Syringe Services Program Implementation in Rural Counties Vulnerable to HIV Outbreak
在易受艾滋病毒爆发的农村县实施注射器服务计划
基本信息
- 批准号:10090585
- 负责人:
- 金额:$ 14.44万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2018
- 资助国家:美国
- 起止时间:2018-03-15 至 2023-02-28
- 项目状态:已结题
- 来源:
- 关键词:AIDS preventionAddressAppalachian RegionAreaAwardCenters for Disease Control and Prevention (U.S.)CharacteristicsCommunitiesCost AnalysisCost SavingsCountyDataDevelopmentDiagnosisDisease OutbreaksDrug AddictionEnvironmentEpidemicEpidemiologyEquipmentFive-Year PlansFundingFutureGenderGoalsHIVHIV InfectionsHIV diagnosisHIV riskHealth BenefitHealth Care CostsHealth PolicyHeroinHuman immunodeficiency virus testIncidenceIndianaIndividualInfectionInjecting drug userInjectionsInterventionInterviewKentuckyKnowledgeLinkLiteratureMentored Research Scientist Development AwardMentorshipModelingNaloxoneNational Institute of Drug AbuseNatureNeedle SharingNeedle-Exchange ProgramsPharmaceutical PreparationsPharmacotherapyPoliciesPopulationPublic HealthPublic Health EducationPublicationsReportingResearchResearch PersonnelResearch Project GrantsRisk BehaviorsRisk FactorsRoleRouteRuralRural AppalachiaRural CommunityRural HealthSavingsShapesSterilityStructureStudy modelsSyringesTimeTrainingTraining ProgramsTreatment CostUnemploymentUnited StatesViral hepatitisWest VirginiaWomanWorkcareercareer developmentcookingcostcost effectivedesignheroin usehigh riskimplementation costimplementation scienceinformal learninginformantinjection drug useinsightmalemeetingsmenmultilevel analysisopioid epidemicopioid injectionprescription opioidprescription opioid misusepreventprevention serviceresponserural arearural countiesservice deliveryservice programsservice utilizationskillssubstance usetransmission processurban area
项目摘要
PROJECT SUMMARY/ABSTRACT
The recent HIV outbreak linked to the injection of prescription opioids in Scott County, Indiana highlighted the
vulnerability of rural communities to the introduction and rapid transmission of HIV and viral Hepatitis among persons
who inject drugs (PWID). In the wake of this epidemic, jurisdictions across the United States have renewed efforts to
address the syndemic of opioid injection and HIV infection, including by implementing syringe services programs (SSPs).
SSPs are associated with decreases in incidence rates of HIV and viral Hepatitis among PWID. Modeling studies have
shown that SSP implementation is cost-effective, resulting in millions in healthcare cost savings from averted HIV
infections. Although the public health benefits of SSPs are well documented, most studies that examined their utility were
conducted in major urban areas; a scarcity of literature exists regarding rural SSP implementation. This is a critical gap in
the literature given that the Centers for Disease Control and Prevention identified 220 predominantly rural counties across
26 states that are vulnerable to an opioid injection-related HIV outbreak. The purpose of this research is to address this
gap in our understanding of rural SSPs through the following specific aims: (1) to determine what individual-level (e.g.,
gender, injection drug of choice) and community-level characteristics (e.g., unemployment and arrest rates) are associated
with HIV prevention services utilization (e.g., SSP engagement, HIV testing) among SSP users (n=330) and nonusers
(n=330) in two rural Appalachian counties vulnerable to HIV outbreak; (2) to explore barriers and facilitators (e.g.,
community response, policy environment) of SSP implementation in two rural Appalachian counties vulnerable to HIV
outbreak with and without SSPs among 40 stakeholders; (3) to conduct cost analyses of SSP implementation in two rural
Appalachian counties vulnerable to HIV outbreak. Aim 1 will allow us to better understand the individual and community
characteristics associated with HIV prevention services utilization among rural PWID. These data will inform the
development of future interventions that aim to reduce HIV risk behaviors among rural PWID. Through semi-structured
key informant interviews (Aim 2), we will be able to compare the barriers and facilitators of SSP implementation in rural
counties with and without SSPs. The results of Aim 3 will shed insights on rural SSP implementation costs and how
service delivery may be impacted by changes in funding levels. This research project will be embedded in a
comprehensive training program consisting of coursework, seminars, guided study, and mentorship by an established team
of experts. The training program is designed to further my strengths and to develop new research skills while contributing
to our scientific understanding of rural SSPs. The training proposal details a five-year plan of formal and informal
instruction in: multilevel modeling, implementation science, and cost analyses. My short-term career goals include:
completing coursework in all training areas, disseminating study findings through publications and presentations,
engaging in career development activities, and applying for independent R01 funding in the latter years of the award. My
long-term career goal is to become an independent investigator in drug dependence and HIV prevention in rural areas.
项目总结/摘要
最近在印第安纳州斯科特县发生的与注射处方阿片类药物有关的艾滋病毒爆发突出表明,
农村社区易受艾滋病毒和病毒性肝炎的传入和在人群中的快速传播
注射毒品者(PWID)在这一流行病之后,美国各地的司法管辖区重新努力,
解决阿片类药物注射和艾滋病毒感染的流行病,包括实施注射器服务计划(SSP)。
SSP与PWID中艾滋病毒和病毒性肝炎发病率的降低有关。建模研究有
表明SSP的实施具有成本效益,可通过避免艾滋病毒而节省数百万美元的医疗费用
感染.虽然SSP的公共卫生效益有很好的记录,但大多数研究都检查了它们的效用,
在主要城市地区进行;缺乏关于农村SSP实施的文献。这是一个关键的差距,
鉴于疾病控制和预防中心确定了全国220个主要是农村的县,
26个州易受阿片类注射相关艾滋病毒爆发的影响。这项研究的目的是解决这个问题。
通过以下具体目标,我们对农村SSP的理解存在差距:(1)确定什么样的个人水平(例如,
性别、选择的注射药物)和社区一级的特征(例如,失业率和逮捕率)
艾滋病毒预防服务的利用(例如,SSP使用者(n=330)和非使用者之间的SSP参与,HIV检测
(n=330)在阿巴拉契亚两个易受艾滋病毒爆发影响的农村县;(2)探索障碍和促进因素(例如,
社区反应,政策环境)在两个易受艾滋病毒感染的阿巴拉契亚农村县实施SSP
在40个利益相关者中进行有和没有SSP的爆发;(3)在两个农村地区进行SSP实施的成本分析
阿巴拉契亚县易受艾滋病毒爆发。目标1将使我们更好地了解个人和社区
农村艾滋病感染者艾滋病预防服务利用的相关特征这些数据将通知
制定未来的干预措施,旨在减少农村PWID中的艾滋病毒风险行为。通过半结构化
通过对关键信息提供者的访谈(目标2),我们将能够比较在农村实施SSP的障碍和促进因素
有和没有SSP的县。目标3的结果将揭示农村SSP的实施成本以及如何
服务的提供可能受到供资水平变化的影响。该研究项目将被嵌入一个
综合培训计划,包括课程,研讨会,指导学习,并由一个既定的团队指导
的专家。该培训计划旨在进一步发挥我的优势,并发展新的研究技能,同时作出贡献
我们对农村SSP的科学理解。培训提案详细说明了一项正式和非正式的五年计划,
教学方向:多层次建模、实施科学和成本分析。我的短期职业目标包括:
完成所有培训领域的课程作业,通过出版物和演讲传播研究结果,
从事职业发展活动,并在该奖项的后几年申请独立的R 01资金。我
长期职业目标是成为农村地区药物依赖和艾滋病毒预防方面的独立调查员。
项目成果
期刊论文数量(0)
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科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Sean T Allen其他文献
Sean T Allen的其他文献
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{{ truncateString('Sean T Allen', 18)}}的其他基金
Syringe Services Program Implementation in Rural Counties Vulnerable to HIV Outbreak
在易受艾滋病毒爆发的农村县实施注射器服务计划
- 批准号:
10347282 - 财政年份:2018
- 资助金额:
$ 14.44万 - 项目类别:
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