ITEST: Innovative Tools to Expand Youth-Friendly HIV Self-Testing

ITEST：扩大青少年友好的艾滋病毒自我检测的创新工具

• 批准号: 10470245
• 负责人: Juliet Iwelunmor
• 金额: $ 128.52万
• 依托单位: SAINT LOUIS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-01 至 2023-09-01
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10470245
• 关键词: AIDS prevention; Acquired Immunodeficiency Syndrome; Address; Adherence; Affect; Africa; Africa South of the Sahara; African; American; Anal Sex; Area; Behavioral; Benchmarking; Chlamydia; Clinical Trials Data Monitoring Committees; Communities; Country; Creativeness; Data; Decentralization; Development; Effectiveness; Ensure; Epidemic; Evaluation; Fright; Goals; Gonorrhea; Government; Guidelines; HIV; HIV Infections; HIV Seronegativity; Human immunodeficiency virus test; Incidence; Individual; Infection; Institutional Review Boards; Intervention; Learning; Link; Local Government; Mentorship; Modality; National Institute of Child Health and Human Development; Newly Diagnosed; Nigeria; Nigerian; Outcome; Patient Self-Report; Persons; Phase; Policies; Prevention strategy; Preventive; Preventive service; Privacy; Procedures; Process; Public Health; Randomized; Randomized Controlled Trials; Request for Applications; Research; Research Priority; Risk; Sampling; Services; Sexually Transmitted Diseases; Social Problems; Social support; Specimen; Syphilis Serodiagnosis; Testing; United States National Institutes of Health; Vagina; World Health Organization; Youth; age group; aged; apprenticeship; authority; base; community based participatory research; condoms; design; disparity reduction; effectiveness evaluation; experience; experimental study; high risk; implementation intervention; implementation strategy; improved; innovation; low and middle-income countries; multidisciplinary; pre-exposure prophylaxis; preference; prevent; prevention service; primary outcome; recruit; resilience; response; secondary outcome; self testing; service uptake; skills; social; social stigma; success; supportive environment; testing services; therapy development; tool; transmission process; trial readiness; uptake; willingness

ABSTRACT HIV incidence remains high among youth aged 14-24 in Sub-Saharan Africa, thus underscoring the importance of interventions to prevent HIV in this age group. Nigerian youth are at the epicenter of an expanding HIV crisis, with the second largest number of new youth HIV infections of any country. Yet fewer than one in five Nigerian youth have ever been HIV tested. Young people are often framed as the fraught victims of new HIV infections, instead of recognizing their resilience and power in advancing effective response to the epidemic. Conventional expert-driven, top-down interventions have largely failed. Innovative solutions that leverage the resourcefulness and resilience of youth are sorely needed. In this proposal, we will develop innovative youth-friendly HIV self-testing services based on open challenges and apprenticeships that are informed by a youth participatory action research framework. Open challenges solicit solutions from the community and then implement the best solutions, while apprenticeship builds local capacity for youth-led projects to increase the likelihood of success and ensure comprehensive evaluation. Three randomized controlled trials based on open challenges have led to improved rates of HIV testing and condom use among at-risk youth, but none of these approaches have been in Africa. These participatory approaches will be used to identify innovative HIV self-testing strategies that meet the specific needs of Nigerian youth. Each strategy will have a comprehensive plan for enhancing HIV prevention (including HIV pre- exposure prophylaxis and behavioral approaches) among at-risk youth. Two HIV self-testing strategies will be selected by judges as semi-finalists and evaluated in separate local government area pilots (UG3 phase). Once the project meets stringent requirements demonstrating trial readiness and pilot effectiveness, a single strategy will be evaluated in a pragmatic, cluster randomized controlled trial in 24 local government areas of Nigeria (UH3 phase). The intervention development process will build capacity for decentralized HIV self- testing, drawing on the strengths, creativity, and engagement of Nigerian youth. Leveraging our extensive experience organizing HIV research in Nigeria, we propose the following specific aims: (1) To use open challenges and apprenticeship to develop new HIV self-testing services; (2) To evaluate the effectiveness of two semi-finalist participatory interventions on HIV testing and other key prevention services among at-risk, HIV-negative youth (14-24years old); (3) To determine the effectiveness of a finalist participatory intervention on HIV testing and other key HIV prevention outcomes in 24 areas using a stepped wedge, pragmatic randomized controlled trial. The overarching goal is not to create a monolithic “one-size fits all” HIV self-testing strategy, but rather to demonstrate that open challenges can engage and inspire youth to develop innovative and effective HIV services. Our focus on open challenges and tailoring services to youth resonates with NICHD, NIH, and US government strategic priorities.

抽象的 撒哈拉以南非洲地区 14-24 岁青少年的艾滋病毒发病率仍然很高，因此凸显了 尼日利亚青年正处于这一年龄段的艾滋病毒干预措施的中心。 艾滋病毒危机，新增青年艾滋病毒感染人数位居所有国家第二位，但数量却较少。 超过五分之一的尼日利亚青年接受过艾滋病毒检测 年轻人常常被认为是令人担忧的群体。 新的艾滋病毒感染者的受害者，而不是认识到他们的恢复力和提高有效性的力量 传统的专家驱动、自上而下的干预措施基本上失败了。 在本提案中，我们迫切需要利用青年的足智多谋和适应能力的解决方案。 基于开放挑战和学徒制开发创新的青年友好型艾滋病毒自我检测服务 以青年参与行动研究框架为基础，公开挑战征求解决方案。 社区，然后实施最佳解决方案，而学徒制则为青年领导的当地能力建设 项目以增加成功的可能性并确保全面评估 三个随机。 基于公开挑战的对照试验提高了艾滋病毒检测率和安全套使用率 面临风险的青年，但这些方法都没有在非洲使用过。 确定满足尼日利亚青年具体需求的创新艾滋病毒自我检测策略。 将制定加强艾滋病毒预防的综合计划（包括艾滋病毒暴露前预防和 法官将在高危青少年中选择两种艾滋病毒自我检测策略。 项目满足要求后，将进入半决赛并在单独的地方政府地区试点中进行评估（UG3 阶段）。 严格要求证明试验准备情况和试点有效性，将采用单一策略 在尼日利亚 24 个地方政府地区进行的一项务实整群随机对照试验中进行了评估（UH3 干预措施制定过程将建设分散的艾滋病毒自我检测、绘制的能力。 利用我们丰富的经验，发挥尼日利亚青年的优势、创造力和参与度。 在尼日利亚组织艾滋病毒研究，我们提出以下具体目标：（1）利用公开挑战和 (2) 评估两名半决赛选手的有效性 对高危、艾滋病毒阴性者进行艾滋病毒检测和其他关键预防服务的参与性干预 青年（14-24岁）；（3）确定最终入围的艾滋病毒参与性干预措施的有效性 使用阶梯楔形、务实的随机方法在 24 个地区进行检测和其他关键的艾滋病毒预防成果 对照试验的首要目标不是创建一个单一的“一刀切”的艾滋病毒自我检测策略， 而是要证明开放式挑战可以吸引和激励青年人发展创新和 有效的艾滋病毒服务。我们对开放挑战和为青少年提供定制服务的关注与 NICHD 产生共鸣 NIH 和美国政府的战略重点。

项目成果

Designing HIV Testing and Self-Testing Services for Young People in Nigeria: A Discrete Choice Experiment.

为尼日利亚年轻人设计艾滋病毒检测和自我检测服务：离散选择实验。

• 发表时间: 2021
• 作者: Ong, Jason J;Nwaozuru, Ucheoma;Obiezu;Airhihenbuwa, Collins;Xian, Hong;Terris;Gbajabiamila, Titilola;Musa, Adesola Z;Oladele, David;Idigbe, Ifeoma;David, Agatha;Okwuzu, Jane;Bamidele, Tajudeen;Iwelunmor, Juliet;T
• 通讯作者: T

Costs of implementing community-based intervention for HIV testing in sub-Saharan Africa: a systematic review.

在撒哈拉以南非洲实施基于社区的艾滋病毒检测干预措施的成本：系统评价。

• 发表时间: 2021-07-05
• 作者: Uzoaru, Florida;Nwaozuru, Ucheoma;Ong, Jason J;Obi, Feli;Obiezu;Tucker, Joseph D;Shato, Thembekile;Mason, Stacey L;Carter, Victoria;Manu, Sunita;BeLue, Rhonda;Ezechi, Oliver;Iwelunmor, Juliet
• 通讯作者: Iwelunmor, Juliet

Understanding factors that promote uptake of HIV self-testing among young people in Nigeria: Framing youth narratives using the PEN-3 cultural model.

了解促进尼日利亚年轻人进行艾滋病毒自我检测的因素：使用 PEN-3 文化模型构建青年叙事。

• 发表时间: 2022
• 影响因子: 3.7
• 作者: Mason, Stacey;Ezechi, Oliver C;Obiezu;Nwaozuru, Ucheoma;BeLue, Rhonda;Airhihenbuwa, Collins;Gbaja;Oladele, David;Musa, Adesola Z;Modi, Karan;Parker, Jessica;Uzoaru, Florida;Engelhart, Alexis;Tucker, Joseph;Iwel
• 通讯作者: Iwel

Sustaining HIV Research in Resource-Limited Settings Using PLAN (People, Learning, Adapting, Nurturing): Evidence from the 4 Youth by Youth Project in Nigeria.

使用 PLAN（人、学习、适应、培育）在资源有限的环境中维持艾滋病毒研究：来自尼日利亚 4 Youth by Youth 项目的证据。

• 发表时间: 2023-04
• 影响因子: 4.6
• 作者: Iwelunmor, Juliet;Tucker, Joseph D;Ezechi, Oliver;Nwaozuru, Ucheoma;Obiezu;Gbaja;Oladele, David;Musa, Adesola Z;Airhihenbuwa, Collins O
• 通讯作者: Airhihenbuwa, Collins O