Improving measurement of alcohol consumption among HIV-affected youth in sub-Saharan Africa: evaluation and implementation of biomarkers

改进对撒哈拉以南非洲受艾滋病毒影响的青少年饮酒量的测量：生物标志物的评估和实施

• 批准号: 10616727
• 负责人: Jeremy Calvin Kane
• 金额: $ 17.54万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-05-01 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10616727
• 关键词: AIDS prevention; Achievement; Address; Adherence; Adolescent; Adolescent and Young Adult; Adoption; Affect; Africa South of the Sahara; Age; Alcohol abuse; Alcohol consumption; Alcohols; Back; Biological Assay; Biological Markers; Body mass index; Caring; Cessation of life; Characteristics; Clinic; Clinical Research; Collaborations; Consumption; Counseling; Country; Data Collection; Dedications; Detection; Development; Development Plans; Diagnosis; Dissemination and Implementation; Ecological momentary assessment; Effectiveness of Interventions; Epidemic; Evaluation; Evidence based practice; Feedback; Focus Groups; Follow-Up Studies; Funding; Gender; Glucuronides; Goals; HIV; HIV Infections; HIV/AIDS; Home; Incidence; Income; Infectious Diseases Research; Interview; Knowledge; Lead; Link; Measurement; Measures; Mentors; Mentorship; Methods; Minority; National Institute on Alcohol Abuse and Alcoholism; Outcome; Patient Self-Report; Policy Maker; Population; Predisposition; Prevalence; Procedures; Process; Professional counselor; Protocols documentation; Psychiatric epidemiology; Public Health; Quality of Care; Religion; Reporting; Research; Research Activity; Research Personnel; Research Training; Resource Allocation; Risk; Role; Scientist; Screening Result; Services; Social Desirability; Societies; Strategic Planning; Test Result; Testing; Training; Treatment Efficacy; Treatment outcome; Underserved Population; United States National Institutes of Health; Universities; Urine; Viral; Visit; Work; Youth; Zambia; alcohol abuse therapy; alcohol epidemiology; alcohol intervention; alcohol measurement; alcohol misuse; alcohol risk; alcohol screening; alcohol services; alcohol testing; brief intervention; career; career development; catalyst; clinical practice; cost; design; diagnostic tool; effectiveness evaluation; efficacy study; evidence base; experience; feasibility testing; follow-up; formative assessment; future implementation; health disparity; high risk sexual behavior; implementation determinants; implementation research; implementation science; implementation strategy; implementation/effectiveness; improved; innovation; laboratory experience; multidisciplinary; novel; phosphatidylethanol; point-of-care diagnostics; population based; prevention service; programs; randomized trial; reduced alcohol use; screening; screening and brief intervention; social stigma; stressor; timeline; transmission process; treatment services; underage drinking; uptake

HIV-affected adolescents and young adults (AYA) in sub-Saharan Africa (SSA) experience stressors that increase their risk for problematic alcohol use, which in turn can lead to HIV infection or transmission and poor HIV outcomes, including linkage to care and ART adherence. Efforts to address the HIV epidemic among adolescents and young adults in SSA have therefore focused, in part, on treating risky alcohol use. Yet, the vast majority of HIV-affected AYA in SSA who need alcohol services do not receive them, resulting in a substantial treatment gap. A critical barrier to the accurate screening for risky alcohol use among AYA and provision of appropriate treatment is a lack of objective measures for alcohol consumption in HIV care settings, which rely primarily on self-report alone. This K01 mentored research scientist development proposal aims to examine the role of biomarkers in improving alcohol screening and treatment referral among AYA in HIV prevention and treatment clinics. Specifically, the proposal will investigate a urine-based biomarker, ethyl glucuronide (UEtG), which has displayed potential as a point-of-care diagnostic tool among clinic-based populations in the U.S. but has not been investigated as a valid and feasible method within HIV care settings among AYA. Research activities for this proposal will take place in Zambia, a country with one of the highest HIV prevalence estimates in the world. The research will leverage over a decade of HIV research in Zambia by Johns Hopkins University and a longstanding collaboration with Centre for Infectious Disease Research in Zambia (CIDRZ), the local implementing partner. Specific aims of the proposal are to: 1) assess the test characteristics of UEtG among HIV-affected AYA in Zambia; 2) develop a protocol for the use of rapid UEtG dip card testing embedded within AYA HIV prevention and treatment; and 3) pilot the UEtG protocol developed in Aim 2 and refine procedures with a formative evaluation process. Findings will inform implementation strategies that can be tested in a follow-up study. The research is designed to be an integral component of a rigorous training and career development plan focused on HIV/AIDS, alcohol biomarkers, and implementation science. Training will take the form of coursework, lab training, and one-on-one mentorship with an experienced and dedicated team of multidisciplinary mentors and consultants who are widely considered to be experts in their respective fields. The goal of the professional development plan is to facilitate the candidate's transition into an independent investigator in alcohol epidemiology and implementation science with specific expertise in HIV and biomarkers. The proposal is directly in line with Goal 2 (“improve diagnosis and tracking of alcohol misuse”) and Objective 5c (“facilitating dissemination and implementation of evidence-based practices for diagnosing alcohol misuse”) of the NIAAA Strategic plan 2017-2021. The proposal is consistent with NIH high priority HIV research in addressing “health disparities in the incidence of new HIV infections” and “research training of the workforce required to conduct high priority HIV/AIDS or HIV/AIDS-related research.”

撒哈拉以南非洲（SSA）的受艾滋病毒影响的青少年和年轻人（aya）经历压力源 增加其饮酒有问题的风险，进而会导致艾滋病毒感染或传播和差 艾滋病毒的结果，包括与护理和艺术依从性的联系。解决艾滋病毒流行的努力 因此，SSA的青少年和年轻人部分集中在治疗危险的饮酒上。但是， SSA中绝大多数受艾滋病毒影响的AYA需要酒精服务都没有接受，导致 大量的治疗差距。准确筛查AYA和 提供适当的治疗是缺乏用于艾滋病毒护理环境中饮酒的客观测量， 这主要依靠自我报告。这项K01讨论研究科学家发展建议旨在 检查生物标志物在改善HIV中AYA中酒精筛查和治疗转诊中的作用 预防和治疗诊所。具体而言，该提案将研究基于尿液的生物标志物乙基 葡萄糖醛酸（UETG），它在基于诊所的诊断工具中表现出潜力 在美国的人群，但尚未作为艾滋病毒护理环境中的一种有效且可行的方法进行调查 在Aya中。该提案的研究活动将在赞比亚举行，这是一个最高的国家之一 艾滋病毒流行率估计。这项研究将利用十年来赞比亚的艾滋病毒研究 约翰·霍普金斯大学（Johns Hopkins University）以及与传染病研究中心的长期合作 Zambia（Cidrz），本地实施合作伙伴。该提案的具体目的是：1）评估测试 赞比亚受艾滋病毒影响的AYA中UETG的特征； 2）开发用于使用快速UETG的协议 浸入AYA HIV预防和治疗中的浸入卡测试； 3）驾驶UETG协议开发了 在AIM 2和通过形成性评估过程的完善程序中。调查结果将告知实施 可以在后续研究中测试的策略。该研究旨在成为一个不可或缺的组成部分 严格的培训和职业发展计划着重于艾滋病毒/艾滋病，酒精生物标志物和实施 科学。培训将采取课程工作的形式，实验室培训和一对一的指导 经验丰富，专门的多学科导师和顾问团队，被广泛认为是 各自领域的专家。专业发展计划的目标是促进候选人的 过渡到酒精流行病学和实施科学领域的独立研究者 艾滋病毒和生物标志物方面的专业知识。该提案直接与目标2一致（“改进诊断和跟踪 滥用酒精”）和目标5C（“促进基于证据的实践的传播和实施 NIAAA战略计划2017-2021。该提案与NIH一致 艾滋病毒在解决“新艾滋病毒感染事件中的健康差异”和 “需要进行高优先级艾滋病毒/艾滋病或艾滋病毒/艾滋病相关的研究所需的劳动力研究培训。”

项目成果

Two-year treatment effects of the common elements treatment approach (CETA) for reducing intimate partner violence and unhealthy alcohol use in Zambia.

• DOI: 10.1017/gmh.2021.2
• 发表时间: 2021
• 期刊: Global mental health (Cambridge, England)
• 作者: Kane JC;Glass N;Bolton PA;Mayeya J;Paul R;Mwenge M;Murray LK
• 通讯作者: Murray LK

Alcohol-focused and transdiagnostic treatments for unhealthy alcohol use among adults with HIV in Zambia: A 3-arm randomized controlled trial.

• DOI: 10.1016/j.cct.2023.107116
• 发表时间: 2023-04
• 期刊: CONTEMPORARY CLINICAL TRIALS
• 影响因子: 2.2
• 作者: Vinikoor, Michael J.;Sharma, Anjali;Murray, Laura K.;Figge, Caleb J.;Bosomprah, Samuel;Chitambi, Chipo;Paul, Ravi;Kanguya, Tukiya;Sivile, Suilanji;Nghiem, Van;Cropsey, Karen;Kane, Jeremy C.
• 通讯作者: Kane, Jeremy C.