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Principal Investigator: CARL A LATKIN
Organization: JOHNS HOPKINS UNIVERSITY
Fiscal Year: 2024
Award: $733,662
Funding agency: National Institute on Drug Abuse
Project Summary
This resubmission of application R01DA050470 proposes to use innovative approaches to identify “hotspots,”
defined as geographic areas in which high rates of HIV or HCV infection, high HIV viral loads, or drug-resistant
HIV strains are found. We propose two novel approaches for identifying hotspots: 1) Use of web-based
mapping technology to document observed and self-reported HIV and overdose risk behaviors among PWID in
private and semi-public injection settings (SPIS) and the attributes of these risk settings; 2) Systematically
collect cookers (containers used to mix and heat drugs before injecting) from injection settings and test them
for HIV and HCV antibodies (testing cookers is a novel method developed in the Johns Hopkins Virology lab).
We will recruit 600 HIV positive and negative people who inject drugs (PWID). These PWID will complete a
survey using a software program developed by our team to locate and map the areas where they inject and
attributes of these injection settings. These data will be used to identify high-risk behaviors in SPIS within
census block groups (CBGs). These participants will be followed for 2 years.
The findings from this observational portion of the study will then be used to inform an innovative pilot of an
injection setting targeted peer-driven intervention to reduce HIV/HCV transmission and overdose risk
behaviors. From the identified CBGs, we will select 60 non-contiguous CBGs for a pilot cluster randomized trial
(CRT) of the intervention. The CBGs will be randomized to one of 4 conditions: 1) Peer education and stocking
of SPIS with risk reduction materials, 2) Peer education only, 3) Stocking SPIS with risk reduction materials
only, and 4) The standard of care. Based on their CBG and SPIS use, 120 index PWID participants will be
selected from the 600 PWID. These index participants will receive training corresponding to the assigned
condition of their CBG. The indexes will implement the intervention targeting two specific SPIS. Each index will
also recruit PWID from their CBG to serve as data collectors. In the SPIS, the data collectors will use
Ecological Momentary Assessment (EMA) and collect cookers for HIV/HCV testing. Data from the indexes
(N=120) and data collectors (N=120) will be used as outcomes of the 4-arm intervention.
Terms: <AIDS Virus><AIDS prevention><AIDS test><AIDS/HIV test><Acquired Immune Deficiency Syndrome Virus><Acquired Immunodeficiency Syndrome Virus><Acute Hepatitis C><Address><Anti-HCV Antibodies><Anti-HIV Positivity><Anti-HIV resistance><Anti-HIV resistant><Anti-Hepatitis C Virus Antibodies><Area><Baltimore><Baseline Surveys><Behavior><Behavioral><Caring><Censuses><Cessation of life><Characteristics><Cities><Cluster randomization trial><Cluster randomized trial><Computer software><Data><Death><Death Rate><Drug resistance in HIV><Drugs><Ecological momentary assessment><Education><Educational aspects><Equipment><Geographic Area><Geographic Locations><Geographic Region><Geographical Location><Goals><HCV Antibodies><HCV Transmission><HCV infection><HCV/HIV><HIV><HIV Infections><HIV Positive><HIV Positivity><HIV Prevention><HIV Seroconversion><HIV Seronegativities><HIV Seronegativity><HIV Seropositivity><HIV and HCV><HIV and hepatitis C><HIV antibody positive><HIV diagnosis><HIV drug resistance><HIV drug resistant><HIV negative><HIV risk><HIV test><HIV-1 test><HIV-2 test><HIV-HCV><HIV/AIDS prevention><HIV/HCV><HIV/Hepatitis C><HTLV-III Infections><HTLV-III Seroconversion><HTLV-III Seronegativities><HTLV-III Seronegativity><HTLV-III Seropositivity><HTLV-III-LAV Infections><Health><Hepatitis C><Hepatitis C Antibodies><Hepatitis C Transmission><Hepatitis C Virus Antibodies><Hepatitis C virus infection><Hepatitis, Viral, Non-A, Non-B, Parenterally-Transmitted><Hepatitus C><High School Student><History><Human Immunodeficiency Viruses><Human T-Lymphotropic Virus Type III Infections><Human immunodeficiency virus test><Incidence><Infection><Injecting drug user><Injection Drug User><Injections><Intervention><Intervention Strategies><Intervention Trial><Interventional trial><LAV-HTLV-III><Location><Lymphadenopathy-Associated Virus><Maps><Maryland><Massachusetts><Medication><Methods><Naloxone><Narcan><Narcanti><On-Line Systems><Online Systems><Opiates><Opioid><Outcome><Overdose><PWID><Participant><Patient Self-Report><Pharmaceutical Preparations><Prevention><Privatization><Randomized><Recording of previous events><Research><Risk><Risk Behaviors><Risk Reduction><Risky Behavior><Sampling><Secondary School Student><Secondary Student><Self-Report><Software><Survey Instrument><Surveys><Technology><Testing><Time><Training><Transmission><Viral Burden><Viral Load><Viral Load result><Virus-HIV><Washington><at risk behavior><drug resistant HIV><drug/agent><evidence base><geographic site><hep C><hepatitis C virus transmission><hepatitis non A non B><high risk><high risk behavior><high schoolers><histories><improved><indexing><infection by hepatitis c virus><injection drug use><innovate><innovation><innovative><intervention arm><interventional strategy><interventions leveraging social networks><mortality rate><mortality ratio><new approaches><non A, non B hepatitis><non-A, non-B hepatitis><novel><novel approaches><novel strategies><novel strategy><online computer><opiate consumption><opiate drug use><opiate intake><opiate overdose><opiate related overdose><opiate use><opioid consumption><opioid drug overdose><opioid drug use><opioid induced overdose><opioid intake><opioid intoxication><opioid medication overdose><opioid overdose><opioid poisoning><opioid related overdose><opioid toxicity><opioid use><overdose death><overdose fatalities><overdose prevention><overdose risk><overdose risk behaviors><overdose risk related behavior><peer><people who inject drugs><people who inject illicit drugs><persons who inject drugs><prevent><preventing><programs><randomisation><randomization><randomly assigned><rapid detection><recruit><reduce risk><reduce risks><reduce that risk><reduce the risk><reduce these risks><reduces risk><reduces the risk><reducing risk><reducing the risk><resistance to HIV drug><resistance to anti-HIV><resistant to HIV drug><risk-reducing><social><social network based intervention><social network intervention><social norm><standard of care><transmission process><treatment arm><trend><virology><web based>