Promoting HIV Testing and Linkage to Care in Cross-Border Migrants in Lesotho

促进莱索托跨境移民的艾滋病毒检测及其与护理的联系

基本信息

批准号：
10483680
负责人：
Yael R Hirsch-Moverman
金额：
$ 19.61万
依托单位：
COLUMBIA UNIVERSITY HEALTH SCIENCES
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-09-01 至 2024-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10483680
关键词：
AIDS prevention AIDS/HIV problem Acquired Immunodeficiency Syndrome Adherence Affect Africa South of the Sahara African Age Agricultural Workers Appointment Automobile Driving Awareness Belief COVID-19 COVID-19 pandemic COVID-19 pandemic effects Caring Characteristics Clinic Clinical Collaborations Communities Consent Continuity of Patient Care Country Custom Data Development Diagnostic Reagent Kits Economics Employment Epidemic Event Face Female Focus Groups Funding Future Goals HIV HIV Infections HIV Seropositivity Health Health Services Accessibility Health care facility Health system Healthcare High Prevalence Human immunodeficiency virus test Individual Interruption Intervention Interview Knowledge Labor Migrations Legal Lesotho Life Style Link Location Measures Meta-Analysis Methods Migrant Migrant Workers Nonmigrant Outcome Participant Persons Phase Policies Population Prevalence Prevention Privacy Public Health Recommendation Recording of previous events Reporting Research Science Services South Africa State Interests Strategic Planning Surveys Testing Typology United States National Institutes of Health Viral Viral Load result Vulnerable Populations age group antiretroviral therapy barrier to care base eligible participant experience experimental study health care availability health disparity health service use home test improved innovation innovative technologies male men migration multidisciplinary population based preference prevention service recruit response self testing sex social social exclusion stakeholder perspectives support tools testing access testing services testing uptake treatment services uptake

项目摘要

PROJECT SUMMARY/ABSTRACT In this R21 application (PA-20-145: Innovations in HIV Prevention, Testing, Adherence and Retention to Optimize HIV Prevention and Care Continuum Outcomes), we propose to explore the use of community or home-based testing, including self-testing (HIVST) and preferences for linkage to confirmatory testing and treatment in cross- border migrants in Lesotho, a country with very high HIV prevalence as well as high rates of mobility. Through our research done as part of the Lesotho Population-based HIV Impact Assessment (LePHIA) in 2020, we found that Lesotho has made great gains in terms of HIV viral load suppression overall, but those who had recently migrated were significantly less likely to be virally suppressed, mainly due to lack of awareness. The Ministry of Health has been rolling out HIVST as a strategy to reach men and populations who do not normally access health care. However, an increase in testing is insufficient as a public health strategy if the barriers to treatment mean that knowledge of status does not translate into engagement in antiretroviral treatment and viral suppression, diminishing the clinical and epidemic control benefits. In order to determine the best strategy for increasing testing and linkage to treatment rates in migrants, we aim to determine preferences for confirmatory testing and treatment in cross-border migrants who report that HIV testing outside the facility is acceptable. First, we will conduct formative research to explore determinants of migrant health and to understand the barriers and facilitators to testing and accessing treatment or prevention in cross-border migrants, exploring preferences regarding location, types of services, and opportunities to use health services in South Africa. Second, we will contact participants in the LePHIA 2020 who identified as recent cross-border migrants and consented to be contacted for future research. Eligible participants will be invited to complete a discrete choice experiment (DCE) on their preferences for confirmatory testing after self- or other community-based testing, and linkage to treatment. The proposed study is innovative because it is the first known attempt to use a DCE in a diverse panel of cross-border migrants, recruited from the community rather than at health facilities. We will use findings to develop an intervention to support testing and linkage in cross-border migrants.

项目概要/摘要在此 R21 应用程序中（PA-20-145：HIV 预防、检测、依从性和保留的创新以优化 HIV 预防和护理连续性成果），我们建议探索使用社区或家庭为基础的测试，包括自我测试（HIVST）以及与交叉验证测试和治疗联系的偏好莱索托的边境移民是一个艾滋病毒感染率非常高且流动率很高的国家。通过我们的作为 2020 年莱索托基于人口的艾滋病毒影响评估 (LePHIA) 的一部分进行的研究，我们发现莱索托总体上在艾滋病病毒载量抑制方面取得了巨大进展，但那些最近移居的人病毒被抑制的可能性显着降低，这主要是由于缺乏认识。卫生部已一直在推出艾滋病毒传播战略，以覆盖通常无法获得医疗保健的男性和人群。然而，如果治疗障碍意味着：对现状的了解并不意味着参与抗逆转录病毒治疗和病毒抑制，减少临床和流行病控制效益。为了确定增加测试的最佳策略以及与移民治疗率的联系，我们的目标是确定确认性检测和治疗的偏好跨境移民报告在设施外进行艾滋病毒检测是可以接受的。首先，我们将进行形成性研究，探索移民健康的决定因素，并了解移民健康的障碍和促进因素对跨境移民进行检测并获得治疗或预防，探索有关地点的偏好，服务类型以及在南非使用卫生服务的机会。其次，我们将联系参与者 LePHIA 2020 被认定为最近的跨境移民，并同意与我们联系以进行未来的研究。合格的参与者将被邀请完成一项关于他们的偏好的离散选择实验（DCE）自我或其他社区检测后的确认检测以及与治疗的联系。拟议的研究是之所以具有创新性，是因为这是首次在不同的跨境移民小组中使用 DCE 的已知尝试，来自社区而不是在卫生机构。我们将利用调查结果制定干预措施以支持测试和跨境移民的联系。