A structural HIV prevention intervention targeting high-risk women

针对高危女性的结构性艾滋病毒预防干预措施

• 批准号: 10709073
• 负责人: Susan G. Sherman
• 金额: $ 14.08万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-15 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10709073
• 关键词: AIDS prevention; African American; Baltimore; Behavior; Behavioral; Behavioral Model; COVID testing; COVID-19 point of care; COVID-19 risk; COVID-19 testing; COVID-19 vaccination; Chronic Disease; Cities; Client; Clothing; Collaborations; Communicable Diseases; Communities; Complex; Counseling; Data; Data Analyses; Data Collection; Drug usage; Enabling Factors; Ethnic Origin; Event; Food; HIV; Handwashing; Harm Reduction; Health Personnel; Health Status; High Risk Woman; Homelessness; Hunger; Immunization Programs; Imprisonment; Individual; Infrastructure; Intervention; Interview; Length; Letters; Lung diseases; Manuscripts; Maryland; Measures; Medical; Naloxone; Nature; Participant; Pharmaceutical Preparations; Phase; Policy Maker; Practical Robust Implementation and Sustainability Model; Predictive Factor; RADx Underserved Populations; Race; Research; Research Infrastructure; Running; Seasons; Self Efficacy; Shapes; Social Distance; Surveys; Syringes; Target Populations; Techniques; Testing; Time; Trauma; Trust; Vaccines; Visit; Woman; Work; acceptability and feasibility; adverse outcome; burden of illness; cohort; community partnership; condoms; coronavirus disease; current pandemic; design; experience; female sex worker; follow-up; food insecurity; health belief; health care service utilization; high risk population; implementation process; informant; innovation; marginalized population; outreach; outreach program; phase 1 study; point of care; preventive intervention; programs; reuptake; risk mitigation; service delivery; service providers; sex; sexual violence; social; social stigma; study population; testing services; testing uptake; therapy design; trend; uptake; vaccine acceptance; vaccine distribution

Project Summary Marginalized populations such as women who use drugs (WWUD) have elevated risk of COVID-19 with risk mitigation techniques owing to the social nature of drug use procurement, drug use and sex work. High rates of structural vulnerabilities (e.g., homelessness, hunger, incarceration) in combination with low levels of healthcare utilization are key drivers of this high burden of disease. Through the “C2SPARC” study, we propose expanding the depth of our understanding of drivers of POCT uptake in both research and service delivery contexts. Specifically, we propose adding a 6-month follow-up visit (“C2SPARC visit”) to the CARE study to more robustly examine trends in POCT uptake over time. Secondly, in partnership with a leading harm reduction organization that serves WWUD, we propose designing and implementing POCT on their nighttime mobile outreach van that provides harm reduction (e.g., condoms, naloxone, syringes) and basic necessities (e.g., food, clothing). C2SPARC will employ Andersen’s Behavioral Model (Aim 1), PRISM (Practical, Robust, Implementation, and Sustainability Model) (Aim 2), and the Theoretical Framework of Acceptability (TFA) (Aim 3) to meet the following aims: 1) to examine predisposing (e.g., social - homelessness, food insecurity; individual - drug use, race/ ethnicity, health beliefs) factors as well as enabling (past COVID-19 testing, vaccine uptake) factors that predict uptake of POCT over a six-month period among WWUD (N=250) in Baltimore, Maryland; 2) to collaborate with the SPARC Center to develop and implement POCT on their mobile outreach van that primarily serves WWUD in Baltimore City, Maryland; and to examine the feasibility (e.g., testing uptake) and acceptability (e.g., participant burden, testing self-efficacy) of mobile POCT testing among WWUD (N=250) who are clients of SPARC outreach. C2SPARC is innovative its leverage of the Phase I cohort to evaluate POCT testing uptake longitudinally which will inform the implementation of COVID-testing in the context of a meaningful community partnership. Situating COVID testing in the context of trusted service provider is urgency needed. The study’s impact and sustainability will also be enhanced by a community advisory board (CAB). Study results can be quickly disseminated to policy makers and the target population through products (i.e., fact sheets, manuscripts) and events (i.e., community forums) to inform community-based testing and eventual vaccination programs targeting WWUD and similarly marginalized populations.

项目摘要 边缘人群，如女性吸毒(WWUD)，患新冠肺炎的风险增加 由于药物使用采购、药物使用和性工作的社会性质，采用了风险缓解技术。 结构性脆弱性(如无家可归、饥饿、监禁)比率高，再加上低 医疗保健利用水平是造成这一高疾病负担的关键驱动因素。通过“C2SPARC” 研究，我们建议在这两项研究中扩大我们对POCT摄取驱动因素的理解 和服务交付上下文。具体地说，我们建议增加为期6个月的后续访问(“C2SPARC访问”) CARE研究，以更有力地检查POCT摄取随时间的趋势。第二，结成伙伴关系 与服务于WWUD的领先的减少危害组织合作，我们建议设计和实施 在他们的夜间流动外展面包车上提供减少伤害的POCT(例如避孕套、纳洛酮、 以及基本必需品(如食物、衣物)。C2SPARC将采用安德森的行为模型 (目标1)、PRISM(实际、稳健、实施和可持续发展模式)(目标2)和理论 可接受性框架(TFA)(目标3)以满足以下目标：1)检查易感性(例如， 社会--无家可归、粮食不安全；个人--吸毒、种族/民族、健康信仰)因素 作为使能(过去的新冠肺炎测试，疫苗接种)因素，预测在六个月内接种POCT 在马里兰州巴尔的摩的WWUD之间(N=250)；2)与SPARC中心合作开发 并在其移动外展面包车上实施POCT，该面包车主要服务于巴尔的摩市的WWUD， 马里兰州；并检查可行性(例如，测试吸收)和可接受性(例如，参与者负担， 移动POCT测试的自我效能感)WWUD(N=250)是SPARC外展服务的客户。 C2SPARC是创新的，它利用第一阶段队列纵向评估POCT测试摄入量 它将在一个有意义的社区的背景下为COVID测试的实施提供信息 伙伴关系。迫切需要将COVID测试置于受信任的服务提供商的环境中。这个 社区咨询委员会(CAB)也将加强研究的影响和可持续性。研究结果 可通过产品(即情况说明书、 手稿)和活动(即，社区论坛)，以提供基于社区的测试和最终 针对WWUD和类似边缘人群的疫苗接种计划。

项目成果

External resilience in the context of drug use and socio-structural vulnerabilities: a qualitative exploration among women who use drugs and sell sex in Baltimore, Maryland.

• DOI: 10.1186/s12954-022-00678-6
• 发表时间: 2022-08-24
• 期刊: HARM REDUCTION JOURNAL
• 影响因子: 4.4
• 作者: Tomko, Catherine;Nestadt, Danielle Friedman;Weicker, Noelle P.;Rudzinski, Katherine;Underwood, Carol;Kaufman, Michelle R.;Sherman, Susan G.
• 通讯作者: Sherman, Susan G.