Feasibility of Pharmacy-Based HIV Interventions among IDUs: India

描述(由申请人提供)：R21 DA024971的重新提交是印度金奈注射吸毒者(IDU)中基于药房的艾滋病毒干预措施的可行性研究。艾滋病毒和其他血液传播病毒的传播与限制通过药店获得注射器有关。通过药店扩大注射器的使用降低了与注射有关的艾滋病毒风险。一种可能的战略是与药剂师合作，充当公共卫生代理人，鼓励他们向其注射吸毒者客户提供注射器和扩大服务。到目前为止，还没有进行全面的研究，以了解药剂师培训和服务的哪些要素在降低疾病风险方面最关键。为填补这一空白而进行的多点干预试验可能会对注射相关艾滋病毒传播率高的地区产生重大影响。这项申请是五个相互关联的R21申请之一-美国(2个)、印度(1个)、俄罗斯(1个)和越南(1个)-将探索参与此类试验的可能性。每个网站都有关于当地与注射有关的艾滋病毒流行和注射吸毒者使用药房获得注射器的信息。需要更多的信息来了解药房/药剂师的当地文化、参与的意愿以及干预的当地障碍。此外，还需要确定注射吸毒者参与此类试验的接受度。约翰霍普金斯大学彭博公共卫生学院的这份申请书建议在金奈开展为期两年的工作，使用快速政策评估和反应方法向药剂师、注射吸毒者以及当地公共卫生和执法官员学习，以制定干预措施。此外，还将从400名注射吸毒者和50名药剂师的样本中收集数据。这项研究有三个主要目的：(1)评估目前的药房服务，以及如何将这些服务扩展到包括在药房购买注射器的注射吸毒者的艾滋病毒相关服务；(2)评估注射吸毒者和药房参与针对注射吸毒者的艾滋病毒预防和获得护理干预的障碍；(3)确定潜在的当地药房和地理位置，进行随机社区对照试验。根据研究设计，该应用程序可以单独使用，也可以与其他应用程序的数据结合起来，在印度开发一项适合文化的干预试验。公共卫生相关性：由于印度和包括美国在内的许多其他国家的注射吸毒者中艾滋病毒水平较高，该提案具有很高的公共卫生相关性。

DESCRIPTION (provided by applicant): This resubmission of R21 DA024971 is a feasibility study of pharmacy-based HIV Interventions among injection drug users (IDUs) in Chennai, India. Transmission of HIV and other bloodborne viruses has been linked to restricting syringe access through pharmacies. Expanding syringe access through pharmacies has reduced injection-related HIV risk. One potential strategy is to work with pharmacists to serve as agents of public health, encouraging them to provide syringes and expanded services to their IDUs customers. To date, no comprehensive studies have been conducted to understand what elements of pharmacist training and services are most critical in reducing the disease risks. A multi-site intervention trial to fill this gap could have a significant impact in locations injection-related HIV transmission is high. This application is one of five linked R21 applications - US (2), India (1), Russia (1), and Vietnam (1) - that will explore the possibility of participating in such a trial. Each site has information about the local injection-related HIV epidemic and IDU use of pharmacies to obtain syringes. More information is needed to understand the local culture of pharmacies/pharmacists, willingness to participate, and local barriers to an intervention. Additionally, determining the receptiveness of IDUs to participate in such a trial are also needed. This application from Johns Hopkins Bloomberg School of Public Health proposes a two-year scope of work in Chennai that uses Rapid Policy Assessment and Response methods to learn from pharmacists, IDUs, and local public health and law enforcement officials to develop an intervention. Also, data will be collected from a sample of 400 IDUs and 50 pharmacists. This study has three major aims: (1) to assess current pharmacy services and how these services can be expanded to include HIV related services for IDUs who purchase syringes in pharmacies; (2) to assess barriers to IDU and pharmacy participation in a HIV prevention and access to care intervention targeted to IDU customers; and (3) to identify potential local pharmacy and geographic sites for a randomized community controlled trial. Based on the study design this application can stand alone or be combined with data from the other applications to develop a culturally appropriate intervention trial in India. PUBLIC HEALTH RELEVANCE: This proposal has high public health relevance due to the high level of HIV among IDUs in India and many other countries including the US.