Positive Connections

积极的联系

• 批准号: 8456143
• 负责人: Deborah Lynne Jones
• 金额: $ 18.67万
• 依托单位: UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-04-09 至 2015-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8456143
• 关键词: AIDS/HIV problem; Accounting; Acquired Immunodeficiency Syndrome; Adherence; Adult; Anti-Retroviral Agents; Appointment; Argentina; Behavioral; Caring; Clinic; Clinical Trials; Cognitive; Communication; Country; Data; Development; Diagnosis; Education; Empathy; Enrollment; Epidemic; Evaluation; Foundations; Frequencies; Government; HIV; HIV Seropositivity; Health; Health Personnel; Health Services Accessibility; Heterosexuals; Individual; Intervention; Knowledge; Life; Long-Term Care; Motivation; Newly Diagnosed; Outcome; Participant; Patients; Persons; Pharmaceutical Preparations; Physicians; Population; Prevalence; Prevention strategy; Protocols documentation; Provider; Randomized; Recommendation; Relative (related person); Research; Research Infrastructure; Role; Sampling; Site; Target Populations; Testing; Treatment outcome; Trust; Variant; Viral; Viral Load result; Woman; Work; antiretroviral therapy; cost; design; falls; follow-up; health literacy; high risk; improved; innovation; medication compliance; men; patient population; programs; provider intervention; standard of care; therapy adherence; tool; transmission process

DESCRIPTION (provided by applicant): With a population of over 40 million people, Argentina has an estimated 88,000 to 150,000 persons living with HIV (UNAIDS/WHO, 2008~ National AIDS Program), with an estimated prevalence of 0.5% of the adult population (UNAIDS, 2009). Once primarily among high risk groups, the HIV/AIDS epidemic in Argentina is now shifting to the heterosexual population and heterosexual transmission accounts for 48% of HIV in men and 87% in women (Pando et al., 2010), making them the fastest growing transmission group (Cohen et al., 2006). The Government of Argentina has made antiretroviral (ARV) medications available to all who need it and has already distributed ARVs to approximately 70% of the HIV infected population (UNAIDS/WHO, 2008). However, if the benefits of large scale provision of ARV therapy are to be maximized, education and motivation to optimize the level of adherence among HIV positive individuals must be systematically incorporated into HIV care. Given the level of access to antiretroviral therapy (ART) in Argentina, optimizing ART adherence could significantly impact both those infected and uninfected as a highly effective prevention strategy to contain the epidemic (Lima, 2008~ Montaner, 2010~ Velaszco- Hernandez et al., 2002). This study seeks to optimize treatment outcomes by facilitating patient-provider partnerships and treatment linkages for newly diagnosed patients new to ARVs. Working with both patients and providers, this study utilizes bio-behavioral strategies to improve engagement, treatment and retention, and to enhance patients' understanding of the role of viral suppression to improve health and reduce HIV transmission. The proposed application seeks to develop, adapt and pilot test an innovative patient-provider intervention, Conexiones y Opciones Positivas en la Argentina (Positive Connections, COPA) designed to 1) enhance HIV/ART knowledge, 2) tailor the level of information provided to patients, and 3) enhance provider-patient treatment communication. This study will enroll newly diagnosed patients new to ARVs (n = 120) and providers (n = 12) in a patient- provider intervention. Using a full factorial design, patients wil be randomized into one of four conditions: 1) Patient/Experimental - Provider/Experimental~ 2) Patient/Experimental - Provider/Standard of Care~ 3) Patient/Standard of Care - Provider/Experimental~ and 4) Patient/Standard of Care - Provider/Standard of Care. The data gathered from the four conditions will guide the development of a clinical trial to test the most efficacious patient-provider intervention with a larger, more representative sample of the target population. Utilizing the existing ARV distribution infrastructure, optimizing the synergy between patient and provider could become a critical component of adherence as an effective prevention strategy in Argentina.

描述（由申请人提供）：阿根廷拥有超过4000万人的人口，估计有88,000至15万人患有艾滋病毒的人（UNAIDS/WHO，2008年，2008年〜国家艾滋病计划），估计占成年人口的0.5％（UNAIDS，2009年）。阿根廷的艾滋病毒/艾滋病流行病现在主要是在高风险群体中，现在正在转向异性恋人群，异性恋传播占男性艾滋病毒的48％，女性的艾滋病毒占87％（Pando等，2010），使它们成为增长最快的传播组（Cohen等，2006）。阿根廷政府已将抗逆转录病毒（ARV）药物提供给所有需要的药物，并且已经将ARV分配给了大约70％的艾滋病毒感染人群（Unaids/WHO，2008年）。 但是，如果要最大程度地提高ARV治疗的大规模提供的好处，则必须系统地纳入艾滋病毒阳性个体之间优化艾滋病毒阳性个体依从性水平的教育和动机。鉴于阿根廷获得抗逆转录病毒疗法（ART）的水平，优化艺术依从性可能会显着影响那些被感染和未感染的人，作为一种高度有效的预防策略，以遏制这种流行病（Lima，2008〜Montaner，2010年〜Velaszco-hernandez等人，2002年）。这项研究旨在通过促进新诊断的ARV患者的患者伙伴关系和治疗联系来优化治疗结果。本研究与患者和提供者一起工作，利用生物行为策略来改善参与，治疗和保留率，并增强患者对病毒抑制作用以改善健康和减少HIV传播的理解。拟议的应用程序旨在开发，适应和试点测试创新的患者提供者干预措施，conexiones y opciones postitivas positivas en la agentina（正连接，COPA）设计为1）增强HIV/ART知识，2）量身定制提供给患者的信息水平，3）增强提供者支持者治疗沟通。这项研究将在患者提供者干预措施中招募新诊断为ARV（n = 120）的患者（n = 120）（n = 12）。使用完整的阶乘设计，患者将被随机分为四个条件之一：1）患者/实验者 - 提供者/实验〜2）患者/实验 - 提供者/护理标准〜3）患者/护理标准 - 提供者/实验性/实验性〜和4）患者/护理标准 - 提供者/护理标准。从四个条件中收集的数据将指导临床试验的开发，以测试最有效的患者治疗者干预措施，并具有更大，更具代表性的目标人群样本。利用现有的ARV分布基础设施，优化患者和提供者之间的协同作用可能成为遵守阿根廷有效预防策略的关键组成部分。