International Feasibility Study of Pharmacy-Based HIV Prevention: St.Petersburg

基于药物的艾滋病毒预防国际可行性研究：圣彼得堡

• 批准号: 7755053
• 负责人: Alla V Shaboltas
• 金额: $ 14.96万
• 依托单位: BIOMEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-15 至 2011-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7755053
• 关键词: AIDS prevention; Address; Adopted; Attitude; Boston; Cities; Communities; Community Health; Country; Cross-Sectional Studies; Data; Data Collection; Drug usage; Elements; Epidemic; Feasibility Studies; Future; Goals; HIV; Health; Health Services Accessibility; India; Injecting drug user; Injection of therapeutic agent; International; Intervention; Intervention Trial; Interview; Investigation; Law Enforcement; Learning; Link; Location; Methodology; Methods; Needles; Outcome Measure; Pharmaceutical Services; Pharmacists; Pharmacy facility; Policies; Policy Maker; Preparation; Public Health; Randomized; Research Personnel; Risk; Russia; Sampling; San Francisco; Scientist; Services; Site; Sterility; Syringes; Testing; Training; Vietnam; Virus; Work; base; control trial; disease transmission; effective intervention; experience; informant; multi-site trial; public health relevance; response; social; transmission process; willingness

DESCRIPTION (provided by applicant): Transmission of HIV and other bloodborne viruses among injection drug users (IDUs) has been linked to restricting syringe access through pharmacies. Conversely, strategies that have expanded syringe access through pharmacies have been shown to reduce injection-related HIV risk. The best of these work with pharmacists to increase their willingness to serve as agents of public health, encouraging them to provide not just more syringes but expanded services to the IDUs who patronize their pharmacies. But to date no comprehensive studies have been undertaken to understand what elements of pharmacist training and which services are most critical in reducing the risks for disease transmission. Ideally, a multi-site intervention trial to fill this gap could have a significant impact in locations in which injection-related HIV transmission poses significant burdens. Before such a trial can begin, however, appropriate sites need to be identified. This application is one of five linked R21 applications - two in the U. S. and one each from India, Russia, and Vietnam -- that have begun to explore the possibility of participating in such a trial. The following scientists with appropriate background and experience will serve as PIs for each of the five international sites: Dr. Alla V. Shaboltas The Biomedical Center St. Petersburg, Russia Dr. Carl Latkin Johns Hopkins Bloomberg Scholl of Public Health Chennai, India Dr. Ted Hammet ABT Associates Ha Giang, Vietnam Dr. Patricia Case Fenway Community Health Boston, MA & Providence, RI, USA Dr. Alexander Kral RTI International San Francisco, CA, USA Each site has information about the local injection-related HIV epidemic and the extent to which IDUs already use pharmacies to obtain syringes. At this point, more information is needed to understand the local culture of pharmacies and pharmacists, their willingness to participate in such a trial, and the local barriers to developing and implementing an intervention. Additionally, determining the receptiveness of IDU syringe customers to participating in such a trial and the influences of the social and political contexts are also needed to help determine feasibility of a multi-site trial. This application from St. Petersburg, Russia proposes to a two-year scope of work that adopts the methodology of Rapid Policy Assessment and Response (RPAR) projects to learn from pharmacists, the IDUs they serve, local public health and law enforcement officials enough to develop an intervention that will work in the local context. In addition, additional data will be collected from a sample of IDUs to better determine the outcome measures to be addressed in the intervention trial. This exploratory 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 staff participation in HIV prevention and access to care intervention targeted to IDU syringe customers, including pharmacists' attitudes, and possible interference from law enforcement and policy makers; and (3) to identify potential sites from among the 21 city districts for a randomized community controlled trial. This application can stand alone or be combined with data from the other linked application to develop a culturally appropriate, politically acceptable intervention trial in St. Petersburg, Russia. PUBLIC HEALTH RELEVANCE: The purpose of this study is to assess the feasibility of using pharmacies as public health venues to provide HIV-prevention to injection drug users (IDUs) in St. Petersburg, Russia. This application is one of the linked R21 proposals developed by India, Vietnam, Russia and USA in preparation for a large-scale, multi-site randomized controlled intervention trial. The expected results of these studies will help to develop the training for the pharmacists to provide HIV- related services to IDUs as highly effective intervention that could be implemented in a wide variety of cultural settings.

描述（由申请人提供）：艾滋病毒和其他血液传播病毒在注射吸毒者（IDUs）中的传播与限制通过药房获得注射器有关。相反，通过药店扩大注射器获取的战略已被证明可以减少与注射有关的艾滋病毒风险。其中最好的是与药剂师合作，以提高他们作为公共卫生代理人的意愿，鼓励他们不仅提供更多的注射器，而且扩大对光顾其药店的注射吸毒者的服务。但迄今为止，还没有进行全面的研究，以了解药剂师培训的哪些内容以及哪些服务对减少疾病传播风险最为关键。理想情况下，填补这一空白的多中心干预试验可能会在注射相关艾滋病毒传播造成重大负担的地区产生重大影响。然而，在这种试验开始之前，需要确定适当的地点。这个应用程序是五个连接的R21应用程序之一-两个在美国。S.印度，俄罗斯和越南各一个，他们已经开始探索参与这样一个试验的可能性。以下具有适当背景和经验的科学家将担任五个国际研究中心的主要研究者：Alla V. Shaboltas博士俄罗斯彼得堡生物医学中心Carl Latkin博士约翰霍普金斯大学彭博公共卫生学院印度钦奈Ted Hammet博士ABT Associates Ha Giang博士越南Patricia Case Fenway社区卫生波士顿MA &普罗维登斯，RI美国亚历山大克拉尔RTI国际博士美国加利福尼亚州旧金山弗朗西斯科每个研究中心都有关于当地与注射有关的艾滋病毒流行情况以及注射吸毒者利用药店获得注射器的程度的信息。在这一点上，需要更多的信息来了解当地的药店和药剂师的文化，他们参与这种试验的意愿，以及当地制定和实施干预措施的障碍。此外，还需要确定IDU注射器客户对参与此类试验的接受程度以及社会和政治背景的影响，以帮助确定多中心试验的可行性。俄罗斯彼得堡的这份申请书建议开展为期两年的工作，采用快速政策评估和反应项目的方法，向药剂师、他们所服务的注射吸毒者、当地公共卫生和执法官员学习，以便制定一项在当地行之有效的干预措施。此外，将从注射吸毒者样本中收集更多数据，以更好地确定干预试验中要解决的结局指标。本探索性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大到包括为在药房购买注射器的注射吸毒者提供的艾滋病毒相关服务;（2）评估注射吸毒者和药房工作人员参与艾滋病毒预防和获得针对注射吸毒者的护理干预的障碍，包括药剂师的态度，以及执法部门和决策者可能的干预;（3）从21个城市地区中确定随机社区对照试验的潜在地点。该应用程序可以单独使用，也可以与来自其他链接应用程序的数据相结合，以在俄罗斯圣彼得堡彼得堡开发文化上适当的、政治上可接受的干预试验。公共卫生关系：本研究的目的是评估使用药店作为公共卫生场所，提供艾滋病毒预防注射吸毒者（IDUs）在俄罗斯圣彼得堡彼得堡的可行性。该申请是由印度，越南，俄罗斯和美国开发的R21提案之一，为大规模，多地点随机对照干预试验做准备。这些研究的预期结果将有助于发展对药剂师的培训，以便向注射吸毒者提供与艾滋病毒有关的服务，作为可在各种文化环境中实施的高度有效的干预措施。