Impact Evaluation of Combination HIV Prevention Interventions in Botswana

博茨瓦纳艾滋病毒联合预防干预措施的影响评估

• 批准号: 8827178
• 负责人: MYRON E ESSEX
• 金额: $ 452.66万
• 依托单位: HARVARD SCHOOL OF PUBLIC HEALTH
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-30 至 2017-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8827178
• 关键词: Impact; Evaluation; Combination; HIV; Prevention

PROJECT SUMMARY/ABSTRACT This proposal is to evaluate the impact and cost effectiveness of combination HIV prevention interventions on population-level HIV incidence in Botswana, a country with a severe generalized HIV epidemic. Despite a 25% prevalence in adults, Botswana has led Africa in scale-up of several interventions for HIV prevention and treatment. The proposal will use 16 distinct, randomized rural communities to meet combination prevention goals of HIV Testing and Counseling (HTC), adult male circumcision (MC), AntiRetroviral Therapy (ART) for patients with AIDS or CD4 d 250, and Prevention of Mother-to-Child Transmission (PMTCT). Eight control communities (Arm A) and 8 enhanced combination-prevention communities (Arm B) will be compared for HIV incidence, anticipating a reduction of e 50% over the study period for Arm B. A third (Arm C) in Mochudi will provide a step-wedge design with 6 communities to add a 3-drug ART intervention for individuals with high viral-load ("high viral load carriers ") along with the enhanced combination prevention interventions used in Arm B, which we anticipate will provide even greater reductions in HIV incidence. All arms will evaluate HIV incidence over the 4-year study. Arms B and C will also include extensive extra activities, such as: community mobilization and education, enhanced HTC, mobile night clinics, linkage with various community organizations, and partner testing; extra testing techniques such as point-of-care CD4 testing to detect a larger fraction of patients who qualify for ART and PMTCT; and earlier ART initiation and enhanced monitoring of the same populations. For ART and PMTCT, we expect our targets to exceed those indicated in the RFA. The Botswana-Harvard Partnership (BHP) is a not-for-profit organization chartered under the laws of Botswana, and is based upon a 15-year official collaboration between Harvard and the Botswana Ministry of Health. In addition to serving as the original source agency to develop the Botswana PEPFAR and the National ART Program, as well as the largest AIDS-related training program in the country, the BHP has conducted scientific studies and extensively published on all the major prevention interventions addressed in the RFA. The BHP also has a large-capacity accredited laboratory that is central in location to the study sites and serves as the national reference lab for HIV/AIDS.

项目摘要/摘要 该建议是评估组合艾滋病毒的影响和成本效益 对博茨瓦纳人口级艾滋病毒发病率的预防干预措施，一个严重的国家 普遍的HIV流行。尽管成人患病率为25％，但博茨瓦纳带领非洲 扩大预防艾滋病毒和治疗的几种干预措施。该提案将使用16 独特的随机农村社区以实现艾滋病毒测试的预防目标 和咨询（HTC），成年男性包皮环切术（MC），抗逆转录病毒疗法（ART） AIDS或CD4 D 250的患者，以及预防母亲到孩子传播（PMTCT）。 八个控制社区（A臂A）和8个增强的预防群体（ARM b）将比较艾滋病毒发病率，预计在研究期内降低E 50％ 对于Mochudi中的第三个（臂C）的手臂B。 为具有高病毒载荷的个体（“高病毒负荷载体”）添加3毒艺术干预措施 以及ARM B中使用的增强组合预防干预措施，我们 预期将提供更大的艾滋病毒发病率。 所有武器将在4年的研究中评估HIV发病率。手臂B和C也将 包括广泛的额外活动，例如：社区动员和教育，增强 HTC，移动夜诊所，与各种社区组织的联系以及合作伙伴测试； 额外的测试技术，例如保健CD4测试，以检测较大的患者 有资格获得艺术和PMTCT的人；以及较早的艺术启动和增强对 同样的人群。对于艺术和PMTCT，我们希望我们的目标超出 RFA。 Botswana-Harvard Partnership（bhp）是一个非营利组织 博茨瓦纳的法律，基于哈佛与哈佛之间的15年官方合作 博茨瓦纳卫生部。除了担任开发原始资源机构之外 博茨瓦纳Pepfar和国家艺术计划以及与艾滋病有关的最大 必和必拓在该国的培训计划进行了科学研究和广泛的科学研究 发表在RFA中解决的所有主要预防干预措施上。必和必拓也有 大容量认可的实验室，位于研究地点的中心，并用作 艾滋病毒/艾滋病的国家参考实验室。