A social network approach for improving medication assisted treatment and HIV prevention and medical care among people who inject drugs in Ukraine

项目摘要 注射毒品(PWID)的人感染和传播艾滋病毒以及致命阿片类药物的风险很高 吸毒过量。此R34的目标是试运行基于更大设置的关键组件 增加药物辅助治疗(MAT)和艾滋病毒医疗护理的随机临床试验(RCT) 药物依从性。在拟议的研究中，我们将招募80名指数PWID(一半艾滋病毒血清阳性)，他们有： 1)在席上至少一年，2)能够招募吸毒的活跃网络成员，3)是 愿意向这些PWID推广MAT。根据我们的试点数据，我们预计这80个指数参与者将 能够招募大约160名网络成员(每人两名)进行研究干预。在基线之后 对指数和网络成员的评估、指数及其各自的网络成员 随机分配到实验干预或对照条件。在实验中 在干预过程中，这些指数将接受关于如何与其网络成员合作宣传MAT和艾滋病毒的培训 对携带艾滋病毒的毒品网络成员的关怀，包括对抗逆转录病毒药物的坚持。所有研究参与者都将 3个月后通过调查和药物测试进行评估。结果将包括网络中的MAT使用率 成员，在指数和网络成员中保留美沙酮，降低艾滋病毒血清转换率 在网络成员中，减少了所有研究参与者的非法药物使用，并与艾滋病毒医疗联系 艾滋病病毒携带者网络参与者的关爱和抗逆转录病毒治疗的坚持。根据我们的调查结果 在之前的研究中，我们还预计指数参与者的健康行为随机到 通过开展同伴教育活动，实验组的学习成绩会有所提高。我们将进行定性的过程和 结果对实验干预条件下的10项指标和10名网络成员进行访谈。我们 还将采访8名MAT和HIV诊所的工作人员，以评估他们对干预可行性的看法 也是可以接受的。鉴于阿片类药物流行的范围和残疾人中艾滋病毒的持续流行， 开发新的干预措施以增加垫子的摄取和保持是至关重要的。

Project Summary People who inject drugs (PWID) are at high risk for HIV infection and transmission as well as fatal opioid overdoses. The goal of this R34 is to pilot the key components necessary for a larger setting-based randomized clinical trial (RCT) for increasing medication-assisted treatment (MAT) and HIV medical care and medication adherence. In the proposed study, we will recruit 80 index PWID (half HIV seropositive) who have: 1) been on MAT for at least one year, 2) are able to recruit active network members who use drugs, and 3) are willing to promote MAT to these PWID. Based on our pilot data, we anticipate these 80 index participants to be able to recruit approximately 160 network members (two each) for the study intervention. After the baseline assessment of the indexes and network members, the indexes and their respective network members will be randomly assigned to the experimental intervention or the comparison condition. In the experimental intervention, the indexes will be trained on how to work with their network members to promote MAT and HIV care, including ART adherence, for drug network members living with HIV. All study participants will be assessed at 3 months with surveys and drug testing. Outcomes will include MAT uptake among network members, retention on methadone amongst indexes and network members, reduced HIV seroconversions among network members, reduced illicit drug use among all study participants, and linkage to HIV medical care and ART adherence among network participants who are living with HIV. Based on findings from our prior studies, we also anticipate that the health behaviors of the index participants randomized to the experimental group will improve due to their peer education activities. We will conduct qualitative process and outcomes interviews with 10 indexes in the experimental intervention condition and 10 network members. We will also interview 8 MAT and HIV clinic staff members to assess their perspectives on intervention feasibility and acceptably. Given the scope of the opioid epidemic and continued HIV epidemic among PWID, development of novel interventions to increase MAT uptake and retention is critical.