Ethno-epidemiology of HCV, HIV and Overdose associated with Drug Markets and Drug Tourism

与毒品市场和毒品旅游相关的丙型肝炎病毒、艾滋病毒和药物过量的民族流行病学

• 批准号: 10704856
• 负责人: STEFFANIE A. STRATHDEE
• 金额: $ 54.75万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-04-01 至 2025-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10704856
• 关键词: Address; Border Community; Characteristics; Cities; Cocaine; Country; Coupled; Data; Data Collection; Disease Outbreaks; Drug Formulations; Drug Prescriptions; Epidemiology; Ethnography; Female; Fentanyl; Future; Geography; HIV; HIV/HCV; Half-Life; Health; Heating; Helping to End Addiction Long-term; Hepatitis C Incidence; Hepatitis C virus; Heroin; Incidence; Injecting drug user; Injections; Intervention; Laws; Lead; Mediating; Methamphetamine; Mexico; Modeling; Molecular Epidemiology; Monitor; National Institute of Drug Abuse; Needle Sharing; Outcome; Overdose; Penetration; Persons; Pharmaceutical Preparations; Powder dose form; Price; Reporting; Research; Risk Behaviors; Route; Sampling; Syringes; Tars; Testing; Time; United States National Institutes of Health; Virus; cohort; drug market; epidemiologic data; male; mathematical model; non-drug; prescription opioid; prevent; preventive intervention; prospective; trafficking; transmission process; trend

This competitive revision aims to increase access and uptake of COVID-19 testing and vaccination among people who inject drugs (PWID), a population highly vulnerable to COVID-19. The proposed RADxUP project, LinkUP, will be nested within the San Diego component of our parent grant, La Frontera, which was funded by NIDA in 04/20. To date, 31% of La Frontera PWID have tested SARS- CoV-2 antibody+, of whom 65% had not previously been tested for COVID-19. Only 3% had been vaccinated by 05/2021 and 45% were vaccine hesitant. Our specific aims are: AIM 1. To prospectively evaluate the prevalence, predictors and barriers to COVID-19 testing among PWID. AIM 2. To prospectively assess incidence, predictors and barriers to COVID-19 vaccination among PWID. AIM 3. To adapt and pilot an intervention offered at a mobile syringe services program (SSP) to improve uptake of COVID-19 testing and vaccination among PWID. AIM 4. To compare COVID testing and vaccination rates before and after the state introduces a) COVID-19 rapid testing and b) COVID-19 vaccination at the SSP, which represents a natural experiment. AIM 5. To prospectively assess the impact of COVID-19 testing and vaccination on PWIDs’ behaviors. To meet Aim 1 and 2, we will conduct interviews with 400 PWID in La Frontera, results which will be available in Fall 2021. Based on these findings and input from our Community and Scientific Advisory Board (CSAB), we will select and adapt a brief intervention to improve COVID-19 testing and vaccination uptake among PWID at the mobile van of our community partner, OnPoint. The LinkUP intervention will then be piloted among a subgroup of 150 La Frontera PWID who have not received COVID-19 vaccine or testing and will be implemented by OnPoint peer counsellors, who will also offer on-site rapid COVID-19 antigen testing and confirmatory PCR and referrals to the closest COVID-19 vaccination center (until vaccine is offered at OnPoint by the state). We will evaluate COVID-19 vaccine uptake independently through ongoing La Frontera study visits that will include self-reported interview data, linkage of electronic health records with the San Diego County COVID-19 database, and by analyzing SARSCoV-2 antibody patterns to differentiate between natural infection and vaccine-induced immunity. Results will be used to estimate effect sizes for a future efficacy trial and shared with the RADxUP consortium, policymakers and program planners. Since there are 185 SSPs across the country, our study will inform efforts to enable SSPs to become important ‘touchpoints’ to reach marginalized PWID, strengthening the nation’s pandemic preparedness infrastructure to reduce COVID-19 health disparities.

此次竞争性修订旨在增加 COVID-19 检测和疫苗接种的可及性和采用率 注射吸毒者 (PWID) 是极易感染 COVID-19 的人群。拟议的 RADxUP 项目 LinkUP 将嵌套在我们母基金 La 的圣地亚哥部分中 Frontera，于 04/20 由 NIDA 资助。迄今为止，31% 的拉弗龙特拉吸毒者已接受过 SARS 检测 CoV-2 抗体+，其中 65% 之前未接受过 COVID-19 检测。只有3%的人曾经 到 2021 年 5 月已接种疫苗，45% 对疫苗犹豫不决。我们的具体目标是： AIM 1. 前瞻性地 评估注射吸毒者中 COVID-19 检测的流行率、预测因素和障碍。目标 2. 至 前瞻性评估吸毒者中 COVID-19 疫苗接种的发病率、预测因素和障碍。目标3。 调整和试点移动注射器服务计划 (SSP) 提供的干预措施，以改善 注射吸毒者接受 COVID-19 检测和疫苗接种的情况。目标 4. 比较新冠病毒检测和 该州引入 a) COVID-19 快速检测和 b) COVID-19 前后的疫苗接种率 在 SSP 进行疫苗接种，这代表了一项自然实验。目标 5. 前瞻性评估 COVID-19 检测和疫苗接种对注射吸毒者行为的影响。为了实现目标 1 和 2，我们将 对拉弗龙特拉的 400 名吸毒者进行访谈，结果将于 2021 年秋季公布。基于 根据我们的社区和科学咨询委员会 (CSAB) 的调查结果和意见，我们将选择并 采取简短的干预措施，以改善注射吸毒者的 COVID-19 检测和疫苗接种情况 我们的社区合作伙伴 OnPoint 的移动货车。 LinkUP 干预措施将在 由 150 名拉弗龙特拉注射吸毒者组成的小组，他们尚未接受过 COVID-19 疫苗或检测，将被 由 OnPoint 同伴辅导员实施，他们还将提供现场快速 COVID-19 抗原检测 进行确认性 PCR 并转诊至最近的 COVID-19 疫苗接种中心（直到提供疫苗 国家在 OnPoint）。我们将通过持续的 La 独立评估 COVID-19 疫苗的接种情况 Frontera 研究访问将包括自我报告的访谈数据、电子健康记录的链接 与圣地亚哥县 COVID-19 数据库合作，并通过分析 SARSCoV-2 抗体模式来 区分自然感染和疫苗诱导的免疫。结果将用于估计 未来疗效试验的效果大小，并与 RADxUP 联盟、政策制定者和 计划策划者。由于全国有 185 个 SSP，我们的研究将为以下工作提供信息： SSP 将成为接触边缘化吸毒者的重要“接触点”，加强国家的 流行病防范基础设施，以减少 COVID-19 健康差异。