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.

抽象的 由于传播持续存在，消除艾滋病毒的最终目标将变得越来越困难 社会最边缘化、最难预防的人群 计划，也是将其纳入流行病学研究中最具挑战性的项目。虽然桑 弗朗西斯科似乎有望在未来几年内实现零新增艾滋病毒感染， 注射吸毒者（PWID）的发展轨迹滞后。下降速度较慢 吸毒者中的艾滋病毒可能是由于认识水平较低和对暴露前的了解程度较低所致 预防（PrEP）。与此同时，邻近的阿拉米达县（奥克兰所在地）几乎没有看到什么。 艾滋病毒流行减少，并且在黑人/非洲裔吸毒者中爆发 美国人或无家可归者。除了艾滋病毒之外，美国的吸毒者还面临着 阿片类药物过量导致死亡人数激增。结束艾滋病毒流行并减轻其他健康问题 为了消除吸毒者之间的差异，数据收集系统需要更加快速、具有代表性和 应对这一高危人群。因此，我们建议建立一个新的流行病学 阿拉米达县和旧金山县的注射吸毒者数据收集系统，名为 Brief 纵向事件哨兵监视（BLISS）。我们将招募 600 名注射吸毒者（每人 300 名） 县）使用一种新颖的基于场地/同行推荐的混合方法，称为海星采样 积累一批并​​纵向跟踪他们。 HIV 检测和基线后 调查问卷，参与者将被征召每月向 11 名哨兵提供简短答复 对艾滋病毒和药物滥用流行病具有高度意义的事件（例如，PrEP 的摄入或 停药、减低危害计划的利用、用药过量经历）。每月数据将是 通过智能手机和在线技术收集，并以现场选项作为备份。 选定的哨点事件将通过生态瞬时触发“深潜”数据收集 评估（EMA）。样本大小旨在检测低速率发生的事件 社区作为预警信号并获得足够的纵向数据来评估因果关系 HIV 风险和预防行为的因素，特别是 PrEP 使用的障碍和促进因素 和坚持。 BLISS 数据将有助于识别和避免疫情爆发、微目标干预、 优先考虑高危人群，满足未满足的护理和预防需求，并结束艾滋病毒流行。