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）：阿根廷人口超过 4000 万，估计有 88,000 至 150,000 名艾滋病毒感染者（UNAIDS/WHO，2008~国家艾滋病规划），估计患病率为成年人口的 0.5% （联合国艾滋病规划署，2009 年）。阿根廷的艾滋病毒/艾滋病流行曾经主要发生在高危人群中，现在正在向异性恋人群转移，异性传播占男性艾滋病毒的 48%，女性艾滋病毒的 87%（Pando 等，2010），使他们成为最快的艾滋病毒/艾滋病传播者。不断增长的传播群体（Cohen 等，2006）。阿根廷政府已向所有需要的人提供抗逆转录病毒 (ARV) 药物，并已向约 70% 的艾滋病毒感染者分发了抗逆转录病毒药物（联合国艾滋病规划署/世界卫生组织，2008 年）。 然而，如果要最大限度地发挥大规模提供抗逆转录病毒治疗的益处，就必须将优化艾滋病毒阳性个体依从水平的教育和动机系统地纳入艾滋病毒护理中。鉴于阿根廷获得抗逆转录病毒治疗 (ART) 的水平，优化 ART 依从性可能会对感染者和未感染者产生重大影响，作为遏制该流行病的高效预防策略（Lima，2008~ Montaner，2010~ Velaszco-Hernandez 等人，2010）。 ，2002）。这项研究旨在通过促进患者与提供者之间的伙伴关系以及新诊断的抗逆转录病毒治疗患者的治疗联系来优化治疗结果。这项研究与患者和医疗服务提供者合作，利用生物行为策略来提高参与度、治疗和保留率，并增强患者对病毒抑制在改善健康和减少艾滋病毒传播方面的作用的理解。拟议的应用程序旨在开发、调整和试点测试一种创新的患者提供者干预措施，Conexiones y Opciones Positivas en la Argentina (Positive Connections, COPA)，旨在 1) 增强 HIV/ART 知识，2) 调整提供的信息水平，以患者，以及 3) 加强医患治疗沟通。本研究将招募刚接受抗逆转录病毒治疗的新诊断患者 (n = 120) 和提供者 (n = 12) 参与患者-提供者干预。使用完整析因设计，患者将被随机分配到以下四种情况之一：1) 患者/实验 - 提供者/实验 ~ 2) 患者/实验 - 提供者/护理标准 ~ 3) 患者/实验 - 提供者/实验 ~ 4) 患者/护理标准 - 提供者/护理标准。从这四种情况收集的数据将指导临床试验的开展，以更大、更具代表性的目标人群样本来测试最有效的患者-提供者干预措施。利用现有的抗逆转录病毒药物分配基础设施，优化患者和提供者之间的协同作用可能成为阿根廷坚持有效预防策略的关键组成部分。