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

基本信息

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
项目类别：
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

项目摘要

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.

计划概要尼日利亚是世界上艾滋病毒流行最严重的国家之一，有 180 万艾滋病毒感染者。据估计，尼日利亚女性人口为 1.02 亿，成年女性中艾滋病毒感染率为 1.6%，非洲女性人数最多，女性艾滋病毒感染者 (WLHIV) 人数在非洲排名第四。多年来，尼日利亚 WLHIV 患者获得抗逆转录病毒治疗 (ART) 的机会有所增加，超过 98% 960,000 名艾滋病毒感染者接受了抗逆转录病毒治疗，艾滋病相关死亡率仍然很高。 2020 年，16,000 名艾滋病毒感染者死于艾滋病。尼日利亚的一项试点实施计划表明，包括宫颈癌在内的相关疾病。利用美国总统艾滋病紧急救援计划 (PEPFAR) 支持艾滋病毒项目在 WLWH 中提供循证宫颈癌筛查和治疗干预措施是可行的。然而，该方案表明，需要制定专门的实施战略来解决具体问题沿着癌症控制连续体的多层次，以解决采用障碍、影响范围和可持续性然而，在艾滋病毒和艾滋病毒负担较高的许多非洲国家，这些措施是成功推广的必要条件。宫颈癌，缺乏基于证据的实施策略来告知有效整合该提案的目标是： 1) 完善整合战略。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情况； 2) 确定核心组的相对有效性实施策略与 Core+ 增强实施策略的对比；以及 3) 评估持续性我们将宫颈癌筛查、治疗和管理干预纳入艾滋病毒项目。组建了来自加州大学圣地亚哥分校、尼日利亚大学 Nsukka 和 John 的强大团队；霍普金斯大学在科学实施、艾滋病毒护理和研究以及癌症护理和研究方面拥有专业知识我们的建议是对 NCI RFA 的回应，并与世界卫生组织的全球一致。到 2030 年消除宫颈癌的计划。如果有效，拟议的项目将产生一系列可行的、具有文化适应性和可持续的实施策略，以整合循证宫颈癌将筛查和治疗纳入 HIV 计划，以改善 WLHIV 的健康和预期寿命。