The role of injection partnerships and preferences for reducing HCV risk: Giving a voice to young women in rural Appalachia

项目摘要 此K 01指导研究科学家开发应用程序的目的是开发Kathryn博士 兰开斯特的职业生涯作为一个独立的调查员在进行长期的，有意义的研究， 妇女中药物使用和血液传播感染的交叉。这个K 01将为兰开斯特博士 在必要的支持下，将她的技能扩展到真正具有变革性和重要性的新方向：1） 多层次数据收集和分析，2）丙型肝炎病毒（HCV）获取的生物学和临床方面 和疾病进展，3）状态偏好理论和离散选择实验的应用，以及4） 建设社区-学术界伙伴关系的能力，以便在新的 社会文化环境-阿巴拉契亚乡村。为了支持这些技能，兰开斯特博士得到了 优秀的跨学科导师团队，拥有强大的研究组合，成功的导师历史， 以及良好的合作记录。这个团队包括：克里斯托弗布朗宁博士（主要导师），博士。 卡洛斯Malvestutto（共同导师），博士约翰F P布里奇斯（共同导师），和博士四月杨（共同导师）。 在美国的农村地区，年轻妇女中注射毒品和丙型肝炎病毒的使用率急剧上升。 States. HCV风险和减少危害服务的利用，如注射器服务计划（SSP）， 由于复杂文化和性别规范，注射伙伴关系各不相同。影响年轻人的社会环境 注射毒品的妇女（YWID）需要深入了解伙伴关系层面的因素和 SSP的偏好在农村环境中形成HCV风险降低。本研究的目的是了解 农村女青年丙肝感染危险因素及SSP治疗方式选择 阿巴拉契亚俄亥俄州（Scioto、Pike和杰克逊县）。兰开斯特博士将利用NIDA资助的国家 农村阿片类药物倡议（UG 3）研究基础设施和社区-学术伙伴关系，特别是：1） 描述注射伴侣水平因素对农村女青年HCV危险行为的影响 阿巴拉契亚; 2）确定注射伴侣水平因素对YWID中HCV危险行为的影响 在农村阿巴拉契亚;和3）在农村阿巴拉契亚的YWID中诱发SSP偏好。深度访谈 将进行与YWID的研究，以探索HCV风险行为在注射内和注射间的变化 伙伴关系。密集的粒度，时间数据数据将每季度收集一次， 进行调查，并通过每月生态瞬时评估予以加强，以了解注入伙伴关系的情况 实时的因素和HCV风险行为。一个正式的启发，说明偏好的SSP将阐明 为YWID量身定制的服务属性。培训和研究计划将产生初步数据， NIDA R 01申请，进行多中心随机对照试验，评估 量身定制的减少伤害一揽子计划，解决注射伙伴关系因素，将减少丙型肝炎病毒的风险， YWID阿巴拉契亚乡村。

PROJECT SUMMARY The purpose of this K01 Mentored Research Scientist Development application is to develop Dr. Kathryn Lancaster's career as an independent investigator in conducting long-term, meaningful research at the intersection of substance use and blood-borne infections among women. This K01 will provide Dr. Lancaster with the necessary support to extend her skills to truly transformative and important new directions in 1) multilevel data collection and analyses, 2) biological and clinical aspects of hepatitis C virus (HCV) acquisition and disease progression, 3) stated-preference theory and application of discrete choice experiments, and 4) building capacity for community-academic partnerships for addressing injection drug use in a new sociocultural environment— rural Appalachia. In support of these skills, Dr. Lancaster is supported by an outstanding interdisciplinary team of mentors with robust research portfolios, successful mentorship histories, and a strong track record of collaboration. This team includes: Dr. Christopher Browning (Primary Mentor), Dr. Carlos Malvestutto (Co-Mentor), Dr. John F P Bridges (Co-Mentor), and Dr. April Young (Co-Mentor). Injection drug use and HCV among young women is dramatically rising in rural settings within the United States. HCV risks and utilization of harm reduction services, like syringe service programs (SSP), within each injection partnership vary due to complex cultural and gender norms. The social milieu that impact young women who inject drugs (YWID) requires an in-depth understanding of how partnership-level factors and preferences for SSP shape HCV risk reduction in rural settings. The goal of this study understand the role of injection partnership-level factors on HCV risk and measure preferences for SSP among YWID in rural Appalachian Ohio (Scioto, Pike, and Jackson Counties). Dr. Lancaster will leverage the NIDA-funded National Rural Opioid Initiative (UG3) study infrastructure and community-academic partnerships to specifically: 1) Describe the contribution of injection partnership-level factors on HCV risk behaviors among YWID in rural Appalachia; 2) Determine the effect of injection partnership-level factors on HCV risk behaviors among YWID in rural Appalachia; and 3) Elicit preferences for SSP among YWID in rural Appalachia. In-depth interviews with YWID will be conducted to explore the how HCV risk behaviors may vary within and across injection partnerships. Intensive granular, temporal data data will be collected quarterly using in-person behavioral surveys and augmented with monthly ecological momentary assessments to capture injection partnership-level factors and HCV risk behaviors in real-time. A formal elicitation of stated preferences for SSP will illuminate attributes for services tailored for YWID. The training and research plan will produce preliminary data to inform a NIDA R01 application to conduct a multisite, randomized controlled trial evaluating the effectiveness of a tailored harm reduction package, addressing injection partnership factors that will reduce HCV risk among YWID rural Appalachian.