Implementing Assisted Partner Services to HIV Test and Treat Men in Western Kenya

在肯尼亚西部实施艾滋病毒检测和治疗男性辅助合作伙伴服务

基本信息

批准号：
10155081
负责人：
CAREY FARQUHAR
金额：
$ 64.57万
依托单位：
UNIVERSITY OF WASHINGTON
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-06-23 至 2024-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10155081
关键词：
Acquired Immunodeficiency Syndrome Address Adopted Adult Advocate Africa South of the Sahara African Attention Caring Clinical Research Counseling Country County Couples Data Diagnosis Effectiveness Effectiveness of Interventions Elements Ensure Epidemic Europe Feasibility Studies Female Female Adolescents Goals Government Guidelines HIV HIV Infections HIV-infected adolescents Health Health care facility Health system Human immunodeficiency virus test Individual Institution Intervention Kenya Knowledge Life Link Measures Methods Modeling Outcome Persons Plasma Policy Maker Population Positioning Attribute Prevalence Principal Investigator Public Health Qualitative Methods RNA Randomized Clinical Trials Reporting Research Research Personnel Resources Services Sexual Partners System Testing Training Universities Viral Washington Woman Work World Health Organization base care systems case finding cost cost effectiveness effectiveness evaluation effectiveness study experience girls health difference high risk implementation science improved indexing male male health meetings member men multidisciplinary prevent programs scale up service intervention service programs success testing services transmission process treatment program treatment services uptake young woman

项目摘要

It is estimated that >50% of HIV-infected Kenyans are unaware of their status and men are significantly less likely to test and link to care than women. Unless more attention is focused on men, Kenya and other sub- Saharan African countries with high HIV prevalence will not achieve UNAIDS 90-90-90 goals by 2020. This proposal addresses low uptake of HIV testing and poor linkage to care and treatment services among men in sub-Saharan Africa. The overarching goal is to demonstrate using implementation science methods that assisted partner services (aPS) is a safe and effective strategy to increase the proportion of men living with HIV who know their serostatus and that aPS will improve male engagement in HIV treatment programs. The study will be based in two counties in Kenya with the highest HIV prevalence in the nation: Homa Bay (27% prevalence) and Kisumu (18.7% prevalence) and be conducted by an experienced and collaborative team with an exceptionally strong track record in HIV partner testing research and implementation science in Kenya. Principal Investigator Carey Farquhar (University of Washington [UW]) will work closely with a multidisciplinary group of investigators and consultants from UW, PATH, Kenya's Ministry of Health, and the National AIDS and STI Control Program (NASCOP), and build on a successful randomized clinical trial of assisted partner services (aPS) conducted by UW and NASCOP from 2012-2015. The proposed research also leverages PATH's vast experience providing HIV testing and treatment in government facilities through the APHIAplus program, as well as PATH's recent mapping of >21,000 adolescent girls and young women for services as part of the DREAMS initiative in western Kenya. The specific aims are as follows:  AIM 1: Determine aPS effectiveness by demonstrating that aPS improves HIV testing, identifies new HIV infections, and promotes linkage, treatment and viral suppression among male partners when implemented among women and adolescent girls in government facilities in Kenya.  AIM 2: Evaluate fidelity, feasibility, and cost/cost-effectiveness when implementing aPS at 38 APHIAplus facilities and 9 “safe spaces” established by the DREAMS initiative in western Kenya. Using a mixed methods approach in this real-world setting, we will obtain data critical to national and regional scale-up. For Aim 1, we will offer aPS to more than 8,000 HIV-infected adolescent girls and women and all of their male partners; if a male partner is HIV-infected aPS will also be offered to his female partners. For Aim 2, we will use quantitative and qualitative methods to collect and evaluate data from a subset of facilities that are high and low performers, determine “necessary” elements of aPS at the level of implementation, and conduct a feasibility study, including analyses of acceptability, integration, demand, technical efficiency and cost data. In this way, the UW/PATH/MOH team will work towards building capacity in Kenya to effectively implement and sustain a model aPS program that could be replicated across sub-Saharan Africa.

据估计，超过 50% 的艾滋病毒感染者肯尼亚人不知道自己的状况，而男性的比例要低得多除非更多的注意力集中在男性、肯尼亚和其他亚裔群体上。艾滋病毒感染率高的撒哈拉非洲国家到 2020 年将无法实现联合国艾滋病规划署的 90-90-90 目标。该提案解决了艾滋病毒检测率低以及与护理和治疗服务的联系不畅的问题撒哈拉以南非洲的男性的总体目标是展示如何使用实施科学方法。辅助伴侣服务 (APS) 是一项安全有效的策略，可提高男性生活水平感染艾滋病毒的人知道自己的血清状况，并且 aPS 将提高男性对艾滋病毒治疗计划的参与度。该研究将在肯尼亚艾滋病毒感染率最高的两个县进行：霍马湾（27% 的患病率）和基苏木（18.7% 的患病率），并由经验丰富且协作的人员进行团队在艾滋病毒伴侣检测研究和实施科学方面拥有非常出色的记录肯尼亚首席研究员 Carey Farquhar（华盛顿大学 [UW]）将与由来自威斯康辛大学、PATH、肯尼亚卫生部和国家艾滋病和性传播感染控制计划 (NASCOP)，并以一项成功的随机临床试验为基础华盛顿大学和 NASCOP 于 2012 年至 2015 年期间开展了协助合作伙伴服务 (aPS)。利用 PATH 在政府设施中提供艾滋病毒检测和治疗的丰富经验， APHIAplus 计划以及 PATH 最近对超过 21,000 名青春期女孩和年轻女性进行的绘图肯尼亚西部 DREAMS 计划的具体目标如下：目标 1：通过证明 aPS 改进 HIV 检测、识别新的 HIV 来确定 aPS 有效性感染，并在实施后促进男性伴侣之间的联系、治疗和病毒抑制肯尼亚政府机构中的妇女和少女。  目标 2：在 38 APHIAplus 实施 aPS 时评估保真度、可行性和成本/成本效益 DREAMS 倡议在肯尼亚西部建立了 9 个“安全空间”。在这种现实世界环境中采用方法方法，我们将获得对国家和区域扩大规模至关重要的数据。对于目标 1，我们将为 8,000 多名感染艾滋病毒的少女和妇女及其所有男性提供 aPS 伴侣；如果男性伴侣感染了 HIV，我们还将向其女性伴侣提供 aPS。使用定性方法来收集和评估来自高水平设施子集的数据和低绩效者，在实施层面确定 aPS 的“必要”要素，并进行可行性研究，包括可接受性、集成、需求、技术效率和成本数据的分析。通过这种方式，威斯康星大学/PATH/MOH 团队将致力于在肯尼亚建设能力，以有效和维持可在撒哈拉以南非洲地区复制的示范 APS 计划。