Penn Mental Health AIDS Research Center

宾夕法尼亚州心理健康艾滋病研究中心

• 批准号: 10819857
• 负责人: Kelly L Jordan-Sciutto
• 金额: $ 24.38万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-03-15 至 2025-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10819857
• 关键词: AIDS prevention; Accident and Emergency department; Acquired Immunodeficiency Syndrome; Address; Affect; Area; Behavior; COVID-19 pandemic; Caring; Cities; Client; Clinical; Cluster Analysis; Cocaine; Communities; Comprehensive Health Care; Counseling; Coupled; Data; Detection; Development; Diagnosis; Environment; Epidemic; Equipment; Equity; Evaluation; Face; Feedback; Fentanyl; Fright; Funding; Geographic Locations; HIV; HIV diagnosis; Health; Health Personnel; Health Priorities; Health Service Area; Healthcare; Height; Heroin; Human immunodeficiency virus test; Incidence; Injecting drug user; Injections; Integrated Delivery of Health Care; Legal; Link; Mental Health; Methamphetamine; Methodology; Needles; Neighborhoods; Newly Diagnosed; Participant; Patient Education; Perception; Persons; Pharmaceutical Preparations; Philadelphia; Prevention; Provider; Public Health; Recording of previous events; Research; Risk; Service delivery model; Service provision; Services; Site; Social Work; Space-Time Clustering; Surveys; System; Training; Trauma; United States National Institutes of Health; Unsafe Sex; community organizations; community partnership; coronavirus disease; cost; experience; health care service; infection rate; injection drug use; innovation; interest; meetings; operation; outpatient programs; outreach; preference; prescription opioid; prevention service; response; scale up; service organization; service providers; social stigma; substance use treatment; success; testing services; transmission process; treatment center; willingness

Project Summary/Abstract People incidence who inject drugs (PWID) are disproportionately affected by HIV incidence in Philadelphia. The HIV in Philadelphia is growing and returning to pre-COVID pandemic levels.At present, the city health department's Department of HIV Health funds many community and clinical health providers for HIV testing and counseling services, including HIV Service Organizations (HSOs), substance use treatment centers, and emergency departments, which have facilitated the detection of many new cases among PWID in Philadelphia. Despite these successes, increasing infection rates in PWID suggest a need for scaled-up detection and linkage strategies. Reliance on traditional HIV prevention providers may yield missed opportunities for HIV diagnoses, timely linkage-to-care, and cluster detection and response. Leveraging providers in healthcare and social service environments outside of traditional HIV prevention settings in neighborhoods with high rates of IDU may maximize opportunities for expanding efforts for HIV cluster detection and response. The extent to which nonclinical HSO-alternative service providers in these areas understand IDU as a significant contributor to the HIV epidemic, routinely conduct or refer PWID high-quality HIV testing services, and are willing and capable to integrate or scale-up HIV testing services within current clinical operations at their agency is poorly understood. To address these gaps, we propose a 2-year study to conduct the following aims: (Aim 1) Employ persons with lived experiences/histories of IDU to conduct secret shopper methodologies toward understanding the current HIV testing/referral practices in nonclinical HSO-alternative outpatient service facilities (N = 15) in Philadelphia neighborhoods with high IDU; (Aim 2) Deploy surveys with N = 100 PWID living without HIV to evaluate environmental preferences for HIV prevention services in nonclinical HSO-alternative outpatient service facilities in Philadelphia; and (Aim 3) Engage with representatives from secret shopper-evaluated facilities through stakeholder meetings to discuss secret shopper feedback, their perceptions of the HIV epidemic among PWID in their service area, and their capacity for HIV prevention services. The proposed study will facilitate local priorities pertaining to the Diagnose pillar of the Ending the HIV Epidemic Initiative and support the city health department's HIV cluster detection and response strategies. Leveraging HSO-alternative providers' capacities to conduct, refer, and coordinate HIV testing will maximize equitable access to HIV prevention for PWID and opportunities to identify new HIV cases and unidentified clusters missed via traditional HIV testing environments, like HSOs.

项目摘要/摘要 人民 发生率 世卫组织注射毒品(PWID)不成比例地受到费城艾滋病毒发病率的影响。艾滋病病毒 费城的人口正在增长，并恢复到新城疫大流行前的水平。目前，该市卫生 该署的艾滋病毒卫生署资助许多社区和临床卫生服务提供者进行艾滋病毒检测和 咨询服务，包括艾滋病毒服务组织(HSO)、药物使用治疗中心和 急诊部门协助发现了费城PWID中的许多新病例。 尽管取得了这些成功，但PWID感染率的上升表明有必要扩大检测和联系 战略。依赖传统的艾滋病毒预防提供者可能会错过艾滋病毒诊断的机会， 及时联动关爱，集群检测和应对。利用医疗保健和社会服务中的提供者 在注射吸毒率高的社区中，传统艾滋病毒预防环境之外的环境可能 最大限度地扩大艾滋病毒聚集性检测和应对工作的机会。在多大程度上 非临床HSO-这些领域的替代服务提供商将IDU理解为 艾滋病毒流行，经常进行或转介PWID高质量的艾滋病毒检测服务，并愿意和有能力 在其机构目前的临床业务中整合或扩大艾滋病毒检测服务的情况鲜为人知。 为了解决这些差距，我们建议进行一项为期两年的研究，以实现以下目标：(目标1)雇用具有以下条件的人员 IDU的亲身经历/历史，指导秘密购物者方法论，以了解当前 费城非临床HSO替代门诊服务机构的艾滋病毒检测/转诊实践(N=15) IDU高的社区；(目标2)部署N=100名未感染艾滋病毒的PWID的调查，以评估 非临床HSO替代门诊设施中艾滋病毒预防服务的环境偏好 在费城；以及(目标3)通过以下方式与来自秘密购物者评估设施的代表接触 利益相关者会议，讨论购物者的秘密反馈，他们对残疾人中艾滋病毒流行的看法 在他们的服务领域，以及他们提供艾滋病毒预防服务的能力。建议的研究将有助本地 与结束艾滋病毒流行倡议和支持城市卫生的诊断支柱有关的优先事项 卫生部的艾滋病毒群组检测和应对战略。利用HSO-替代提供商的能力 进行、转介和协调艾滋病毒检测将最大限度地公平地获得PWID和 通过传统的艾滋病毒检测环境错过了识别新的艾滋病毒病例和不明聚集性的机会， 就像HSO一样。