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：
7787517
负责人：
SHERI Dawn WEISER
金额：
$ 16.74万
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/7787517
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 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 Outcome Patients Pharmacy facility Play Policies Population Population Intervention Poverty Program Effectiveness Protocols documentation Regimen Research Research Infrastructure Resources Risk Risk Behaviors Risk Reduction Role Scientist Secure T cell response Target Populations Training Training Programs 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 primary outcome programs prospective sex sex risk standard of care transmission process treatment adherence 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、联合国艾滋病规划署和世界粮食计划署已认识到，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）计划有效性的主要威胁，因为其不利影响对 ART 依从性和 HIV 疾病传播和进展的影响。然而，对这些问题指导政策决策的实证研究却很少。在国际知名科学家的指导下，我提出了 3 个具体的研究目标：(1) 确定粮食不安全对乌干达姆巴拉拉乌干达抗逆转录病毒治疗结果 (UARTO) 队列中艾滋病毒感染者依从抗逆转录病毒治疗的影响； (2) 确定粮食不安全对 UARTO 队列中艾滋病毒治疗结果的影响； (3) 确定粮食不安全对 UARTO 队列中高风险性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，这是一项正在进行的前瞻性观察队列研究，对乌干达姆巴拉拉的 500 名 HIV 感染者进行 ART 治疗，并在为期 2 年的时间内每 3 个月纵向跟踪该队列中的所有患者。 UARTO 群体的现有基础设施，包括操作协议和强大的社区关系，将有助于确保当前提案既具有成本效益又可行。这项研究的创新之处在于，它将首次定量和首次纵向评估粮食不安全对撒哈拉以南非洲接受抗逆转录病毒治疗的患者的抗病毒治疗依从性、艾滋病毒治疗结果和艾滋病毒风险行为的影响。通过促进国际粮食政策参与者和撒哈拉以南非洲抗逆转录病毒疗法推广参与者之间的对话，这项研究可能有助于两个群体更有效地利用其有限的资源。这项研究与我的培训计划紧密相关，其中包括纵向研究的设计、实施和分析；营养流行病学和国际粮食政策方面的专业知识；以及干预试验的设计和实施。该提案将为开展一项干预研究提供初步数据和培训，研究有针对性的粮食援助对撒哈拉以南非洲参加抗逆转录病毒疗法项目的个人的艾滋病毒健康结果和降低性风险的作用，该研究将作为R01 在研究期结束时。