Frimpong Jemima A, D'Aunno Thomas, Perlman David C, Strauss Shiela M, Mallow Alissa, Hernandez Diana, Schackman Bruce R, Feaster Daniel J, Metsch Lisa R
Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York, USA.
Robert F. Wagner Graduate School of Public Service, New York University, New York, USA.
Trials. 2016 Mar 3;17(1):117. doi: 10.1186/s13063-016-1225-4.
More than 1.2 million people in the United States are living with human immunodeficiency virus (HIV), and 3.2 million are living with hepatitis C virus (HCV). An estimated 25 % of persons living with HIV also have HCV. It is therefore of great public health importance to ensure the prompt diagnosis of both HIV and HCV in populations that have the highest prevalence of both infections, including individuals with substance use disorders (SUD).
METHODS/DESIGN: In this theory-driven, efficacy-effectiveness-implementation hybrid study, we will develop and test an on-site bundled rapid HIV/HCV testing intervention for SUD treatment programs. Its aim is to increase the receipt of HIV and HCV test results among SUD treatment patients. Using a rigorous process involving patients, providers, and program managers, we will incorporate rapid HCV testing into evidence-based HIV testing and linkage to care interventions. We will then test, in a randomized controlled trial, the extent to which this bundled rapid HIV/HCV testing approach increases receipt of HIV and HCV test results. Lastly, we will conduct formative research to understand the barriers to, and facilitators of, the adoption, implementation, and sustainability of the bundled rapid testing strategy in SUD treatment programs.
Novel approaches that effectively integrate on-site rapid HIV and rapid HCV testing are needed to address both the HIV and HCV epidemics. If feasible and efficacious, bundled rapid HIV/HCV testing may offer a scalable, potentially cost-effective approach to testing high-risk populations, such as patients of SUD treatment programs. It may ultimately lead to improved linkage to care and progress through the HIV and HCV care and treatment cascades.
ClinicalTrials.gov: NCT02355080 . (30 January 2015).
美国有超过120万人感染人类免疫缺陷病毒(HIV),320万人感染丙型肝炎病毒(HCV)。据估计,25%的HIV感染者同时感染了HCV。因此,在这两种感染患病率最高的人群中,包括患有物质使用障碍(SUD)的个体,确保及时诊断HIV和HCV具有重大的公共卫生意义。
方法/设计:在这项理论驱动的、疗效-效果-实施混合研究中,我们将为SUD治疗项目开发并测试一种现场捆绑式快速HIV/HCV检测干预措施。其目的是增加SUD治疗患者中HIV和HCV检测结果的获取率。通过涉及患者、提供者和项目管理者的严格流程,我们将把快速HCV检测纳入基于证据的HIV检测以及与护理干预的联系中。然后,我们将在一项随机对照试验中测试这种捆绑式快速HIV/HCV检测方法在多大程度上能增加HIV和HCV检测结果的获取率。最后,我们将进行形成性研究,以了解在SUD治疗项目中采用、实施和维持捆绑式快速检测策略的障碍和促进因素。
需要有效整合现场快速HIV和快速HCV检测的新方法来应对HIV和HCV疫情。如果可行且有效,捆绑式快速HIV/HCV检测可能为检测高危人群,如SUD治疗项目的患者,提供一种可扩展的、潜在具有成本效益的方法。它最终可能会改善与护理的联系,并推动HIV和HCV护理及治疗级联的进展。
ClinicalTrials.gov:NCT02355080。(2015年1月30日)