体目标是:目标1。评估PDMP与处方和非处方之间的关系 随着时间的推移阿片类药物的使用,检查艾滋病毒状态和种族的修改作用。目标二。评估关系 HPL之间,获得药物和酒精治疗,以及治疗利用率随着时间的推移,检查 艾滋病毒状况,健康保险和SU模式的修改作用。目标3:评估 MML,获得合法大麻,大麻使用和危险饮酒,检查修改 艾滋病毒感染状况和SU模式的作用。目标4:在感染艾滋病毒的妇女中,评估PDMPS、HPL、 和MML对HIV病毒抑制的作用,检查SU、药物和酒精的介导或修饰作用 治疗为了实现这些目标,申请人将接受以下方面的培训:1)SU的流行病学,2) 实证政策分析,3)先进的纵向多层次分析,在大学的指导下, 北卡罗来纳州查佩尔山的教授薇薇安·戈博士、阿达奥拉·阿迪莫拉博士、马克·霍姆斯博士和丹尼尔·鲍尔博士。这些 分析将为未来的政策和结构性干预提供信息,提供有关政策如何 影响SU和酒精和药物治疗随着时间的推移在美国妇女与艾滋病毒的风险。

项目成果

期刊论文数量(3)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
Measuring small-area violent crime: a comparison of observed versus model-estimated crime rates and preterm birth.
  • DOI:
    10.1016/j.annepidem.2020.11.008
  • 发表时间:
    2021-03
  • 期刊:
  • 影响因子:
    5.6
  • 作者:
    Gobaud AN;Kramer MR;Stearns ER;Haley DF
  • 通讯作者:
    Haley DF
{{ item.title }}
{{ item.translation_title }}
  • DOI:
    {{ item.doi }}
  • 发表时间:
    {{ item.publish_year }}
  • 期刊:
  • 影响因子:
    {{ item.factor }}
  • 作者:
    {{ item.authors }}
  • 通讯作者:
    {{ item.author }}

数据更新时间:{{ journalArticles.updateTime }}

{{ item.title }}
  • 作者:
    {{ item.author }}

数据更新时间:{{ monograph.updateTime }}

{{ item.title }}
  • 作者:
    {{ item.author }}

数据更新时间:{{ sciAawards.updateTime }}

{{ item.title }}
  • 作者:
    {{ item.author }}

数据更新时间:{{ conferencePapers.updateTime }}

{{ item.title }}
  • 作者:
    {{ item.author }}

数据更新时间:{{ patent.updateTime }}

Danielle Frances Haley其他文献

Danielle Frances Haley的其他文献

{{ item.title }}
{{ item.translation_title }}
  • DOI:
    {{ item.doi }}
  • 发表时间:
    {{ item.publish_year }}
  • 期刊:
  • 影响因子:
    {{ item.factor }}
  • 作者:
    {{ item.authors }}
  • 通讯作者:
    {{ item.author }}

{{ truncateString('Danielle Frances Haley', 18)}}的其他基金

Quantifying health policy impacts on substance use and treatment among women with and at risk for HIV: a longitudinal multilevel analysis using the Women's Interagency HIV Study
量化卫生政策对感染艾滋病毒和有感染艾滋病毒风险的妇女的药物使用和治疗的影响:利用妇女机构间艾滋病毒研究进行纵向多层次分析
  • 批准号:
    10219745
  • 财政年份:
    2020
  • 资助金额:
    $ 17.59万
  • 项目类别:
Quantifying health policy impacts on substance use and treatment among women with and at risk for HIV: a longitudinal multilevel analysis using the Women's Interagency HIV Study
量化卫生政策对感染艾滋病毒和有感染艾滋病毒风险的妇女的药物使用和治疗的影响:利用妇女机构间艾滋病毒研究进行纵向多层次分析
  • 批准号:
    9954037
  • 财政年份:
    2020
  • 资助金额:
    $ 17.59万
  • 项目类别:
Neighborhood Factors, Sexual Risk, and STIs in HIV-Infected and High-Risk Women
HIV 感染者和高危女性的邻里因素、性风险和性传播感染
  • 批准号:
    8788761
  • 财政年份:
    2014
  • 资助金额:
    $ 17.59万
  • 项目类别:

相似海外基金

Rational design of rapidly translatable, highly antigenic and novel recombinant immunogens to address deficiencies of current snakebite treatments
合理设计可快速翻译、高抗原性和新型重组免疫原,以解决当前蛇咬伤治疗的缺陷
  • 批准号:
    MR/S03398X/2
  • 财政年份:
    2024
  • 资助金额:
    $ 17.59万
  • 项目类别:
    Fellowship
Re-thinking drug nanocrystals as highly loaded vectors to address key unmet therapeutic challenges
重新思考药物纳米晶体作为高负载载体以解决关键的未满足的治疗挑战
  • 批准号:
    EP/Y001486/1
  • 财政年份:
    2024
  • 资助金额:
    $ 17.59万
  • 项目类别:
    Research Grant
CAREER: FEAST (Food Ecosystems And circularity for Sustainable Transformation) framework to address Hidden Hunger
职业:FEAST(食品生态系统和可持续转型循环)框架解决隐性饥饿
  • 批准号:
    2338423
  • 财政年份:
    2024
  • 资助金额:
    $ 17.59万
  • 项目类别:
    Continuing Grant
Metrology to address ion suppression in multimodal mass spectrometry imaging with application in oncology
计量学解决多模态质谱成像中的离子抑制问题及其在肿瘤学中的应用
  • 批准号:
    MR/X03657X/1
  • 财政年份:
    2024
  • 资助金额:
    $ 17.59万
  • 项目类别:
    Fellowship
CRII: SHF: A Novel Address Translation Architecture for Virtualized Clouds
CRII:SHF:一种用于虚拟化云的新型地址转换架构
  • 批准号:
    2348066
  • 财政年份:
    2024
  • 资助金额:
    $ 17.59万
  • 项目类别:
    Standard Grant
BIORETS: Convergence Research Experiences for Teachers in Synthetic and Systems Biology to Address Challenges in Food, Health, Energy, and Environment
BIORETS:合成和系统生物学教师的融合研究经验,以应对食品、健康、能源和环境方面的挑战
  • 批准号:
    2341402
  • 财政年份:
    2024
  • 资助金额:
    $ 17.59万
  • 项目类别:
    Standard Grant
The Abundance Project: Enhancing Cultural & Green Inclusion in Social Prescribing in Southwest London to Address Ethnic Inequalities in Mental Health
丰富项目:增强文化
  • 批准号:
    AH/Z505481/1
  • 财政年份:
    2024
  • 资助金额:
    $ 17.59万
  • 项目类别:
    Research Grant
ERAMET - Ecosystem for rapid adoption of modelling and simulation METhods to address regulatory needs in the development of orphan and paediatric medicines
ERAMET - 快速采用建模和模拟方法的生态系统,以满足孤儿药和儿科药物开发中的监管需求
  • 批准号:
    10107647
  • 财政年份:
    2024
  • 资助金额:
    $ 17.59万
  • 项目类别:
    EU-Funded
Ecosystem for rapid adoption of modelling and simulation METhods to address regulatory needs in the development of orphan and paediatric medicines
快速采用建模和模拟方法的生态系统,以满足孤儿药和儿科药物开发中的监管需求
  • 批准号:
    10106221
  • 财政年份:
    2024
  • 资助金额:
    $ 17.59万
  • 项目类别:
    EU-Funded
Recite: Building Research by Communities to Address Inequities through Expression
背诵:社区开展研究,通过表达解决不平等问题
  • 批准号:
    AH/Z505341/1
  • 财政年份:
    2024
  • 资助金额:
    $ 17.59万
  • 项目类别:
    Research Grant
{{ showInfoDetail.title }}

作者:{{ showInfoDetail.author }}

知道了