Harnessing big data to arrest the HIV/HCV/opioid syndemic in the rural and urban South
利用大数据遏制南方农村和城市的艾滋病毒/丙型肝炎/阿片类药物流行病
基本信息
- 批准号:10696612
- 负责人:
- 金额:$ 37.19万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2023
- 资助国家:美国
- 起止时间:2023-06-01 至 2028-03-31
- 项目状态:未结题
- 来源:
- 关键词:Acquired Immunodeficiency SyndromeAcute HepatitisAcute Hepatitis CAddressAffectAlabamaAntibodiesAntigensAreaBehaviorBehavioralBig DataCOVID-19COVID-19 pandemicCenters for Disease Control and Prevention (U.S.)Cessation of lifeCharacteristicsChronic Hepatitis CClassificationCollaborationsCountyDataDiseaseDisease OutbreaksEpidemicEpidemiologistEpidemiologyEventFundingFutureHIVHIV diagnosisHIV riskHIV/AIDSHIV/HCVHealthHepatitis CHepatitis C IncidenceHepatitis C TransmissionHepatitis C co-infectionHepatitis C virusIncidenceIndianaIndividualInterventionKentuckyLaboratoriesLawsLegalLinkLiteratureMethodsMindModelingMonitorNaloxoneNeedle-Exchange ProgramsNeighborhoodsNucleic Acid Amplification TestsOpiate AddictionOpioidOutcomeOverdosePatternPersonsPharmaceutical PreparationsPoliciesPopulationPopulations at RiskPovertyPredispositionPregnant WomenPrescription drug overdosePreventionPrevention ResearchProbabilityProxyPublic HealthReportingResearchResearch PersonnelResourcesRiskRisk BehaviorsRoleRuralRural CommunityRural PopulationScourgeSourceSouth CarolinaSurveillance ProgramSystemTennesseeTerritorialityTestingTimeTranslatingTransportationUnited States National Institutes of HealthUpdateUrban CommunityViralVirginiaWest VirginiaWorkassaultcausal modelco-infectioncomorbiditycontextual factorsdashboarddata disseminationepidemiological modelepidemiology studyfetalheterogenous datahigh rewardhigh riskimprovedindexinginformatics infrastructureinjection drug useinterestmathematical modelmortalitynovelopioid abuseopioid epidemicopioid injectionopioid overdoseopioid policyopioid useoutcome disparitiesoverdose deathoverdose preventionpandemic preparednesspredictive modelingprescription opioidpreventprogramspublic health interventionpublic health relevancerural arearural residencerural settingsharing platformsocial health determinantssociodemographicssubstance usesyndemictransmission processurban areaurban setting
项目摘要
Project Summary / Abstract
The HIV, HCV, and opioid epidemics disparately impact populations in different regions of the US, with
higher burden (51% of new HIV diagnoses in the US) and poorer outcomes (highest HIV mortality in the US, at
6-10 per 1,000 persons with HIV) in the South, particularly largely rural states. Southern states also rank
among those with the highest rates of acute and chronic Hepatitis C virus (HCV), with massive increases in
HCV infections due to injected opioid use in Tennessee, Kentucky, Virginia, and West Virginia between 2006
and 2012 (from 1 to nearly 4 per 100,000). The region has also seen a dramatic increase in overdose mortality
during the COVID-19 pandemic (West Virginia and Tennessee ranked 1st and 3rd in the US, respectively, with
≥50 deaths per 100,000), with opioid abuse a continued driver of the regional HIV/HCV syndemic.
With the relatively recent HIV/HCV outbreak in Scott County, Indiana in mind, the CDC assessed
county-level vulnerabilities to an HIV outbreak based on acute HCV infection. Acute HCV infection was used
as a proxy of high HIV risk due to the proximal cause of shared injection drug use, an increasingly common
practice in areas afflicted with high rates of opioid use and overdose. The research directly informed the
initiation of the Tennessee Prescription Drug Overdose Program, a CDC-funded surveillance system to monitor
both fatal and non-fatal drug overdoses. Reporting requirements have also been revamped and a new
informatics infrastructure has been created to accommodate automated laboratory uploads of viral hepatide
antibody, antigen, and nucleic acid testing to ascertain acute HCV infection, alongside the state’s already
robust HIV surveillance program. Similar programs now exist in 32 states. In addition, over the past several
years, syringe service programs and expanded access to non-prescription naloxone were made legal under
Public Chapters 413 and 596 in Tennessee, while the state’s “fetal assault” law, along with similar ones in
Alabama and South Carolina, penalized expectant mothers with opioid addictions until recently.
The proposed research will therefore harmonize, link, and analyze readily available “big data” sources
to enhance the epidemiology of HIV, HIV/HCV co-infection, and opioid overdose mortality outcomes which will
inform HIV/HCV and overdose prevention and treatment activities by improving the targeting of highest-
risk/highest-reward populations for their receipt (Aims 1 and 2). Assessing the impact of individual behavior
and environmental context (neighborhood characteristics such as structural poverty and disorder, lack of
transportation, etc.) as well as policy changes on these outcomes will be an essential addition to the literature,
and as importantly, to data dissemination platforms (e.g., dashboards) which will improve deployment of
prevention and treatment activities in southern states (Aims 1, 2, and 3). Using epidemiologic research to
inform policy, while creating dissemination platforms which may be updated and re-deployed in future for
regional pandemic preparedness, means this work will remain a valuable resource for years to come.
项目摘要/摘要
艾滋病毒、丙型肝炎病毒和阿片类药物的流行对美国不同地区的人口产生了不同的影响,
更高的负担(美国新诊断的艾滋病毒病例的51%)和更差的结果(美国艾滋病毒死亡率最高,为
在南方,特别是农村各州,每1000名艾滋病毒携带者中有6至10人感染艾滋病毒。南部各州也排在
在急性和慢性丙型肝炎病毒(丙型肝炎病毒)感染率最高的人群中,
2006年间田纳西州、肯塔基州、弗吉尼亚州和西弗吉尼亚州注射阿片类药物引起的丙型肝炎病毒感染
和2012年(从每10万人中有1人增加到近4人)。该地区的服药过量死亡率也大幅上升。
在新冠肺炎大流行期间(西弗吉尼亚州和田纳西州分别位居美国第一和第三位,
每100 000人中有50人死于≥),阿片类药物滥用是区域艾滋病毒/丙型肝炎综合征的持续驱动因素。
考虑到印第安纳州斯科特县最近爆发的艾滋病毒/丙型肝炎病毒,疾控中心评估
基于急性丙型肝炎病毒感染的艾滋病毒暴发的县级脆弱性。使用急性丙型肝炎病毒感染
由于共用注射毒品的近端原因,作为艾滋病毒高风险的代表,越来越普遍
在阿片类药物使用率和过量使用率较高的地区进行实践。这项研究直接向
启动田纳西州处方药过量计划,这是一个由疾病预防控制中心资助的监测系统
致命性和非致命性药物过量。报告要求也进行了修改,并建立了新的
建立了信息学基础设施,以适应病毒肝炎病毒的自动实验室上传
抗体、抗原和核酸检测以确定急性丙型肝炎病毒感染,同时国家已经
强有力的艾滋病毒监测计划。类似的项目现在分布在32个州。另外,在过去的几年里,
多年来,注射器服务计划和扩大获得非处方药纳洛酮的机会在
田纳西州的第413章和第596章是公开的,而该州的“胎儿侵害法”以及田纳西州的类似法律
阿拉巴马州和南卡罗来纳州,直到最近还惩罚有阿片成瘾的孕妇。
因此,拟议的研究将协调、链接和分析现成的“大数据”来源
加强艾滋病毒、艾滋病毒/丙型肝炎病毒混合感染和阿片类药物过量死亡后果的流行病学,这将
为艾滋病毒/丙型肝炎病毒和过量用药预防和治疗活动提供信息,提高对最高-
风险/最高回报人群的收入(目标1和2)。评估个人行为的影响
和环境背景(邻里特征,如结构性贫困和无序,缺乏
交通等)以及对这些结果的政策变化将是对文献的重要补充,
同样重要的是,到数据传播平台(例如仪表板),这将改善
南部各州的预防和治疗活动(目标1、2和3)。利用流行病学研究
告知政策,同时创建传播平台,这些平台可能会在未来更新和重新部署
地区性大流行准备意味着这项工作在未来几年仍将是一项宝贵的资源。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Peter F Rebeiro其他文献
Peter F Rebeiro的其他文献
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{{ truncateString('Peter F Rebeiro', 18)}}的其他基金
The HIV Care Continuum and Health Policy: Changes through Context and Geography
艾滋病毒护理连续体和卫生政策:环境和地理的变化
- 批准号:
9523428 - 财政年份:2017
- 资助金额:
$ 37.19万 - 项目类别:
The HIV Care Continuum and Health Policy: Changes through Context and Geography
艾滋病毒护理连续体和卫生政策:环境和地理的变化
- 批准号:
10172831 - 财政年份:2017
- 资助金额:
$ 37.19万 - 项目类别:
The HIV Care Continuum and Health Policy: Changes through Context and Geography
艾滋病毒护理连续体和卫生政策:环境和地理的变化
- 批准号:
9410134 - 财政年份:2017
- 资助金额:
$ 37.19万 - 项目类别:
Epidemiology of Clinical Retention Among HIV-Infected Persons in North America
北美 HIV 感染者临床保留的流行病学
- 批准号:
8540794 - 财政年份:2013
- 资助金额:
$ 37.19万 - 项目类别:
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