ACCESS: Accelerating Cervical Cancer Elimination through the integration of Screen-and-treat Services

访问：通过整合筛查和治疗服务加速消除宫颈癌

• 批准号: 10541677
• 负责人: GREGORY AARONS
• 金额: $ 66.6万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-07 至 2027-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10541677
• 关键词: Acquired Immunodeficiency Syndrome; Address; Adoption; Adult; Africa; African; Aftercare; California; Cancer Control; Cancer Etiology; Caring; Cervical Cancer Screening; Cessation of life; Clinical effectiveness; Communities; Country; Data; Diagnosis; Emergency Situation; Epidemic; Exploration Preparation Implementation and Sustainment; Female; General Population; Goals; HIV; HIV Infections; Health; Health Personnel; Health care facility; Healthcare; Hybrids; Implementation readiness; Improve Access; Individual; Infrastructure; Intervention; Life Expectancy; Malignant Neoplasms; Malignant neoplasm of cervix uteri; Methods; Nigeria; Outcome; Persons; Population; Prevalence; Protocols documentation; Randomized; Recommendation; Reporting; Research; Resource-limited setting; Resources; Risk; Services; System; Universities; Woman; World Health Organization; anticancer research; antiretroviral therapy; arm; cancer care; comparative effectiveness; effectiveness outcome; evidence base; implementation evaluation; implementation outcomes; implementation science; implementation strategy; improved; low and middle-income countries; meetings; mortality; programs; scale up; screening; service delivery; sustainability framework; treatment center; treatment program; treatment site; trial design; uptake

Program Summary Nigeria has one of the largest HIV epidemics in the world with 1.8 million people living with HIV infection. With an estimated female population of 102 million and HIV prevalence of 1.6% among adult females, Nigeria has the largest population of women and the 4th largest number of women living with HIV (WLHIV) in Africa. Although access to antiretroviral therapy (ART) among WLHIV in Nigeria has increased over the years, with over 98% of the 960,000 WLHIV on ART, AIDS-related mortality remains high. In 2020, 16,000 WLHIV died from AIDS- related illnesses including cervical cancer. A pilot implementation program in Nigeria demonstrated that leveraging the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) supported HIV programs for the provision of evidence-based cervical cancer screen-and-treat interventions in WLWH is feasible. The pilot program demonstrated, however, that tailored implementation strategies will be needed to address specific multilevel barriers along the cancer control continuum in order to address adoption, reach, and sustainability that are necessary for successful scale-up. However, in many African countries with a high burden of both HIV and cervical cancer, there is a paucity of evidence-based implementation strategies to inform effective integration of HIV and cervical cancer services delivery. Objectives of this proposal are to: 1) Refine strategies to integrate cervical cancer screening, treatment and management within existing comprehensive HIV treatment programs and determine implementation readiness; 2) Determine the comparative effectiveness of a Core set of implementation strategies versus Core+ enhanced implementation strategies; and 3) assess sustainment of the integration of cervical cancer screening, treatment, and management intervention into HIV programs. We have assembled a strong team from University of California San Diego; University of Nigeria, Nsukka and John Hopkins University with expertise in implementation science, HIV care and research, and cancer care and research. Our proposal is responsive to the NCI RFA and consistent with the World Health Organization global plan of elimination of cervical cancer by 2030. If effective, the proposed project will result in a set of feasible, culturally adaptable, and sustainable implementation strategies to integrate evidence-based cervical cancer screening and treatment into HIV programs in order to improve the health and life expectancy of WLHIV.

程序摘要 尼日利亚是世界上最大的艾滋病毒发作之一，其中180万人感染了艾滋病毒感染。和 尼日利亚的女性估计女性人口估计为1.02亿，艾滋病毒患病率为1.6％ 非洲最大的妇女人口和艾滋病毒（WLHIV）的第四大妇女。虽然 多年来，尼日利亚WLHIV中获得抗逆转录病毒疗法（ART），超过98％ 960,000 WLHIV关于ART，与艾滋病相关的死亡率仍然很高。 2020年，16,000个WLHIV死于艾滋病 - 包括宫颈癌在内的相关疾病。尼日利亚的试点实施计划表明 利用美国总统的紧急艾滋病救济计划（PEPFAR）支持艾滋病毒计划 在WLWH中提供基于证据的宫颈癌筛查和治疗干预措施是可行的。飞行员 但是，计划表明，将需要量身定制的实施策略来解决特定 沿着癌症控制的多层障碍，以解决采用，覆盖范围和可持续性 对于成功扩展是必要的。但是，在许多非洲国家，艾滋病毒和 宫颈癌，基于证据的实施策略很少，以为有效整合 艾滋病毒和宫颈癌服务。该提案的目标是：1）完善整合策略 现有综合艾滋病毒治疗计划中的宫颈癌筛查，治疗和管理 并确定实施准备； 2）确定核心集的比较有效性 实施策略与核心+增强的实施策略； 3）评估维持 将宫颈癌筛查，治疗和管理干预整合到HIV计划中。我们有 从加州大学圣地亚哥分校组成了一个强大的团队；尼日利亚大学，Nsukka和John 霍普金斯大学具有实施科学，艾滋病毒护理和研究以及癌症护理的专业知识以及 研究。我们的建议对NCI RFA有响应，并且与世界卫生组织全球一致 到2030年消除宫颈癌的计划。如果有效，则建议的项目将导致一组可行的， 具有文化适应性和可持续的实施策略，以整合循证宫颈癌 筛查和治疗艾滋病毒计划，以提高WLHIV的健康和预期寿命。