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: 10683947
• 负责人: William McFarland
• 金额: $ 20.57万
• 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/10683947
• 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; Rotation; Sample Size; San Francisco; Sentinel; Sentinel Surveillance; Services; Signal Transduction; Societies; System; Technology; Time; Time trend; cohort; epidemiologic data; epidemiology study; experience; health disparity; high risk; marginalization; 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