The goal of the Transdisciplinary Theoretical Synthesis and Development Core (""""""""Theory Core,"""""""" for short) is to strengthen the theoretical bases of CDUHR Investigators'research and, more generally, of global research in HIV epidemiology, prevention, and care for substance users (SUs) and those in their communities. In CDUHR-III, the Theory Core focused heavily on training and consultation about the relative merits of appropriate individual/ psychological and social theories for studying individual- and social-level influences and correlates of HIV risk, prevention, adherence, and retention for SUs. However, HIV research and interventions now face serious problems that require a shift beyond reliance on the psychosocial theoretical approaches that have dominated HIV prevention and care for the last three decades. Despite many new promising behavioral and biomedical prevention and treatment interventions, the HIV and substance use epidemic continues to spread at unacceptable rates in the U.S. and internationally. Further, widespread ongoing tumultuous economic, social and political environments may lead to large increases in high-risk substance use, high-risk networks or contexts, and high-risk sex, and to renewed HIV outbreaks based on these changes or on other structural barriers to maintaining adequate antiretroviral therapy. The complexity of these processes is increased by the rapidity of scientific discovery (including social/behavioral and biomedical prevention and treatment strategies) and the resulting changes in the organization and staffing of HIV prevention and care programs. Yet new clinical and prevention approaches are, of necessity, embedded not only in behavioral complexities but in social, economic and cultural complexities and we need to understand the mechanisms through which socioeconomic contexts affect both clinical/biomedical and behavioral interventions. Training and consultation must incorporate theoretical frameworks that can address emerging problems and perspectives such as these. Prospects for vaccines, biomedical prevention, and possibly microbicides look promising, and clinical science has found therapeutic regimens for HIV and related diseases that have prolonged and transformed infected peoples'lives. Yet there are gaps between intrinsic efficacy and effectiveness when translated into practice. The Seek, Test, Treat and Retain (STTR) strategy seeks to extend these clinical benefits to larger numbers of people, and recent research suggests that STTR may reduce community viral load enough to decrease HIV transmission and, in time, end the epidemic.[1,2] Existing research, however, falls short of convincingly ascertaining the size and variation in the effectiveness of STTR strategies for preventing HIV transmission in substance-using populations and their communities, in part because it has used theoretical models that assume random mixing while ignoring network effects (like the """"""""firewall"""""""" restriction on acute HIV transmission epidemics[3]). New network modeling techniques like Exponential Random Graph Modeling (ERGM) offer methods to incorporate network structural features into current analyses,[4-6] but have yet to be applied to existing data sets that include SUs. The Theory Core seeks to bring graph modeling and dynamic simulation capabilities to CDUHR investigators. The increasing need for transdisciplinary research, which can encompass multiple levels of influence on the HIV-substance use epidemic, poses many challenges for CDUHR and other researchers nationally and internationally. Theoretical training, innovation, and guidance can make such research more successful. Further, theoretical development is needed to incorporate a focus in research on both socioeconomic change'and the organizational complexities created by rapid scientific advance. Moreover, we need theoretical development in support of a systemic theory of research translation in a time of rapid social, political, economic and scientific change.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Center Core Grants (P30)
Project #
5P30DA011041-17
Application #
8650798
Study Section
Special Emphasis Panel (ZDA1-EXL-T)
Project Start
Project End
Budget Start
2014-01-01
Budget End
2014-12-31
Support Year
17
Fiscal Year
2014
Total Cost
$150,209
Indirect Cost
$54,901
Name
New York University
Department
Type
DUNS #
041968306
City
New York
State
NY
Country
United States
Zip Code
10012
Palamar, Joseph J; Acosta, Patricia; Sherman, Scott et al. (2016) Self-reported use of novel psychoactive substances among attendees of electronic dance music venues. Am J Drug Alcohol Abuse 42:624-632
Jarlais, Don C Des; Arasteh, Kamyar; Feelemyer, Jonathan et al. (2016) From Long-Term Injecting to Long-Term Non-Injecting Heroin and Cocaine Use: The Persistence of Changed Drug Habits. J Subst Abuse Treat 71:48-53
Morgan, Ethan; Khanna, Aditya S; Skaathun, Britt et al. (2016) Marijuana Use Among Young Black Men Who Have Sex With Men and the HIV Care Continuum: Findings From the uConnect Cohort. Subst Use Misuse 51:1751-9
Gelpí-Acosta, Camila; Pouget, Enrique R; Reilly, Kathleen H et al. (2016) Time Since Migration and HIV Risk Behaviors Among Puerto Ricans Who Inject Drugs in New York City. Subst Use Misuse 51:870-81
Kurth, Ann E; Cleland, Charles M; Chhun, Nok et al. (2016) Accuracy and Acceptability of Oral Fluid HIV Self-Testing in a General Adult Population in Kenya. AIDS Behav 20:870-9
Friedman, Samuel R; Pouget, Enrique R; Sandoval, Milagros et al. (2016) Interpersonal Attacks on the Dignity of Members of HIV Key Populations: A Descriptive and Exploratory Study. AIDS Behav :
Gwadz, Marya; Cleland, Charles M; Kutnick, Alexandra et al. (2016) Factors Associated with Recent HIV Testing among Heterosexuals at High Risk for HIV Infection in New York City. Front Public Health 4:76
Reed, Jennifer R; Jordan, Ashly E; Perlman, David C et al. (2016) The HCV care continuum among people who use drugs: protocol for a systematic review and meta-analysis. Syst Rev 5:110
Gwadz, Marya; Cleland, Charles M; Jenness, Samuel M et al. (2016) Exploring Factors Associated with Recent HIV Testing among Heterosexuals at High Risk for HIV Infection Recruited with Venue-based Sampling. J AIDS Clin Res 7:
Dombrowski, Kirk; Khan, Bilal; Habecker, Patrick et al. (2016) 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 :

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