Undetectable and Untransmittable: reducing HIV transmission among young women living with HIV, their partners and children in South Africa

无法检测和无法传播：减少南非感染艾滋病毒的年轻女性及其伴侣和儿童中的艾滋病毒传播

• 批准号: 10473036
• 负责人: Elona Toska
• 金额: $ 8.07万
• 依托单位: UNIVERSITY OF CAPE TOWN
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-08-05 至 2024-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10473036
• 关键词: AIDS prevention; Address; Adolescent; Adult; Africa; Africa South of the Sahara; Award; Behavior Therapy; Caregivers; Caring; Child; Communities; Complex; Consultations; Decision Making; Development; Development Plans; Emotional; Equation; Evidence based intervention; Exposure to; Failure; Family; Foundational Skills; Foundations; Future; Future Generations; Generations; Goals; HIV; HIV Infections; Health; Health system; Home; Individual; Intervention; Knowledge; Leadership; Love; Maps; Measures; Mental Health; Mentors; Mentorship; Modeling; Mothers; Outcome Measure; Pathway interactions; Population; Pregnancy; Psychometrics; Public Health; Qualitative Research; Reproduction; Reproductive Health; Research; Research Infrastructure; Research Personnel; Resources; Review Literature; Risk; Risk Factors; Risk Reduction; Science; Scientist; Sexual Health; Sexual Partners; Sexual Transmission; Shapes; Social Behavior; South Africa; South African; Structure; Testing; Theory of Change; Training; Treatment outcome; United States National Institutes of Health; Unsafe Sex; Viral; Viral Load result; Vulnerable Populations; base; career; career development; cognitive interview; cohort; effective intervention; epidemiology study; evidence base; experience; low and middle-income countries; male; meetings; neglect; novel; physical conditioning; prevent; primary caregiver; psychologic; reproductive; resilience; role model; secondary analysis; sex; sexual relationship; sexually active; skills; stem; theories; tool; transmission process; unintended pregnancy; young mother; young woman

PROJECT SUMMARY Candidate: Dr. Toska is steadfast in her commitment to support young women living with HIV in lower- and middle-income countries (LMICs) to survive and thrive, which includes developing interventions that enable them to adhere to ART, engage in healthy sexual relationships, and plan safe pregnancies. Her career development plan focuses on: 1) cultivating scientific expertise to investigate sexual and reproductive health resilience, a concept developed for this award, 2) gaining knowledge on developing socio-behavioral interventions for young women living with HIV, and 3) expanding leadership and mentorship skills. These objectives will be realized through the support of highly-experienced mentors, who are global scientists in research on HIV, adolescents and young people, and sexual and reproductive health in LMICs. Through this award, Dr. Toska will consolidate her career goal of becoming a global leader in socio-behavioral interventions to reduce onward HIV transmission among young people living with HIV in LMICs. Research: Reducing onward HIV transmission among young women living with HIV in LMICs is central to breaking the cycle of transmission, by addressing both vertical (mother-to-child) and horizontal (sexual) transmission to partners. Global HIV prevention efforts to date focus on supporting all people living with HIV to stop onward HIV transmission through viral suppression (Undetectable=Untransmittable). Growing evidence has documented how young women living with HIV experience poorer HIV treatment outcomes, higher rates of unintended pregnancies and greater risk of passing on HIV to their children. No intervention addresses these two aspects of U=U among young women living with HIV. The scientific goal of this K43 is to inform the development of an evidence-based intervention that addresses the complex relationship ‘clusters’ that young women living with HIV are part of, to reduce onward HIV transmission to their partners and children. The training objective of this K43 is to obtain intensive mentoring and formal training on the foundational skills necessary to develop an evidence-based intervention to stem onward HIV infection among young women living with HIV. The specific research aims of this award are to 1) investigate predictors of onward HIV transmission, 2) develop and validate a quantitative measure for sexual and reproductive health resilience, and 3) map causal pathways between sexual and reproductive health resilience, unintended pregnancies, and viral suppression among young women living with HIV. This award capitalizes on the intellectual and research infrastructure of two existing cohorts, Mzantsi Wakho and HEY BABY, based in the Eastern Cape, South Africa. The study advances NIH priorities by advancing science on HIV transmission in a highly vulnerable population, promoting the development of an evidence-based interventions for HIV prevention for this population, and building capacity for an LMIC emerging researcher and the early career researchers she will collaborate with.

项目概要 候选人：托斯卡博士坚定地致力于支持低收入和低收入地区感染艾滋病毒的年轻女性 中等收入国家（LMIC）生存和繁荣，其中包括制定使它们能够生存和繁荣的干预措施 坚持 ART、建立健康的性关系并规划安全怀孕。 计划的重点是：1）培养科学专业知识以调查性健康和生殖健康的复原力， 为该奖项制定的概念，2）获得有关为年轻人制定社会行为干预措施的知识 感染艾滋病毒的女性，以及 3) 扩大领导和指导技能 这些目标将得以实现。 通过经验丰富的导师的支持，他们是艾滋病毒研究领域的全球科学家，青少年 托斯卡博士将通过该奖项巩固中低收入国家的青年和性与生殖健康。 她的职业目标是成为社会行为干预措施的全球领导者，以减少艾滋病毒的进一步传播 中低收入国家感染艾滋病毒的年轻人中。 研究：减少中低收入国家感染艾滋病毒的年轻女性中艾滋病毒的进一步传播至关重要 通过解决垂直（母婴）和水平（性）传播问题，打破传播循环 迄今为止，全球艾滋病毒预防工作的重点是支持所有艾滋病毒感染者 通过病毒抑制来阻止艾滋病毒的进一步传播（不可检测=不可传播）。 记录了感染艾滋病毒的年轻女性如何经历较差的艾滋病毒治疗结果、较高的感染率 意外怀孕和将艾滋病毒传染给孩子的风险更大，没有任何干预措施可以解决这些问题。 感染艾滋病毒的年轻女性中 U=U 的两个方面 本 K43 的科学目标是告知人们。 开发基于证据的干预措施来解决年轻人所面临的复杂关系“集群” 感染艾滋病毒的妇女参与了该培训，以减少艾滋病毒进一步传播给其伴侣和儿童。 K43 的目标是获得有关必要基本技能的强化指导和正式培训 制定基于证据的干预措施，以阻止感染艾滋病毒的年轻女性继续感染艾滋病毒。 该奖项的具体研究目标是 1) 研究 HIV 继续传播的预测因子，2) 开发 并验证性健康和生殖健康复原力的定量测量，以及 3) 绘制因果路径 年轻人的性健康和生殖健康复原力、意外怀孕和病毒抑制之间的关系 该奖项利用了两个现有的知识和研究基础设施。 位于南非东开普省的 Mzantsi Wakho 和 HEY BABY 等人的研究推动了 NIH 的发展。 通过推进有关高度脆弱人群中艾滋病毒传播的科学、促进 制定针对该人群的艾滋病毒预防循证干预措施，并建设预防艾滋病毒的能力 一位中低收入国家的新兴研究员和她将与之合作的早期职业研究员。