Half or more of HIV transmission events may occur within the period of high infectivity (and often high risk behavior) that can last 11 months or more after a person is initially infected. Unfortunately, neither test-and-treat intervention methods nor Acute HIV Infection projects have found effective ways to intervene against transmission during this risky """"""""recent infection"""""""" period. We seek to develop effective intervention techniques against HIV transmission among drug users and their community members during the recent infection period using a combination of drug injection-, sexual- and social-network-based contact tracing methods;community alerts in the networks and venues of recent infectees;and the logic of going """"""""up"""""""" and """"""""down"""""""" infection chains.
Our first Aim i s to develop and evaluate ways to locate """"""""seeds,"""""""" defined as drug users and other people who have recently been infected.
Our second Aim targets members of seeds' networks and people who attend their venues. We will test them for acute and for recent infection, and alert them to the probability that their networks contain highly-infectious members so they should reduce their risk and transmission behaviors for the next several months to minimize their chances of getting infected. This may also reduce transmission by untested people with recent infection. Community, network and venue education about the need and value of supporting those with recent infection should reduce stigma.
Our third Aim i s to reduce HIV transmission and to develop new ways to evaluate """"""""prevention for positives"""""""" generally as well as our own success in reducing transmission. We will do this using a combination of follow- up interviews and testing, including of viral loads;phylogenetic techniques;and discrete event simulation modeling to assess our effectiveness.

National Institute of Health (NIH)
National Institute on Drug Abuse (NIDA)
NIH Director’s Pioneer Award (NDPA) (DP1)
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Special Emphasis Panel (ZDA1-NXR-B (06))
Program Officer
Lambert, Elizabeth
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National Development & Research Institutes
New York
United States
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Dombrowski, Kirk; Khan, Bilal; Habecker, Patrick et al. (2017) The Interaction of Risk Network Structures and Virus Natural History in the Non-spreading of HIV Among People Who Inject Drugs in the Early Stages of the Epidemic. AIDS Behav 21:1004-1015
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Nikolopoulos, Georgios K; Fotiou, Anastasios (2015) ""Integrated interventions are dead. Long live sustainable integrated interventions!""--Austerity Challenges the Continuation of Effective Interventions in the Field of Drug Use-Related Harm Reduction. Subst Use Misuse 50:1220-2
Vasylyeva, T I; Friedman, S R; Smyrnov, P et al. (2015) A new approach to prevent HIV transmission: Project Protect intervention for recently infected individuals. AIDS Care 27:223-8
Nikolopoulos, Georgios K; Sypsa, Vana; Bonovas, Stefanos et al. (2015) Big Events in Greece and HIV Infection Among People Who Inject Drugs. Subst Use Misuse 50:825-38
Friedman, Samuel R; Perlman, David C; Ompad, Danielle C (2015) The Flawed Reliance on Randomized Controlled Trials in Studies of HIV Behavioral Prevention Interventions for People Who Inject Drugs and Other Populations. Subst Use Misuse 50:1117-24

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