The Diversion of Antiretroviral Medications to Street Markets

抗逆转录病毒药物转移到街头市场

基本信息

  • 批准号:
    7580136
  • 负责人:
  • 金额:
    $ 45.68万
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
    2008
  • 资助国家:
    美国
  • 起止时间:
    2008-12-01 至 2012-11-30
  • 项目状态:
    已结题

项目摘要

DESCRIPTION (provided by applicant): Prescription drug "diversion" -- the unlawful channeling of regulated pharmaceuticals from legal sources to the illicit marketplace -- has been a topic of widespread commentary since the latter part of the 1990s, and a number of recent studies have addressed patterns of narcotic analgesic abuse and diversion. The scientific literature, however, has been virtually silent regarding the diversion of antiretroviral medications (ARV) for HIV. Nevertheless, pilot work conducted by the investigators of this application suggests that ARV diversion is a growing problem among drug-involved individuals in Miami, and is likely occurring in other large urban centers where rates of HIV infection are high. The ramifications of this diversion are potentially significant. Importantly, those prescribed ARV medications may not be consistently adhering to their treatment regimens, resulting in a deterioration of their own health and increasing the potential for the emergence of medication-resistant strains of HIV. From a public health perspective, the widespread transmission of drug-resistant HIV could leave newly-infected individuals with few viable treatments. Within this context, the overall goals of the proposed 4-year project are to examine the patterns and predictors of ARV diversion among drug-involved HIV-positive individuals in Miami (Dade County), Florida, and to describe the dynamics of ARV medication diversion to local street markets. The study will utilize a theory-driven, mixed method approach to achieve these goals. The specific aims of the qualitative component of the proposed research are to: 1) Describe the key individual, provider, and environmental factors that influence ARV diversion through formative qualitative research; and, 2) Adapt and refine the Andersen model of health services utilization to include the key dimensions of ARV diversion identified in the formative qualitative research phase. Aims 1 and 2 will be accomplished by: 1) Conducting baseline and follow-up in-depth interviews with 90 drug-involved, indigent, HIV positive ARV diverters and non-diverters to examine motivations for diversion and non-diversion over time; 2) Conducting baseline and follow-up in-depth interviews with 30 "pill brokers" to document their ARV diversion activities over time; and, 3) Conducting in-depth baseline and follow-up interviews with 45 HIV positive buyers of illicit ARVs to examine motivations for illicit ARV purchases over time. The primary specific aim of the quantitative component of the research is to: 3) Compare the key differences between ARV diverters and non-diverters on individual, provider, and environmental level factors described by the modified Andersen Model of health services utilization, and examine their effects on patterns of ARV medication diversion. Aim 3 will be accomplished by: 1) Recruiting a sample of 500 indigent, HIV positive individuals who are current drug users [250 of whom divert ARV medications and 250 who do not]; and, 2) assessing the constellation of individual, provider and environmental factors hypothesized to predict ARV diversion. PUBLIC HEALTH RELEVANCE: A comprehensive understanding of the nature, motivations for, and mechanisms of ARV medication diversion is critical for funding and regulatory agencies, industry, public health organizations, and health care providers as they attempt to develop appropriate prevention, risk management, treatment, and policy initiatives. Most importantly, this study will inform interventions targeting the significant health consequences of ARV diversion and non-adherence by highly vulnerable populations.
描述(由申请人提供):处方药“转移” - 从法律来源到非法市场的非法通道 - 自1990年代后期以来一直是广泛评论的话题,最近的许多研究涉及麻醉止痛药的滥用和转移模式。然而,关于艾滋病毒的抗逆转录病毒药物(ARV)的转移,科学文献几乎一直保持沉默。然而,该应用程序的研究人员进行的试点工作表明,ARV转移是迈阿密药物涉及的个体的日益严重的问题,并且很可能发生在其他大型城市中心,那里的HIV感染率很高。这种转移的后果可能是显着的。重要的是,那些规定的ARV药物可能不会始终如一地遵守其治疗方案,从而导致其自身健康状况恶化,并增加了抗药性HIV菌株的潜力。从公共卫生的角度来看,耐药艾滋病毒的广泛传播可能会使新感染的人几乎没有可行的治疗方法。在这种情况下,拟议的4年项目的总体目标是研究佛罗里达州迈阿密(戴德县)的毒品涉及艾滋病毒阳性个体的ARV转移的模式和预测因素,并描述ARV药物转移到当地街头市场的动态。该研究将利用一种理论驱动的混合方法来实现这些目标。拟议研究的定性组成部分的具体目的是:1)描述通过形成性定性研究影响ARV转移的关键个体,提供者和环境因素; 2)适应和完善安徒生的卫生服务利用模型,包括在形成性定性研究阶段确定的ARV转移的关键维度。目标1和2将通过:1)进行基线和随访的深入访谈,以90次涉及药物的,贫穷的,HIV阳性的ARV ARV分流者和非转移者进行检查,以检查随着时间的推移转移和非言论的动机; 2)对30个“药丸经纪人”进行基线和随访的深入访谈,以记录其ARV转移活动; 3)对45个非法ARV的艾滋病毒阳性买家进行深入基准和后续采访,以检查随着时间的推移非法ARV购买的动机。研究的定量组成部分的主要特定目的是:3)比较ARV分流器与非转移者对个人,提供者和环境层面因素的关键差异,该因素通过修改后的Andersen卫生服务模型利用模型,并检查其对ARV药物分化模式的影响。 AIM 3将通过以下方式完成:1)招募500名贫困的,艾滋病毒阳性的人,这些人是现任吸毒者[其中250个转移ARV药物和250名不属于的药物];以及2)评估个人,提供者和环境因素的星座,以预测ARV转移。公共卫生相关性:对ARV药物转移的性质,动机和机制的全面理解对于资助和监管机构,行业,公共卫生组织和医疗保健提供者来说至关重要。最重要的是,这项研究将为针对高度脆弱人群的ARV转移和不遵守的重大健康后果的干预措施提供信息。

项目成果

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HILARY L SURRATT其他文献

HILARY L SURRATT的其他文献

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{{ truncateString('HILARY L SURRATT', 18)}}的其他基金

Integrated PrEP Interventions for People Who Inject Drugs in Rural Kentucky
针对肯塔基州农村地区注射毒品者的综合 PrEP 干预措施
  • 批准号:
    10320665
  • 财政年份:
    2021
  • 资助金额:
    $ 45.68万
  • 项目类别:
Integrated PrEP Interventions for People Who Inject Drugs in Rural Kentucky
针对肯塔基州农村地区注射毒品者的综合 PrEP 干预措施
  • 批准号:
    10452614
  • 财政年份:
    2021
  • 资助金额:
    $ 45.68万
  • 项目类别:
Integrated PrEP Interventions for People Who Inject Drugs in Rural Kentucky
针对肯塔基州农村地区注射毒品者的综合 PrEP 干预措施
  • 批准号:
    10670122
  • 财政年份:
    2021
  • 资助金额:
    $ 45.68万
  • 项目类别:
Examining Social Influences on Syringe Exchange Uptake among Rural PWID at Risk for HIV
检查社会对有艾滋病毒风险的农村吸毒者更换注射器的影响
  • 批准号:
    9481503
  • 财政年份:
    2017
  • 资助金额:
    $ 45.68万
  • 项目类别:
The Diversion of Antiretroviral Medications to Street Markets
抗逆转录病毒药物转移到街头市场
  • 批准号:
    8223567
  • 财政年份:
    2008
  • 资助金额:
    $ 45.68万
  • 项目类别:
The Diversion of Antiretroviral Medications to Street Markets
抗逆转录病毒药物转移到街头市场
  • 批准号:
    8329025
  • 财政年份:
    2008
  • 资助金额:
    $ 45.68万
  • 项目类别:
The Diversion of Antiretroviral Medications to Street Markets
抗逆转录病毒药物转移到街头市场
  • 批准号:
    7741733
  • 财政年份:
    2008
  • 资助金额:
    $ 45.68万
  • 项目类别:
The Diversion of Antiretroviral Medications to Street Markets
抗逆转录病毒药物转移到街头市场
  • 批准号:
    8013055
  • 财政年份:
    2008
  • 资助金额:
    $ 45.68万
  • 项目类别:
HIV/AIDS PREVENTION RESEARCH IN ST.CROIX,U.S. V.I.
美国圣克罗伊岛的艾滋病毒/艾滋病预防研究
  • 批准号:
    6589920
  • 财政年份:
    2002
  • 资助金额:
    $ 45.68万
  • 项目类别:
HIV/AIDS PREVENTION RESEARCH IN ST.CROIX,U.S. V.I.
美国圣克罗伊岛的艾滋病毒/艾滋病预防研究
  • 批准号:
    6667086
  • 财政年份:
    2002
  • 资助金额:
    $ 45.68万
  • 项目类别:

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