PS07-003, Minority HIV/AIDS Research Initiative

PS07-003，少数民族艾滋病毒/艾滋病研究计划

• 批准号: 7922506
• 负责人: Silvia Amesty
• 金额: $ 2.35万
• 依托单位: NEW YORK ACADEMY OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-30 至 2011-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7922506
• 关键词: PS07; 003; Minority; HIV; AIDS

DESCRIPTION (provided by applicant): Summary The purpose of this community-based evaluation study is to pilot test the feasibility of expanding pharmacy services to include provision of HIV testing referrals and services to injection drug users (IDUs) who purchase syringes in pharmacies in the Harlem community of New York City. In 2001, New York State pharmacies were allowed to register to sell syringes without a prescription through the Expanded Syringe Access Demonstration Program (ESAP), a public health policy targeted to IDUs to reduce syringe sharing and subsequent HIV transmission. This proposed evaluation study is based on two observations: black and Hispanic IDUs are disproportionately affected by HIV, and some pharmacists support ESAP and consider their work to include public health practice. Given our research team's extensive research in evaluating pharmacy syringe access, we believe that extending services, such as HIV testing, is a logical next step in the effort to help reduce racial disparities in HIV. Thus, the specific aims are: (1) to pilot test the feasibility of 10 ESAP-registered pharmacies in the delivery of HIV testing referrals to local HIV testing sites among IDU-syringe customers; and (2) to evaluate the feasibility of offering and performing HIV counseling and testing to IDU syringe-purchasing customers in 2 additional pilot pharmacies. To accomplish these aims, 10 pharmacies from the Harlem community will be randomly selected from 100 ESAP-registered pharmacies in the Harlem area. In collaboration with community members and local pharmacists, the research team will utilize a previously developed training module for pharmacists and pharmacy staff on the availability of HIV testing services, and how to engage/offer referrals to IDU syringe customers. IDUs who receive services from the pilot pharmacies will be asked to participate in a brief structured survey administered at the pharmacy by research staff. Among approximately 362 IDUs, we will compare those who have used the HIV testing referral vs. those who did not with respect to demographics, drug and sexual risk behaviors, perceptions and attitudes toward HIV testing, prior HIV testing, and previous HIV-positive diagnosis (Aim 1). We will also select and train pharmacy staff at 2 additional pilot pharmacies to perform HIV counseling and testing on-site (Aim 2); among IDUs who are offered on-site testing (N=82), we will administer a brief structured survey to compare those who agree to be tested vs. those who refuse with respect to similar factors described in Aim 1. Finally, semi-structured questionnaires will be administered to all pharmacy staff to qualitatively ascertain the impact of expanded services on customer base, daily business flow, and attitudes and perceptions of HIV testing services (referrals or on-site) among IDUs. Descriptive statistics and logistic regression will be used to analyze quantitative IDU data and standard qualitative techniques will be used to analyze pharmacy staff data. This proposed research is highly significant in that it aims to explore new venues for HIV testing that can reach high risk black and Hispanic communities in New York City. Due to a recently implemented expanded syringe access program allowing pharmacies to sell syringes without a prescription, a natural next step is to explore linking additional services, namely HIV testing referrals and on-site HIV testing services, with syringe sales to IDUs. If successful, this model can be duplicated not only through-out other high risk neighborhoods in New York, but in several other states with similar pharmacy access programs (e.g, New Jersey, California, Connecticut, Minnesota, Rhode Island, and Maine).

这项以社区为基础的评估研究的目的是试点测试扩大药房服务的可行性，包括向在纽约市哈莱姆社区的药店购买注射器的注射吸毒者（IDUs）提供艾滋病毒检测转诊和服务。2001年，纽约州的药店通过扩大注射器使用示范方案（ESAP）获准注册销售无需处方的注射器，这是一项针对注射吸毒者的公共卫生政策，旨在减少共用注射器和随后的艾滋病毒传播。这项拟议的评估研究基于两个观察结果：黑人和西班牙裔注射吸毒者受到艾滋病毒的影响不成比例，一些药剂师支持ESAP，并认为他们的工作包括公共卫生实践。鉴于我们的研究团队在评估药房注射器获取方面的广泛研究，我们认为，扩大服务，如艾滋病毒检测，是帮助减少艾滋病毒种族差异的一个合乎逻辑的下一步。因此，具体目标是：(1)试点测试10家esap注册药房向注射针筒客户提供HIV检测转介到当地HIV检测站点的可行性；(2)评估在另外两家试点药店向注射u注射器购买客户提供和执行艾滋病毒咨询和检测的可行性。为了实现这些目标，将从哈莱姆地区100家esap注册的药店中随机选出10家哈莱姆社区的药店。研究小组将与社区成员和当地药剂师合作，利用以前为药剂师和药房工作人员开发的培训模块，了解艾滋病毒检测服务的可得性，以及如何吸引/向IDU注射器客户提供转介。接受试点药店服务的注射吸毒者将被要求参加由研究人员在药店进行的一项简短的结构化调查。在大约362名注射吸毒者中，我们将比较那些使用了HIV检测转诊的人与那些没有使用HIV检测转诊的人，包括人口统计学、药物和性风险行为、对HIV检测的认知和态度、之前的HIV检测和之前的HIV阳性诊断（目的1）。我们还将在另外两家试点药店选择和培训药房工作人员，以便在现场进行艾滋病毒咨询和检测（目标2）；在接受现场检测的注射吸毒者中（N=82），我们将进行一项简短的结构化调查，比较那些同意接受检测的人与那些拒绝接受检测的人，这与Aim 1中描述的类似因素有关。最后，将对所有药房工作人员进行半结构化问卷调查，以定性地确定扩大服务对客户群、日常业务流以及注射吸毒者对艾滋病毒检测服务（转诊或现场）的态度和看法的影响。描述性统计和逻辑回归将用于分析定量IDU数据，标准定性技术将用于分析药房员工数据。这项拟议的研究非常重要，因为它旨在探索新的艾滋病毒检测场所，可以到达纽约市的高风险黑人和西班牙裔社区。由于最近实施了扩大注射器获取规划，允许药店在没有处方的情况下销售注射器，下一步自然是探索将其他服务（即艾滋病毒检测转诊和现场艾滋病毒检测服务）与向注射吸毒者销售注射器联系起来。如果成功，这种模式不仅可以在纽约的其他高风险社区推广，还可以在其他几个有类似药房准入计划的州（如新泽西州、加利福尼亚州、康涅狄格州、明尼苏达州、罗德岛州和缅因州）推广。