ART diversion in Rakai, Uganda

摘要 药物共享是其他处方药的常见报告，但到目前为止，还没有研究进行检查 抗逆转录病毒药物转用(购买、出售、借入或借出)用于艾滋病患者的治疗 爱滋病毒。我们之前对高发渔业中的艾滋病毒携带者进行了定性采访。 乌干达拉凯地区维多利亚湖沿岸的社区(热点)。参与者报告频繁、短暂- 与同事/朋友分享抗逆转录病毒治疗(ART)的术语，其动机是保持 尽管定期就诊和坚持服药面临挑战，但仍在服药。然而，我们不知道如何 常见的抗逆转录病毒药物转移是在人群水平上，谁最有可能转移抗逆转录病毒药物，或者是ART 转移影响艾滋病毒的治疗结果，如艾滋病毒病毒抑制。因此，我们提出了混合方法 研究以更好地理解艺术转移，以及是否可以利用它来达到和支持次优 依附的、难以接触的艾滋病毒携带者。这项研究将通过Rakai社区进行 队列研究，一项以人口为基础的队列研究，在40个社区的15-49岁的所有居民中进行 乌干达中南部。目标1将测量与抗逆转录病毒药物转移相关的流行率、分布和因素。 在这个具有代表性的样本中。AIM 2将评估抗逆转录病毒药物转移和HIV病毒之间的联系 压制。目标3将探索一种新的艺术共享二元体干预的可接受性和可行性 它建立在这些现有的社会信任网络之上，以接触到次优的、难以接触到的艾滋病毒 病人。

Summary Drug sharing is commonly reported for other prescription medications, but to date, no studies have examined antiretroviral drug diversion (buying, selling, borrowing, or lending) for therapeutic use among people living with HIV. We previously conducted qualitative interviews with people living with HIV in high-prevalence fishing communities (hotspots) along Lake Victoria in the Rakai region, Uganda. Participants reported frequent, short- term sharing of antiretroviral treatment (ART) with coworkers/friends that was motivated by the desire to keep taking drugs despite challenges to regular clinic attendance and adherence. However, we do not know how common ART diversion is at the population-level, who is most likely to divert antiretroviral drugs, or whether ART diversion affects HIV treatment outcomes such as HIV viral suppression. We therefore propose a mixed methods study to better understand ART diversion and whether it can be leveraged to reach and support sub-optimally adherent, hard-to-reach individuals living with HIV. The study will be conducted through the Rakai Community Cohort Study, a population-based cohort study conducted among all residents aged 15-49 in 40 communities in southcentral Uganda. Aim 1 will measure the prevalence, distribution, and factors associated with ART diversion in this representative sample. Aim 2 will assess the association between ART diversion and HIV viral suppression. Aim 3 will explore acceptability and feasibility of a novel intervention among ART-sharing dyads that builds upon these existing networks of social trust to reach sub-optimally adherent, hard-to-reach HIV patients.