Brief Longitudinal Incident Sentinel Surveillance (BLISS) to End the HIV Epidemic among Persons Who Inject Drugs (PWID)

简短的纵向事件哨点监测 (BLISS) 以结束注射吸毒者 (PWID) 中的艾滋病毒流行

• 批准号: 10458903
• 负责人: William McFarland
• 金额: $ 17.81万
• 依托单位: SAN FRANCISCO DEPARTMENT OF PUBLIC HEALTH
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-15 至 2027-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10458903
• 关键词: Adherence; African American; African American population; Awareness; Back; Baseline Surveys; Behavior; Black race; California; Caring; Cellular Phone; Cessation of life; Cities; Communities; County; Data; Data Collection; Disease Outbreaks; Drug usage; Ecological momentary assessment; Enrollment; Epidemic; Epidemiology; Equipment and supply inventories; Event; HIV; HIV Infections; HIV diagnosis; HIV risk; Harm Reduction; Home; Homelessness; Human immunodeficiency virus test; Hybrids; Infection; Injecting drug user; Intervention; Interview; Methods; Outcome; Overdose; Participant; Pattern; Persons; Population; Prevalence; Prevention; Prevention program; Preventive; Questionnaires; Reporting; Risk; Risk Behaviors; Sample Size; San Francisco; Sentinel; Sentinel Surveillance; Services; Signal Transduction; Societies; System; Technology; Time; Time trend; base; cohort; epidemiologic data; epidemiology study; experience; health disparity; high risk; men who have sex with men; novel; opioid overdose; outreach; overdose prevention; peer; pre-exposure prophylaxis; programs; recruit; response; starfish sampling; substance use; success; surveillance data; transmission process; uptake

ABSTRACT The endgame for eliminating HIV will become increasingly difficult as transmission persists in populations who are the most marginalized from society, the hardest to reach with prevention programs, and the most challenging to include in epidemiological studies. Although San Francisco appears on track to achieve zero new HIV infections within the next few years, the trajectory among people who inject drugs (PWID) lags behind. The slower rate of decrease in HIV among PWID may be due to lower levels of awareness and uptake of pre-exposure prophylaxis (PrEP). Meanwhile, neighboring Alameda County (home to Oakland) has seen little decrease in the HIV epidemic, and outbreaks occur among PWID who are Black/African American or experiencing homelessness. In addition to HIV, PWID in the US are experiencing a surge in deaths due opioid overdose. To end the HIV epidemic and mitigate other health disparities for PWID, data collection systems need to be more rapid, representative, and responsive to this population at high risk. We therefore propose to create a new epidemiological data collection system for PWID in Alameda and San Francisco counties called Brief Longitudinal Incident Sentinel Surveillance (BLISS). We will recruit 600 PWID (300 each in county) using a novel venue-based / peer-referral hybrid method called Starfish Sampling to accrue a cohort and follow them longitudinally. Following HIV testing and a baseline questionnaire, participants will be enlisted to provide monthly brief responses to 11 sentinel events of high significance to the HIV and substance use epidemics (e.g., PrEP uptake or discontinuation, harm reduction program utilization, overdose experiences). Monthly data will be collected through smart phone and online technologies with in-person options as back up. Selected sentinel events will trigger “deeper dive” data collection through ecological momentary assessments (EMAs). The sample size is geared to detect events occurring at low rates in the community as early warning signals and to obtain sufficient longitudinal data to assess causal factors for HIV risk and preventive behaviors, particularly barriers and facilitators to PrEP use and adherence. BLISS data will help identify and avert outbreaks, micro-target interventions, prioritize those at highest risk, fill unmet care and prevention needs, and end the HIV epidemic.

摘要 随着艾滋病毒的持续传播，消除艾滋病毒的最后阶段将变得越来越困难， 被社会边缘化程度最高、最难获得预防服务的人群 项目，最具挑战性的包括在流行病学研究。虽然San 弗朗西斯科似乎有望在未来几年内实现艾滋病毒感染率为零的目标， 注射毒品者（PWID）的轨迹落后。下降速度较慢， 艾滋病毒在PWID可能是由于较低水平的认识和吸收前暴露 PrEP（PrEP）。与此同时，邻近的阿拉米达县（奥克兰的所在地）几乎没有看到什么 艾滋病毒流行减少，在黑人/非洲裔艾滋病感染者中爆发疫情 美国人或无家可归者。除了艾滋病毒，美国的PWID正在经历一场 因阿片类药物过量而死亡的人数激增。结束艾滋病毒流行并减轻其他健康问题 由于PWID的差异，数据收集系统需要更加快速，具有代表性， 对这些高危人群做出反应。因此，我们建议建立一个新的流行病学 阿拉米达和弗朗西斯科县的PWID数据收集系统，称为Brief 纵向事件哨点监测（布利斯）。我们将招募600名PWID（每名300人， 县）使用一种新的基于场地/同行推荐的混合方法，称为海星抽样， 累积一个队列并纵向跟踪它们。在艾滋病毒检测和基线 问卷，参与者将被招募提供每月简要回应11个哨兵 对艾滋病毒和药物使用流行病具有重要意义的事件（例如，PrEP摄取或 停药、危害减少计划利用、过量用药经历）。每月数据将 通过智能手机和在线技术收集，并以亲自选择作为备份。 选定的哨兵事件将触发“更深的潜水”数据收集， 评估（EMA）。样本大小适合于检测在低发生率的事件， 作为早期预警信号，并获得足够的纵向数据， 艾滋病毒风险和预防行为的因素，特别是使用PrEP的障碍和促进因素 和坚持。布利斯数据将有助于识别和避免疫情，微观目标干预， 优先考虑高危人群，满足未得到满足的护理和预防需求，并结束艾滋病毒的流行。