Akiyama Matthew J, Manley Hannah N, Riback Lindsey R, Zhang Chenshu, Alvandi Amirhossein, Gile Krista, Jiang Yun, Nyakowa Mercy, Ganatra Nazila, Bashir Issak, Coleman Ewan, Stone Jack, Vickerman Peter, Walker Josephine G
Albert Einstein College of Medicine.
University of Massachusetts.
Res Sq. 2025 Aug 20:rs.3.rs-7401891. doi: 10.21203/rs.3.rs-7401891/v1.
HIV and Hepatitis C (HCV) are blood borne infections (BBIs) that remain a significant cause of global morbidity and mortality among people who inject drugs (PWID). UNAIDS and WHO have set goals for the elimination of viral hepatitis and HIV as major public health threats by 2030. To achieve these targets, innovative strategies are required among marginalized populations such as PWID, especially in resource-limited countries where coverage of harm reduction services is often limited. The goal of this study is to inform targeted strategies to prevent transmission of BBIs among PWID.
We will use respondent driven sampling (RDS) to recruit PWID from needle and syringe programs in Kenya. Participants will complete biobehavioral and social network surveys and receive point-of-care HCV, HIV, and hepatitis B (HBV) testing. Participants will return for at least one follow-up visit to complete additional surveys and testing. We will use network data from RDS, egocentric, and viral phylogenetics to identify how highly central PWID contribute to transmission networks and use mathematical modelling to investigate the impact of targeted interventions based on network characteristics.
This study will provide important information for policymakers and researchers designing strategies for BBI elimination. Network- and molecular epidemiologic-informed tools to guide targeted strategies may be critical to maximizing the impact of treatment and prevention efforts in resource-limited settings. This approach may provide a durable template for future studies, including prospective assessments of targeted prevention and elimination strategies among PWID, and assist with monitoring elimination progress in resource-limited settings.
艾滋病毒和丙型肝炎（HCV）是通过血液传播的感染性疾病，在注射吸毒者（PWID）中仍然是全球发病和死亡的重要原因。联合国艾滋病规划署（UNAIDS）和世界卫生组织（WHO）已设定目标，到2030年消除病毒性肝炎和艾滋病毒这两大主要公共卫生威胁。为实现这些目标，需要在注射吸毒者等边缘化人群中采取创新策略，尤其是在资源有限的国家，这些国家减少伤害服务的覆盖范围往往有限。本研究的目的是为预防注射吸毒者中血液传播感染性疾病传播的针对性策略提供信息。
我们将采用应答驱动抽样（RDS）方法，从肯尼亚的针头和注射器项目中招募注射吸毒者。参与者将完成生物行为和社会网络调查，并接受即时检验的丙型肝炎病毒、艾滋病毒和乙型肝炎病毒（HBV）检测。参与者将返回进行至少一次随访，以完成额外的调查和检测。我们将使用来自应答驱动抽样、自我中心网络和病毒系统发育学的网络数据，以确定处于高度中心地位的注射吸毒者如何对传播网络产生影响，并使用数学模型来研究基于网络特征的针对性干预措施的影响。
本研究将为政策制定者和研究人员设计消除血液传播感染性疾病的策略提供重要信息。利用网络和分子流行病学的工具来指导针对性策略，对于在资源有限的环境中最大限度地提高治疗和预防工作的效果可能至关重要。这种方法可能为未来的研究提供一个持久的模板，包括对注射吸毒者中针对性预防和消除策略的前瞻性评估，并有助于监测资源有限环境中的消除进展情况。
