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.

项目总结/摘要 人 发生率 注射吸毒者（PWID）在费城受到艾滋病毒发病率的不成比例的影响。艾滋病毒 在费城的增长和恢复到前COVID大流行的水平。目前，城市卫生 该部门的艾滋病毒卫生部资助许多社区和临床卫生服务提供者进行艾滋病毒检测， 咨询服务，包括艾滋病毒服务组织（HSO），物质使用治疗中心， 急诊部门，这有助于在费城发现许多新的PWID病例。 尽管取得了这些成功，但PWID感染率的增加表明需要扩大检测和联系 战略布局对传统艾滋病毒预防提供者的依赖可能会错失艾滋病毒诊断的机会， 及时的连接到关怀，以及集群检测和响应。利用医疗保健和社会服务提供商 在注射吸毒率高的社区，传统的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集群检测和应对工作的机会。的程度 这些地区的非临床HSO替代服务提供者将IDU理解为 艾滋病毒流行，定期进行或转介PWID高质量的艾滋病毒检测服务，并愿意和有能力 对在其机构目前临床业务中整合或扩大艾滋病毒检测服务了解甚少。 为解决这些问题，我们建议进行一项为期两年的研究，以达致以下目的： IDU的生活经历/历史，以指导秘密购物者方法，了解当前 费城非临床HSO替代门诊服务机构的HIV检测/转诊实践（N = 15） 高IDU社区;（目标2）对N = 100名未感染艾滋病毒的PWID进行调查，以评估 非临床HSO-替代门诊服务设施中HIV预防服务的环境偏好 在费城;（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，讨论秘密购物者的反馈，他们对艾滋病毒在艾滋病患者中流行的看法 以及它们提供艾滋病毒预防服务的能力。建议的研究将促进当地 与结束艾滋病毒流行病倡议的诊断支柱有关的优先事项，并支持城市卫生 艾滋病病毒集群检测和应对策略。利用保健组织替代提供者的能力 开展、转诊和协调艾滋病毒检测将最大限度地使残疾人公平获得艾滋病毒预防服务， 发现新的艾滋病毒病例和传统艾滋病毒检测环境错过的未识别的聚集群的机会， 比如HSO。