Increasing representation of black communities in SARS-CoV-2 serosurveys by understanding barriers and motivations for participation

通过了解参与的障碍和动机，增加黑人社区在 SARS-CoV-2 血清调查中的代表性

• 批准号: 10843497
• 负责人: Heather Bradley
• 金额: $ 24.96万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-06-01 至 2024-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10843497
• 关键词: 2019-nCoV; Accident and Emergency department; Accounting; Achievement; Acquired Immunodeficiency Syndrome; Acute Hepatitis C; Address; Admission activity; Age; Bayesian Modeling; Behavior; Big Data; Big Data to Knowledge; Blood; Canada; Characteristics; Collaborations; Communicable Diseases; Communities; Complement; County; Data; Data Set; Dependence; Development; Diagnosis; Disease; Electronics; Epidemic; Epidemiologist; Epidemiology; Estonia; Goals; HIV Infections; HIV/HCV; Health; Health Services; Health Services Accessibility; Hepatitis C; Hepatitis C virus; Heterogeneity; Hospital Records; Household; Imprisonment; Individual; Infection; Infective endocarditis; Injecting drug user; Injections; Inpatients; Intervention; Joints; Leadership; Link; Measures; Methodology; Methods; Modeling; Monitor; Motivation; Needle-Exchange Programs; New York; Opioid; Persons; Pharmaceutical Preparations; Pharmacotherapy; Politics; Population; Population Sizes; Prevention program; Probability; Process; Public Health; Reporting; Resources; Risk; Route; Services; Standardization; Stigmatization; Surveys; System; United States National Institutes of Health; Work; burden of illness; data visualization; disorder risk; drug use behavior; experience; high risk; housing instability; improved; infection burden; injection drug use; innovation; male; opioid epidemic; opioid use disorder; prevention service; preventive intervention; remediation; research study; response; serosurvey; sex; surveillance data; treatment program

ABSTRACT Injection is an increasingly common route of administration for opioids and other drugs in the U.S. Unsafe injection drug use (IDU) behavior threatens recent progress made in reducing HIV and hepatitis C virus (HCV) infections among persons who inject drugs (PWID), which is a major impediment to achieving ambitious national goals for reducing new HIV infections. During the past decade, New York State has experienced growing rates of opioid use disorder and, consequently, increases in IDU-related infectious diseases. New York has strong political will to reduce the burden of these infections among PWID and is the first U.S. state to commit to both “Ending the AIDS Epidemic” and HCV elimination strategies. However, New York, like other states, does not have a current, statewide estimate of how many PWID need infectious disease prevention services. Robust estimates of PWID population sizes are needed in New York and elsewhere to facilitate optimal allocation of scarce resources, measure risk-specific infectious disease burden among PWID, and assess coverage of prevention interventions. We propose to estimate PWID population size and associated risk-specific disease and prevention intervention coverage rates in New York using multiple systems estimation (MSE) with a combination of extant administrative and PWID survey data. MSE is an application of capture- recapture methods that allows estimation of underlying population size using joint probabilities of observing individuals in linked administrative datasets vis-à-vis their receipt of a service or diagnosis. We will apply MSE methods to linked, statewide datasets in New York including claims data, inpatient and emergency room electronic hospital records, drug treatment program data, and infectious disease surveillance data. We will also improve the rigor of MSE methods by addressing potential violations of key statistical assumptions through augmented estimation models, partially informed by survey data currently being collected by the study team. Our Specific Aims are: (1)To estimate PWID population size in New York State using MSE with indications of current IDU behavior from linked administrative datasets, overall and by region, sex, and age; (2) To create refined PWID population size estimates accounting for bias due to unequal probabilities of observing individuals in datasets; (3) To allocate state PWID population size to all 62 counties using a standardization modeling approach; (4) To compute key epidemiologic indicators needed to measure infectious disease risk among PWID: risk-specific HIV and HCV diagnosis rates, syringe service program utilization rates, and number of PWID initiating IDU during past year; (5) To disseminate estimates and methodology using the AIDSVu data visualization platform. The national impact of this work, using New York as a model, will be to establish a robust, replicable method for producing estimates that can guide efforts to improve PWID health and reduce the burden of HIV and HCV in this high-risk, under-studied group.

摘要 在美国，注射是阿片类药物和其他药物越来越常见的给药途径 注射吸毒(IDU)行为威胁到最近在减少艾滋病毒和丙型肝炎病毒(HCV)方面取得的进展 注射吸毒者的感染(PWID)，这是实现雄心壮志的主要障碍 减少新的艾滋病毒感染的国家目标。在过去的十年里，纽约州经历了 阿片类药物使用障碍的比率不断上升，从而增加了与注射成瘾相关的传染病。新的 纽约州有强烈的政治意愿来减轻PWID患者的这些感染负担，并是美国第一个 致力于“结束艾滋病流行”和消除丙型肝炎病毒战略。然而，纽约和其他城市一样 没有目前全州范围内有多少PWID需要传染病预防的估计 服务。在纽约和其他地方需要对PWID人口规模进行强有力的估计，以便于 优化分配稀缺资源，衡量PWID中特定风险的传染病负担，以及 评估预防干预措施的覆盖面。我们建议估计PWID的人口数量和相关的 使用多系统估计的纽约特定风险疾病和预防干预覆盖率 (MSE)，并结合现有的行政和PWID调查数据。MSE是一种捕获应用程序- 允许使用联合观测概率估计潜在种群大小的重新捕获方法 链接的管理数据集中的个人与其接受服务或诊断的情况。我们将申请MSE 方法链接到纽约州的全州数据集，包括索赔数据、住院和急诊室 电子医院记录、药物治疗计划数据和传染病监测数据。我们还将 通过以下方式解决可能违反关键统计假设的问题，从而提高MSE方法的严格性 增强的估计模型，部分由研究小组目前收集的调查数据提供信息。 我们的具体目标是：(1)使用MSE估计纽约州的PWID人口数量，并显示 来自链接的管理数据集的当前IDU行为，总体和按地区、性别和年龄；(2)创建 改进的PWID种群规模估计，考虑了观测概率不相等造成的偏差 数据集中的个体；(3)使用标准化将州PWID人口规模分配给所有62个县 建模方法；(4)计算衡量传染病风险所需的关键流行病学指标 在PWID中：特定风险的艾滋病毒和丙型肝炎诊断率、注射器服务计划使用率和 在过去一年中，PWID发起了IDU；(5)利用AIDSVu数据传播估计数和方法 可视化平台。这项工作的全国影响，以纽约为榜样，将建立一个 稳健、可复制的方法，用于产生可指导努力改善PWID健康和减少 艾滋病毒和丙型肝炎病毒在这一高危、研究不足的群体中的负担。