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))
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Lambert, Elizabeth
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National Development & Research Institutes
New York
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Vasylyeva, Tetyana I; Friedman, Samuel R; Paraskevis, Dimitrios et al. (2016) Integrating molecular epidemiology and social network analysis to study infectious diseases: Towards a socio-molecular era for public health. Infect Genet Evol 46:248-255
Nikolopoulos, Georgios K; Kostaki, Evangelia-Georgia; Paraskevis, Dimitrios (2016) Overview of HIV molecular epidemiology among people who inject drugs in Europe and Asia. Infect Genet Evol 46:256-268
Nikolopoulos, Georgios K; Pavlitina, Eirini; Muth, Stephen Q et al. (2016) A network intervention that locates and intervenes with recently HIV-infected persons: The Transmission Reduction Intervention Project (TRIP). Sci Rep 6:38100
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Hatzakis, Angelos; Sypsa, Vana; Paraskevis, Dimitrios et al. (2015) Design and baseline findings of a large-scale rapid response to an HIV outbreak in people who inject drugs in Athens, Greece: the ARISTOTLE programme. Addiction 110:1453-67
Sypsa, Vana; Paraskevis, Dimitrios; Malliori, Meni et al. (2015) Homelessness and Other Risk Factors for HIV Infection in the Current Outbreak Among Injection Drug Users in Athens, Greece. Am J Public Health 105:196-204
Vasylyeva, Tetyana I; Friedman, Samuel R; Magiorkinis, Gkikas (2015) Prevention of early HIV transmissions might be more important in emerging or generalizing epidemics. Proc Natl Acad Sci U S A 112:E1515
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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