Prevention Ambassadors: an HIV self-testing intervention to promote HIV service engagement in the networks of SSP clients

预防大使：艾滋病毒自我检测干预措施，以促进 SSP 客户网络中艾滋病毒服务的参与

• 批准号: 10682911
• 负责人: Angela Robertson Bazzi
• 金额: $ 24.64万
• 依托单位: SAN DIEGO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-04-15 至 2026-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10682911
• 关键词: AIDS prevention; Acceleration; Area; Authorization documentation; Behavior; California; Caring; Characteristics; Client; Collaborations; Communities; County; Data; Diagnostic Reagent Kits; Diffusion of Innovation; Disease Outbreaks; Epidemic; Face; Fentanyl; Frequencies; Future; Goals; HIV; HIV diagnosis; Harm Reduction; Health; Homelessness; Human immunodeficiency virus test; Individual; Information Services; Injecting drug user; Injections; Intervention; Interview; Medical; Medical Records; Methamphetamine; Methods; Naloxone; Needle-Exchange Programs; Network-based; Newly Diagnosed; Outcome; Phase; Police; Prevention; Process; Randomized; Research; Services; Social Network; Sterility; Surveys; Syringes; Testing; Training; Transportation; Trust; United States; Visit; Work; acceptability and feasibility; authority; care systems; efficacy trial; empowerment; experience; follow-up; health care service utilization; health care settings; indexing; injection drug use; member; novel; opioid use; peer; pilot test; pilot trial; polysubstance use; pre-exposure prophylaxis; prevention service; preventive intervention; recruit; self testing; service engagement; service providers; service uptake; sexual risk behavior; social; social influence; social stigma; standard of care; stimulant use; success; testing uptake; theories; transmission process; trend; uptake

100.7 PROJECT SUMMARY ABSTRACT Amidst the ongoing opioid and polysubstance use epidemics, HIV transmission attributed to injection drug use is threatening decades of HIV prevention progress in the United States. HIV testing and subsequent engagement in HIV prevention and care services are suboptimal among people who inject drugs (PWID) due to multilevel barriers including low healthcare utilization, stigma, homelessness, and limited transportation. HIV self-testing (HIVST) is a discreet, convenient, and empowering HIV testing strategy with great potential to increase HIV testing coverage among PWID. Syringe service programs (SSPs), which successfully promote the secondary distribution (i.e., peer delivery) of sterile syringes, naloxone, and other harm reduction supplies, are uniquely poised to increase the reach of HIVST into the social networks of their clients (i.e., PWID). Leveraging our existing partnership with the Inland Empire Harm Reduction (IEHR) SSP in the Ending the HIV Epidemic (EHE) priority jurisdiction of Riverside County (RC), California, this project seeks to develop and evaluate the “Prevention Ambassadors” (PA) intervention to promote HIV testing and engagement in HIV prevention and care services among PWID via the secondary distribution of HIVST kits with local HIV service information and referrals to HIV service navigation (hereafter “HIVST plus information/referrals”) in the social networks of SSP clients. This novel intervention, informed by the Diffusion of Innovations (DOI) theory, adapts effective social network-based HIV prevention interventions for PWID to extend IEHR’s secondary distribution of sterile syringes and naloxone (i.e., IEHR standard of care; SOC) to include HIVST plus information/referrals. In this two-phase project, we will first engage in an iterative process with PWID and SSP/HIV service providers in RC to adapt, pretest, and refine PA to train PWID (indexes) to distribute HIVST plus information/referrals to other PWID in their social networks (peer-recruits; AIM 1). Next, we will pilot PA with 50 indexes randomized 1:1 to PA or SOC to examine the preliminary effect of PA (vs. SOC) on indexes’ and ~100 peer-recruits’ HIV testing and HIV service engagement outcomes (linkage to PrEP/HIV care, PrEP/ART uptake; AIM 2); explore whether individual and social network characteristics modify the effects of PA (AIM 3); and explore PA acceptability, feasibility, and areas for refinement among indexes, peer-recruits, and local SSP/HIV service providers using a mixed-methods approach (AIM 4). Outcomes will be assessed via surveys, medical records, and qualitative interviews. Findings will support a future R01 efficacy trial and potential PA dissemination to other SSPs nationally to accelerate efforts to end the HIV epidemic among PWID.

100.7项目摘要 在阿片类药物和多种物质使用流行的持续期间，艾滋病毒的传播归因于注射吸毒 正在威胁着美国几十年来艾滋病预防的进展。艾滋病毒检测及后续 艾滋病毒预防和护理服务的参与在注射吸毒者中是次优的， 多层次的障碍，包括医疗保健利用率低，耻辱，无家可归和有限的交通。艾滋病毒 自我检测（HIVST）是一种谨慎、方便和授权的艾滋病毒检测策略，具有很大的潜力， 提高艾滋病毒检测在残疾妇女中的覆盖率。注射器服务计划（SSP），成功地促进了 二次分布（即，同行递送）无菌注射器、纳洛酮和其他减少危害的用品， 是唯一准备增加艾滋病毒/艾滋病传播到他们的客户的社交网络（即，PWID）。 利用我们与内陆帝国减少危害（IEHR）SSP的现有合作伙伴关系来终结艾滋病毒 加州滨江县（RC）的流行病（EHE）优先管辖权，该项目旨在开发和 评估“预防大使”的干预措施，以促进艾滋病毒检测和参与艾滋病毒 通过与当地艾滋病毒服务机构一起二次分发艾滋病毒/艾滋病防治工具包，为残疾人提供预防和护理服务 信息和转介到艾滋病毒服务导航（以下简称“艾滋病毒加信息/转介”）， SSP客户端网络。这种新的干预，由创新扩散（DOI）理论提供信息， 为艾滋病感染者提供有效的基于社会网络的艾滋病毒预防干预措施，以扩大《国际教育人权报告》的二次分发 无菌注射器和纳洛酮（即，IEHR护理标准（SOC），包括艾滋病毒/艾滋病加信息/转诊。 在这两个阶段的项目中，我们将首先与PWID和SSP/HIV服务提供者进行迭代过程 在驻地协调员中，调整、预先测试和改进PA，以培训PWID（索引），将艾滋病毒/艾滋病防治和预防信息/转诊信息分发给 其他PWID在他们的社交网络中（同伴招募; AIM 1）。接下来，我们将用随机化的50个指标进行PA试验 以1：1的比例与PA或SOC进行比较，以检查PA（与SOC）对指标和约100名同伴新兵HIV的初步影响 检测和艾滋病毒服务参与结果（与PrEP/艾滋病毒护理，PrEP/ART摄取的联系; AIM 2）;探索 个人和社会网络特征是否改变PA的影响（AIM 3）;并探索PA 指标、同伴招募和当地SSP/HIV服务之间的可接受性、可行性和改进领域 使用混合方法的供应商（AIM 4）。结果将通过调查、医疗记录、 定性访谈。研究结果将支持未来的R 01疗效试验和潜在的PA传播， 全国其他SSP加快努力，结束艾滋病毒在艾滋病患者中的流行。