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项目总结摘要 在持续流行的阿片类药物和多物质使用中，艾滋病毒传播归因于注射吸毒 正在威胁着美国几十年来预防艾滋病毒的进展。艾滋病毒检测和随后的 在注射毒品(PWID)人群中，参与艾滋病毒预防和护理服务的情况不佳 到多层次的障碍，包括低医疗保健利用率、耻辱、无家可归和有限的交通。艾滋病病毒 自我检测(HIVST)是一种谨慎、方便和授权的艾滋病毒检测策略，具有巨大的潜力 提高艾滋病患者的艾滋病毒检测覆盖率。注射器服务计划(SSP)，成功地促进了 无菌注射器、纳洛酮和其他减少危害用品的二次分发(即同行分发)， 都独一无二地准备扩大HIVST进入其客户的社交网络(即PWID)的范围。 利用我们与内陆帝国减少危害(IEHR)SSP的现有伙伴关系来结束艾滋病毒 疫情(EHE)优先管辖加利福尼亚州河滨县(RC)，该项目旨在开发和 评估“预防大使”(PA)干预措施，以促进艾滋病毒检测和参与艾滋病毒 通过二次分发HIVST试剂盒和当地艾滋病毒服务，在PWID中提供预防和护理服务 社会服务中艾滋病毒服务导航的信息和转介(以下称为HIVST+信息/转介) SSP客户端的网络。在创新扩散(DOI)理论的启发下，这种新颖的干预措施适应了 有效的基于社会网络的艾滋病预防干预措施扩大iEHR的二次分布 将无菌注射器和纳洛酮(即iEHR护理标准；SOC)纳入HIVST加信息/转诊。 在这个分两个阶段的项目中，我们将首先与PWID和SSP/HIV服务提供商进行迭代过程 在RC中调整、预测和改进PA，以培训PWID(索引)以向其分发HIVST+信息/推荐 社交网络中的其他PWID(同龄人招募；目标1)。接下来，我们将试点PA，随机选择50个指数 1：1到PA或SOC，以检查PA(与SOC)对指标和~100名同行新兵HIV的初步影响 检测和艾滋病毒服务参与结果(与PrEP/HIV护理的联系，PrEP/ART的吸收；AIM 2)；探索 个人和社会网络特征是否会改变PA的效果(目标3)；并探索PA 可接受性、可行性和指数、同行招聘和当地SSP/艾滋病毒服务的改进领域 使用混合方法的提供者(AIM 4)。结果将通过调查、医疗记录、 和定性访谈。研究结果将支持未来的R01疗效试验和潜在的PA传播 全国其他SSP加快努力，在残疾人中结束艾滋病毒流行。