The Impact of Food Insecurity on HIV Outcomes and Sexual Risk Behavior in Uganda

乌干达粮食不安全对艾滋病毒感染结果和性危险行为的影响

基本信息

批准号：
7229197
负责人：
SHERI Dawn WEISER
金额：
$ 16.93万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
依托单位国家：
美国
项目类别：
财政年份：
2007
资助国家：
美国
起止时间：
2007-04-01 至 2012-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7229197
关键词：
AIDS prevention Acquired Immunodeficiency Syndrome Address Adherence Affect Africa Africa South of the Sahara Anti-Retroviral Agents Antiretroviral resistance Automobile Driving Behavioral Model CD4 Positive T Lymphocytes Canned Foods Caring Clinic Clinical Cohort Studies Coitus Communities Data Development Disease Progression Drug resistance Effectiveness Empirical Research Enrollment Ensure Epidemic Food Food Policy Food Supplementation Foundations Future Gender Goals Grant HIV HIV Seropositivity Health Health behavior Individual International Interruption Intervention Intervention Studies Intervention Trial Knowledge Lead Link Longitudinal Studies Malnutrition Mentorship Metabolism Methodology Methods Morbidity - disease rate Nutritional Opportunistic Infections Other Resources Outcome Patients Pharmacy facility Play Policies Population Population Intervention Poverty Program Effectiveness Protocols documentation Research Research Infrastructure Resources Risk Risk Behaviors Risk Reduction Role Scientist Secure Standards of Weights and Measures Target Populations Thinking Training Training Programs Treatment Protocols Treatment outcome Uganda Viral Viral Load result Woman Work World Health Organization absorption base cohort cost design disease transmission high risk sexual behavior improved innovation mortality nutritional epidemiology prevent programs prospective response sex transmission process treatment program

项目摘要

DESCRIPTION (provided by applicant): The World Health Organization, UNAIDS, and the World Food Program have recognized that food insecurity is a major threat to the effectiveness of emerging antiretroviral treatment (ART) programs in sub- Saharan Africa as a result of its adverse impact on ART adherence and HIV disease transmission and progression. Yet there has been very little empirical research on these issues to guide policy decisions. Working under the mentorship of internationally recognized scientists, I propose 3 specific research aims: (1) To determine the impact of food insecurity on ART adherence among HIV-infected individuals in the Uganda Antiretroviral Treatment Outcomes (UARTO) cohort in Mbarara, Uganda; (2) To determine the impact of food insecurity on HIV treatment outcomes in the UARTO cohort; and (3) To determine the impact of food insecurity on high-risk sexual behaviors in the UARTO cohort and how gender modifies these relationships. I will leverage the resources of the UARTO cohort, an ongoing prospective observational cohort study of 500 HIV-infected individuals on ART treatment in Mbarara, Uganda and follow all patients in the cohort longitudinally every 3 months for a 2-year period. The pre-existing infrastructure of the UARTO cohort, including the operational protocols and strong community relationships, will help ensure that the current proposal is both cost-effective and feasible. This study is innovative in that it will provide the first quantitative and the first longitudinal assessment of the effects of food insecurity on ARV adherence, HIV treatment outcomes, and HIV risk behaviors in ART-treated patients in sub-Saharan Africa. By contributing to a dialogue between those involved in international food policy and those involved in ART roll-out in sub- Saharan Africa, this research may help both groups utilize their limited resources more effectively. This research is integrally linked to my training program, which includes the design, implementation, and analysis of longitudinal studies; content expertise in nutritional epidemiology and international food policy; and the design and implementation of intervention trials. This proposal will provide the preliminary data and training for the development of an intervention study of the role of targeted food assistance on HIV health outcomes and sexual-risk reduction among individuals enrolled in ART programs in sub-Saharan Africa, which will be proposed as an R01 at the end of the study period.

描述（由申请人提供）：世界卫生组织，UNAID和世界粮食计划计划已经认识到，粮食不安全是对撒哈拉以南非洲新兴抗逆转录病毒治疗（ART）计划的有效性的主要威胁，这是由于其对艺术依从性和HIV疾病传播和进展的不利影响。然而，在这些问题上几乎没有实证研究来指导政策决策。在国际公认的科学家的指导下工作，我提出了3个具体研究目的：（1）确定乌干达抗逆转录病毒治疗结果（UARTO）同胞在乌干达Mbarara的乌干达抗逆转录病毒治疗结果中粮食不安全感对艾滋病毒感染者的艺术依从性的影响；（2）确定粮食不安全对UARTO队列中HIV治疗结果的影响；（3）确定粮食不安全对乌尔托队列中高危性行为行为的影响，以及性别如何改变这些关系。我将利用Uarto队列的资源，Uarto队列的资源是一项对500名HIV感染者在乌干达姆巴拉拉（Mbarara）的ART治疗中的前瞻性观察队列研究，并每3个月纵向纵向关注所有患者，共2年。 UARTO队列的先前存在的基础设施，包括运营方案和牢固的社区关系，将有助于确保当前的提案既具有成本效益又可行。这项研究具有创新性，因为它将对撒哈拉以南非洲的ART治疗患者进行第一次定量和第一次纵向评估对粮食不安全感对ARV依从性，HIV治疗结果和HIV风险行为的影响。通过为参与国际粮食政策的人们与参与撒哈拉以南非洲艺术推出的人之间的对话，这项研究可能有助于两组更有效地利用其有限的资源。这项研究与我的培训计划完全相关，其中包括对纵向研究的设计，实施和分析；营养流行病学和国际食品政策方面的内容专业知识；以及干预试验的设计和实施。该提案将为开发有针对性的粮食援助对艾滋病毒健康结果的作用以及在撒哈拉以南非洲招生的人的性风险减少的作用的开发提供初步数据和培训，该研究将在研究期结束时作为R01提出。