Investigator Development Core

研究者开发核心

基本信息

批准号：
10309107
负责人：
Brooke E.E. Montgomery
金额：
$ 17.97万
依托单位：
UNIV OF ARKANSAS FOR MED SCIS
依托单位国家：
美国
项目类别：
财政年份：
2007
资助国家：
美国
起止时间：
2007-09-30 至 2022-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10309107
关键词：
Address Adherence Advocate African American Arkansas COVID-19 COVID-19 disparity COVID-19 mortality COVID-19 outbreak COVID-19 prevention Caring Case Study Cessation of life Characteristics Clinical Services Code Communities County Criminal Justice Data Data Set Development Disease Outbreaks Ecosystem Epidemic Epidemiology Ethnic Origin Evaluation Foundations Funding Future Geographic Locations Goals HIV HIV Infections HIV risk Health Healthcare High Prevalence Imprisonment Incidence Individual Intervention Jail Location Mental disorders Modeling Morality Morbidity - disease rate New York Pharmaceutical Preparations Play Population Poverty Prevalence Prisons Public Health Quarantine Race Recommendation Recording of previous events Research Research Personnel Resources Risk Risk Factors Role Rotation Rural Rural Community Science Sexual Partners Sexually Transmitted Diseases Site Socioeconomic Status Statistical Models Structure System Tenofovir Testing Time Treatment Efficacy United States National Institutes of Health United States Public Health Service Woman Wood material base combat coronavirus disease data repository efficacy testing emtricitabine ethnic minority population evidence base exhaustion experience geographic population health disparity health service use high risk high risk men improved indexing infection rate low socioeconomic status member men men who have sex with men minority health mortality novel open label pandemic disease pre-exposure prophylaxis prison population racial and ethnic rural area rural counties rural underserved rurality sex social socioeconomic disparity socioeconomics substance use substance user trait underserved area underserved rural area uptake urban setting vision science

项目摘要

Abstract Criminal justice (CJ) involved individuals have extremely high prevalence of risk factors associated with HIV infection including poverty, substance use, transactional sex, high numbers of sex partners, high prevalence of sexually transmitted infections and mental illness. African Americans (AA) are at disproportionate risk for both incarceration and HIV infections. A growing body of evidence highlights the efficacy of a once daily medication, emtricitabine/tenofovir, also known as pre-exposure prophylaxis (PrEP), in reducing HIV acquisition. However, structural and social barriers can undermine optimal PrEP uptake, adherence, and retention in care and must be addressed especially among those with recent CJ experience. Our proposed study is directly aligned with NIMHD Science Visioning to advance intervention approaches to improve minority health or to reduce health disparities. Our proposed study will: provide a novel exploration of facilitators and barriers to PrEP; allow us to target hard to reach populations, including MSM and substance users (both of which are top funding priority groups for the National Institutes of Health) who experience intersecting markers of HIV risk; and inform regional, and possibly national, intervention approaches to combat the overlapping epidemic of HIV and incarceration: The specific aims of the project are: Aim 1: Perform a qualitative assessment of facilitators and barriers to PrEP uptake among high-risk jail detainees, systems and interactor levels; Aim 2: Develop the PrEP-LINK intervention and perform an open label evaluation with high-risk individuals being discharged from the Pulaski County Jail; Aim 3: Conduct a pilot RCT of the PrEP-LINK intervention among high-risk men and women being released from the Pulaski County Jail. Results will inform a subsequent multi-site RCT to test efficacy of the intervention in improving PrEP uptake, adherence, and retention in care among men with CJ-experience.

抽象的涉及个人的刑事司法（CJ）与艾滋病毒相关的风险因素的患病率极高感染包括贫困，药物使用，交易性别，高数量的性伴侣，高流行率性传播感染和精神疾病。非洲裔美国人（AA）对这两者的风险不成比例监禁和艾滋病毒感染。越来越多的证据凸显了每天一次药物的功效， Emtricerabine/Tenofovir，也称为预防前预防（PREP），以减少HIV的获取。然而，结构性和社会障碍可能会破坏最佳的预期，遵守和保留率，并且必须特别是在最近有CJ经验的人中。我们提出的研究直接与 NIMHD科学愿景以提高干预方法以改善少数民族健康或减少健康差异。我们提出的研究将：提供对促进者和准备障碍的新颖探索；允许我们目标难以到达人口，包括MSM和药物用户（这都是最重要的优先级美国国立卫生研究院的小组，经历与艾滋病毒风险相交的标记；并告知区域，甚至可能是国家的干预方法，以打击艾滋病毒和艾滋病毒的重叠流行监禁：项目的具体目的是：目标1：对促进者进行定性评估以及在高危监狱被拘留者，系统和互动级别中进行预先吸收的障碍；目标2：开发预订干预并与高风险个体进行开放标签评估从普拉斯基县监狱出院； AIM 3：进行准备链接的飞行员RCT 从普拉斯基县监狱释放的高风险男女之间的干预。结果将告知随后的多站点RCT，以测试干预措施改善预备摄取，依从性，并保留CJ经验的男性。