Ethno-epidemiology of HCV, HIV and Overdose associated with Drug Markets and Drug Tourism

此次竞争性修订旨在增加新冠肺炎检测和疫苗接种的可及性和接受度 在注射吸毒者(PWID)中，这是一个极易感染新冠肺炎的人群。建议数 RADxUP项目LinkUp将嵌套在我们的父母赠款La的圣地亚哥部分 到目前为止，31%的La Frontera PWID已经测试过SARS-- CoV-2抗体阳性，其中65%以前没有进行过新冠肺炎检测。只有3%的人 接种过05/2021和45%的人对疫苗感到犹豫。我们的具体目标是：目标1.前瞻性地 评估PWID人群新冠肺炎检测的患病率、预测因素和障碍。目标2.目标 前瞻性评估PWID患者接种新冠肺炎疫苗的发病率、预测因素和障碍。目标3. 调整和试点流动注射器服务计划(SSP)提供的干预措施，以改善 PWID人群新冠肺炎检测和疫苗接种情况调查目的4.比较COVID检测和 国家出台a)新冠肺炎快速检测和b)新冠肺炎前后疫苗接种率 在SSP接种疫苗，这是一项自然的实验。目标5.前瞻性评估 新冠肺炎检测和疫苗接种对残疾人群行为的影响为了实现目标1和目标2，我们将 在La Frontera与400名PWID进行访谈，结果将于2021年秋季公布。基于 这些发现和意见来自我们的社区和科学咨询委员会(CSAB)，我们将选择和 采取一项简短的干预措施，以改善艾滋病患者的新冠肺炎检测和疫苗接种率 我们社区合作伙伴OnPoint的移动面包车。然后，链接干预将在 150名尚未接种新冠肺炎疫苗或检测的La Frontera PWID亚组，将 由OnPoint同行顾问实施，他们还将提供现场快速新冠肺炎抗原检测 以及确认的聚合酶链式反应和转诊到最近的新冠肺炎疫苗接种中心(直到提供疫苗为止 在该州的OnPoint)。我们将通过正在进行的LA独立评估新冠肺炎疫苗的接种情况 Frontera研究访问，将包括自我报告的采访数据，电子健康记录的链接 与圣地亚哥县新冠肺炎数据库进行比较，并通过分析SARS-2抗体模式来 区分自然感染和疫苗诱导免疫。结果将用于估计 未来疗效试验的效果大小并与RADxUP财团、政策制定者和 节目策划者。由于全国有185个SSP，我们的研究将为实现以下目标提供参考 SSP将成为接触边缘化的PWID的重要“触点”，加强国家的 大流行防疫基础设施，以减少新冠肺炎健康差距。

This competitive revision aims to increase access and uptake of COVID-19 testing and vaccination among people who inject drugs (PWID), a population highly vulnerable to COVID-19. The proposed RADxUP project, LinkUP, will be nested within the San Diego component of our parent grant, La Frontera, which was funded by NIDA in 04/20. To date, 31% of La Frontera PWID have tested SARS- CoV-2 antibody+, of whom 65% had not previously been tested for COVID-19. Only 3% had been vaccinated by 05/2021 and 45% were vaccine hesitant. Our specific aims are: AIM 1. To prospectively evaluate the prevalence, predictors and barriers to COVID-19 testing among PWID. AIM 2. To prospectively assess incidence, predictors and barriers to COVID-19 vaccination among PWID. AIM 3. To adapt and pilot an intervention offered at a mobile syringe services program (SSP) to improve uptake of COVID-19 testing and vaccination among PWID. AIM 4. To compare COVID testing and vaccination rates before and after the state introduces a) COVID-19 rapid testing and b) COVID-19 vaccination at the SSP, which represents a natural experiment. AIM 5. To prospectively assess the impact of COVID-19 testing and vaccination on PWIDs’ behaviors. To meet Aim 1 and 2, we will conduct interviews with 400 PWID in La Frontera, results which will be available in Fall 2021. Based on these findings and input from our Community and Scientific Advisory Board (CSAB), we will select and adapt a brief intervention to improve COVID-19 testing and vaccination uptake among PWID at the mobile van of our community partner, OnPoint. The LinkUP intervention will then be piloted among a subgroup of 150 La Frontera PWID who have not received COVID-19 vaccine or testing and will be implemented by OnPoint peer counsellors, who will also offer on-site rapid COVID-19 antigen testing and confirmatory PCR and referrals to the closest COVID-19 vaccination center (until vaccine is offered at OnPoint by the state). We will evaluate COVID-19 vaccine uptake independently through ongoing La Frontera study visits that will include self-reported interview data, linkage of electronic health records with the San Diego County COVID-19 database, and by analyzing SARSCoV-2 antibody patterns to differentiate between natural infection and vaccine-induced immunity. Results will be used to estimate effect sizes for a future efficacy trial and shared with the RADxUP consortium, policymakers and program planners. Since there are 185 SSPs across the country, our study will inform efforts to enable SSPs to become important ‘touchpoints’ to reach marginalized PWID, strengthening the nation’s pandemic preparedness infrastructure to reduce COVID-19 health disparities.