Ending HIV and Taming HCV and Overdose Among Puerto Rican PWID in New York City: The Ganchero Intervention
纽约市波多黎各吸毒者中消灭艾滋病毒、控制丙型肝炎和吸毒过量:Ganchero 干预措施
基本信息
- 批准号:10699316
- 负责人:
- 金额:$ 16.52万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2023
- 资助国家:美国
- 起止时间:2023-06-01 至 2026-04-30
- 项目状态:未结题
- 来源:
- 关键词:AIDS preventionAirBehavioralBostonClientClinical TrialsConsultationsCountyDataDiffusionDisease OutbreaksDrug ResiduesEducational CurriculumEffectivenessEthnic PopulationEthnographyEvaluationFeedbackFocus GroupsFutureGoalsGrantHIVHIV/HCVHealthHealth behavior changeHepatitis CHepatitis C PrevalenceHigh PrevalenceIndianaInjecting drug userInjectionsInterventionInterviewKnowledgeLearningMassachusettsMeasuresMethodsMigrantModelingNaloxoneNeedle SharingNeighborhoodsNew York CityNonmigrantNot Hispanic or LatinoOutcome MeasureOverdosePharmaceutical PreparationsPositioning AttributeProcessProtocols documentationPuerto RicanPuerto RicoRecommendationReportingResearchResourcesRiskRisk BehaviorsRisk ReductionRoleRuralSeriesServicesSocial NetworkSterilityStructureSyringesTimeTrainingUnited StatesVeinsVisualWaiting ListsWateranalogdesigndrug use behavioreffectiveness outcomeeffectiveness/implementation trialempowermentethnic minorityevidence baseimplementation fidelityimplementation interventionimplementation strategyinnovationintervention refinementmeetingsmembermigrationmortalityopioid overdoseoutreachoverdose deathoverdose preventionoverdose riskpeerpeer influencepreventpreventive interventionracial minorityresponserural areasurveillance studysyndemictheoriesurban area
项目摘要
Project Summary/Abstract
The threat of HIV among people who inject drugs (PWID) in the United States (US) is not over. Multiple HIV
outbreaks among PWID in rural and urban areas of the US have occurred recently, from 2015 in rural Indiana
to 2018 in Boston, Massachusetts. PWID who are racial/ethnic minorities continue to be disproportionately
infected with HIV. Among these, Puerto Rican (PR) PWID who started injecting drugs in Puerto Rico (PR) and
continue to inject drugs in New York City (NYC) remain vulnerable not only to HIV, but also to hepatitis C
(HCV) and fatal opioid overdose. Analyses conducted in NYC found PR PWID, especially those who migrated
from PR, are the most HIV-vulnerable ethnic group. In 2017, the US overdose mortality rate for US-born and
PR-born Puerto Rican PWID exceeded the rate for Non-Hispanic Whites, and the same holds true in NYC.
Recent research showed that PR PWID have significantly higher prevalence of HCV than non-PR-PWID, and
that PR-born migrant PWID have the highest HCV prevalence (86%) of all three groups. Helping PR-born
PWID avoid HIV will help prevent HIV outbreaks in NYC. Lowering their HCV and overdose risk will help
reduce overall HCV prevalence (67%) and overdose mortality rates (21.2 per 100,000) in NYC’s PWID.
In this 3-year study, we will develop an innovative and culturally tailored HIV, HCV, and overdose risk-
reduction intervention for migrant PR PWID in NYC that leverages the key migrant PWID role of the Ganchero,
frequently used “injection doctors,” and migrants’ strong social network ties. The intervention will be twofold: 1)
it will train Gancheros on the foundational HIV, HCV, and overdose knowledge required to, 2) deploy
Gancheros to disseminate evidence-based risk-reduction messages and resources and to implement safer
injection practices as they deliver their regular services to migrant PWID clients. The intervention will use a
wait-list control design with 10 Gancheros and 60 clients in two Bronx neighborhoods. Across two time-lagged
intervention implementation cycles (one per neighborhood, each consisting of a 6-session, small-group
Ganchero training and a 4-month deployment period) and five assessment time points, we will measure the
intervention’s feasibility (via Ganchero and client participation rates), acceptability (via Ganchero and client
Visual Analog Scale [VAS] ratings and qualitative feedback) and preliminary effectiveness in increasing
migrant clients’ rates of sterile syringe use (primary effectiveness outcome) and naloxone carriage (secondary
effectiveness outcome). Changes in Gancheros’ HIV, HCV, and overdose knowledge and personal drug use
behaviors will also be assessed before and after the training component. Ethnographic observations of
Gancheros deploying intervention strategies will assess fidelity of implementation, barriers, and Gancheros’
responses to barriers, to inform refinements of the intervention and its implementation strategy. If successful,
this intervention will reduce the high rates of HCV and overdose, and the significant potential for an HIV
outbreak. We will then evaluate the Ganchero intervention in a hybrid effectiveness-implementation trial (R01).
项目摘要/摘要
美国注射吸毒者(PWID)中艾滋病毒的威胁还没有结束。多重艾滋病毒
自2015年以来,美国农村和城市地区的PWID疫情最近在印第安纳州农村地区爆发
至2018年在马萨诸塞州波士顿举行。少数族裔的PWID继续不成比例
感染了艾滋病毒。其中,在波多黎各开始注射毒品的波多黎各人(PR)和
在纽约市(NYC)继续注射毒品不仅容易感染艾滋病毒,而且容易感染丙肝
(丙型肝炎病毒)和致命的阿片类药物过量。在纽约进行的分析发现PR PWID,特别是那些迁徙的人
来自PR,是最易感染艾滋病毒的种族群体。2017年,美国出生和儿童的服药过量死亡率
公关出生的波多黎各人PWID的比例超过了非西班牙裔白人,纽约市也是如此。
最近的研究表明,PR-PWID患者的丙型肝炎病毒感染率显著高于非PR-PWID患者,并且
在所有三个群体中,公关出生的移民PWID的丙型肝炎感染率最高(86%)。帮助出生的公关人员
PWID避免艾滋病毒将有助于防止纽约爆发艾滋病毒。降低他们的丙型肝炎病毒和过量用药风险将有所帮助
降低纽约市PWID的总体丙型肝炎感染率(67%)和过量死亡率(21.2/10万)。
在这项为期3年的研究中,我们将开发一种创新的、根据文化定制的艾滋病毒、丙型肝炎病毒和过量服药风险-
减少对纽约市移民公关PWID的干预,利用甘切罗的关键移民PWID角色,
经常使用的“打针医生”,以及外来务工人员强大的社会关系网。干预将有两个方面:1)
它将对甘切罗进行有关艾滋病毒、丙型肝炎病毒和过量用药的基础知识的培训,2)部署
甘切罗斯传播以证据为基础的减少风险信息和资源,并实施SAFER
在向残疾人移民客户提供常规服务时,他们采取了注射做法。干预将使用
等待名单控制设计,在两个布朗克斯社区有10个甘切罗和60个客户端。跨越两个时间滞后
干预实施周期(每个邻里一个,每个由6次会议的小组组成
甘切罗培训和4个月的部署期间)和五个评估时间点,我们将衡量
干预的可行性(通过甘切罗和客户参与率)、可接受性(通过甘切罗和客户
视觉模拟评分[VAS]评级和定性反馈)和初步有效性
流动人口无菌注射器使用率(主要有效结果)和纳洛酮携带率(次要结果)
有效性结果)。甘切罗斯艾滋病、丙型肝炎病毒感染与吸毒知识和个人用药情况的变化
还将在培训部分之前和之后对行为进行评估。的人种学观察
甘切罗斯部署干预战略将评估实施的保真度、障碍和甘切罗斯的
应对障碍,为改进干预措施及其实施战略提供信息。如果成功,
这一干预措施将降低丙型肝炎病毒的高感染率和过量用药,并显著降低感染艾滋病毒的可能性
疫情爆发。然后,我们将在一项混合有效性-实施试验中评估甘切罗预措施(R01)。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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HONORIA M GUARINO其他文献
HONORIA M GUARINO的其他文献
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{{ truncateString('HONORIA M GUARINO', 18)}}的其他基金
The Staying Safe Intervention: Preventing HCV among Young Opioid Injectors
保持安全的干预措施:预防年轻阿片类药物注射者丙型肝炎病毒
- 批准号:
9919265 - 财政年份:2019
- 资助金额:
$ 16.52万 - 项目类别:
Opioid Use and HIV/HCV Risk among Immigrant Youth from the Former Soviet Union
前苏联移民青年中阿片类药物的使用和艾滋病毒/丙型肝炎风险
- 批准号:
8542098 - 财政年份:2013
- 资助金额:
$ 16.52万 - 项目类别:
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