The Impact of Stigma on Interpersonal Relationships of Young Adult People who Inject Drugs

Parent Grant摘要：一项测试合作伙伴导航干预效果的随机试验 针对注射毒品的青壮年人群的丙型肝炎治疗(R01DA053325) 全球有超过350万人感染丙型肝炎病毒(丙型肝炎病毒)。在美国，由于 随着阿片类药物的流行，丙型肝炎病例有所增加，特别是在30岁以下的成年人中。然而，很少有年轻人 注射毒品的人(30岁的PWID≤)--他们是美国丙型肝炎疫情的中心--正在受益 来自治愈的丙型肝炎病毒治疗。增加丙型肝炎病毒治疗的潜在希望，但尚未开发的途径 PWID是利用他们的注入合作伙伴成功地穿越多重障碍 诊断和治疗。我们团队对DYADS的广泛研究确定了一个潜在的作用点 注入可以通过行为干预来驾驭的伙伴关系。已确定的定量结果 特定的注入与人际关系相关的因素(即信任、亲密、合作) 注射伙伴关系的健康和安全。然后是定性结果，与 人际因素、伴侣参与(即情感的、有形的、深情的和积极的社会支持) 增强合作伙伴协调行为的能力(并元能力)。与伴侣的人际关系因素 研究发现，参与治疗可以克服丙型肝炎治疗的障碍。 在我们广泛的二元研究和二元行为改变理论的基础上，我们开发了 合作伙伴导航干预--两次会议注入合作伙伴干预以增强二元 青壮年PWID患者启动丙型肝炎病毒治疗的能力。建议的研究是随机对照研究。 评估首次行为干预的有效性和作用机制的研究(RCT) 青壮年PWID患者开始接受丙型肝炎病毒治疗。与我们基于社区的丙型肝炎病毒检测合作 组织(CBO)，我们将随机选择最近诊断为丙型肝炎病毒感染的年轻人PWID(250 伙伴关系(n=500)及其主要注射伙伴接受干预或护理标准。可扩展性是核心 两会干预的设计。会议1扩展了丙型肝炎病毒感染诊断的标准护理 咨询顾问与丙型肝炎病毒阳性的PWID患者进行讨论，以确定情况和个人情况 丙型肝炎病毒治疗的障碍，并确定注射合作伙伴，以帮助他们的丙型肝炎治疗导航。第二节 对于年轻的PWID患者和他们的注射伙伴来说，这是一个二元式的会话。一位顾问促成了讨论 将制定战略，以应对已确定的丙型肝炎病毒治疗启动障碍和伙伴关系实践 制定战略，并制定一项涉及双方合作伙伴的计划，以解决障碍，包括时间表和 治疗导航中的潜在替代战略。在两次会议期间，辅导员记录关键字 在作为干预工具的纸质讲义(合作伙伴导航图)上讨论的信息。一个 社区咨询委员会将指导青年残疾人发展计划的实施和传播。建议数 研究将提高这一高度受影响人群的治愈率。我们增强并元容量的战略 可能适用于影响年轻PWID的其他健康行为的有针对性的改变(例如，预防丙型肝炎)。

Abstract of Parent Grant: A Randomized Trial to Test the Efficacy of a Partner Navigation Intervention for HCV Treatment among Young Adult People who Inject Drugs (R01DA053325) Globally, more than 3.5 million people are infected with hepatitis C virus (HCV). In the United States, due to the opioid epidemic, HCV cases have increased, especially among adults under 30. However, few young people who inject drugs (PWID ≤30 years old) – who are at the center of the HCV epidemic in the US – are benefiting from curative HCV therapy. A potentially promising, yet untapped avenue for increasing HCV treatment among PWID is the leveraging of their injecting partners to successfully navigate the multiple obstacles between diagnosis and treatment. Our team’s extensive research with dyads identified a potential action-point within injecting partnerships that can be harnessed through behavioral intervention. Quantitative findings identified specific injecting related interpersonal factors (i.e., trust, intimacy, cooperation) associated with increased health and safety for injecting partnerships. Followed by qualitative results that in combination with interpersonal factors, partner involvement (i.e., emotional, tangible, affectionate, and positive social support) enhances a partnership’s ability to coordinate behavior (dyadic capacity). Interpersonal factors with partner involvement was found to overcome barriers to HCV treatment. Building on our extensive foundation of dyadic research and dyadic behavior change theories, we developed the Partner Navigation Intervention a two-session injecting partnership intervention to enhance dyadic capacity for HCV treatment initiation for young adult PWID. The proposed study is a randomized controlled study (RCT) to assess the efficacy and mechanism of action of the first behavioral intervention to increase HCV treatment initiation among young adult PWID. In partnership with our community-based HCV testing organizations (CBOs), we will randomize young adult PWID with recently diagnosed HCV infection (250 partnerships, n=500) and their primary injecting partner to intervention or standard of care. Scalability was core to the design of the two-session intervention. Session 1 expands on standard-of-care HCV infection diagnosis counseling with counselor-led discussion with the HCV positive PWID to identify situational and personal barriers to HCV treatment and identify an injecting partner to aid in their HCV treatment navigation. Session 2 is a dyad session with both the young adult PWID and their injecting partner. A counselor facilitated discussion will develop strategies to respond to the identified HCV treatment initiation barriers and partnerships practice strategies and concretize a plan involving both partners for addressing barriers, including a timeline and potential alternative strategies in treatment navigation. During both sessions the counselor records key information discussed onto a paper handout (Partner Navigation Map) serving as the intervention tool. A community advisory board young adult PWID will guide implementation and dissemination. The proposed study will improve the cure rate in this highly impacted population. Our strategy of enhancing dyadic capacity may be adapted for targeted change of other health behaviors (e.g., HCV prevention) affecting young PWID.