HIV Rapid Testing for Young Substance Users

描述（由申请人提供）：本申请是通过NIDA小额赠款计划申请R03奖，以评估16-25岁青少年和年轻成人药物使用者快速检测艾滋病毒的可接受性和可行性。首席研究员Pugatch博士是布朗医学院（Brown Medical School）儿科和医学助理教授。今年是他获得NIDA指导职业发展奖的最后一年。16-25岁的年轻药物使用者由于共用针头和共用与注射毒品使用有关的“工作”以及危险的性行为而处于感染艾滋病毒的高风险。在本研究中，我们提出了两种高活性物质使用率的青少年群体：1)住院、短期药物治疗机构的青少年和2)从事社会服务的无家可归的青少年。研究人员在对吸毒青少年进行艾滋病毒检测研究方面有相当丰富的经验。艾滋病毒检测结果的后续跟进在全国范围内都是一个问题，现在的新技术使快速进行艾滋病毒检测并立即获得结果成为可能。OraQuick(r)是FDA批准的一种新的快速HIV检测方法，可以很容易地在临床环境之外进行管理。快速检测尚未在高危青少年人群中进行实地测试。300名年龄在16-25岁之间的年轻人将完成一项简短的面对面风险评估。该研究将在两种环境中进行，一种是短期住院药物治疗设施，另一种是无家可归者的社区外展计划（每个地点有75名同年龄组的男性和75名女性）。在完成问卷后，参与者将使用OraQuick(r)进行快速手指棒HIV检测。艾滋病病毒检测前和检测后的咨询将采用标准方案。结果将在一小时内送达。测试呈阳性的参与者将获得初步阳性结果，将通过确认性Western Blot重新测试，并立即与医疗保健联系起来。快速测试的可接受性、拒绝的原因、对快速咨询和测试方案的满意度以及接受结果的测试者比例将按地点、每个地点的性别和参与者风险的敏锐度进行分析。这些结果将为未来的随机试验提供初步数据，以比较当日快速检测与标准检测，并对检测验收、接收结果和风险降低进行为期一周的随访。

DESCRIPTION (provided by applicant): This application is a request for an R03 award through the NIDA Small Grants Program to evaluate the acceptability and feasibility of rapid testing for HIV among adolescent and young adult substance users 16-25 years of age. Dr. Pugatch, the principal investigator, is an Assistant Professor of Pediatrics and Medicine at the Brown Medical School. He is currently in his final year of a NIDA mentored career development award. Young substance users ages 16-25 are at high-risk for HIV disease due to both needle sharing and sharing of "works" associated with injection drug use, and risky sexual behaviors. Two populations of adolescents with high rates of active substance use are proposed for this study: 1) adolescents at an in-patient, short-term drug treatment facility and 2) homeless youth engaged in social services. The investigators have considerable experience conducting adolescent HIV testing research in adolescents with drug abuse. Follow-up for HIV test results is a problem nationwide, and new technology now makes it possible to do rapid HIV testing and make immediate results available. OraQuick(r) is a new rapid HIV test approved by the FDA and can easily be administered outside of a clinical setting. Rapid tests have not yet been field tested in at-risk adolescent populations. Three hundred youth between the ages 16-25 will complete a brief face-to-face risk assessment. The study will be conducted in two settings, one being a short-term inpatient drug treatment facility and the other a community outreach program for the homeless (75 males and 75 females of the same age group at each site). After completion of the questionnaire, participants will be offered the rapid finger-stick HIV test using OraQuick(r). A standard protocol will be used for HIV pre- and post-test counseling. Results will be delivered within one hour. Participants who test positive will be given a preliminary positive result, will be re-tested by confirmatory Western Blot, and immediately linked to medical care. Acceptability of rapid testing, reasons for refusal, satisfaction with the rapid counseling and testing protocol and proportion of testers who receive results will be analyzed by site, by gender at each site, and by the acuity of the participants' risk. These results will provide preliminary data for a future randomized trial to compare same-day rapid testing versus standard testing with one week follow-up for testing acceptance, receiving results, and risk reduction.