Developing and Assessing a Male Engagement Intervention for Option B+ in Malawi

在马拉维制定和评估选项 B 的男性参与干预措施

• 批准号: 9025583
• 负责人: Nora Rosenberg
• 金额: $ 8.4万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-03-01 至 2017-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9025583
• 关键词: AIDS prevention; Address; Africa South of the Sahara; Area; Award; Behavior; Behavior Therapy; Behavioral Research; Behavioral Sciences; Biological Markers; Caring; Characteristics; Clinic; Communicable Diseases; Continuity of Patient Care; Contracts; Counseling; Couples; Diagnosis; Effectiveness of Interventions; Epidemiologist; Epidemiology; Evaluation; Exhibits; Exposure to; Face; Female; Funding; Future; Goals; HIV; HIV Infections; HIV Seropositivity; HIV diagnosis; HIV prevention trial; Health; Health behavior; Human immunodeficiency virus test; Incidence; Intervention; Lead; Learning; Link; Low Prevalence; Malawi; Mentors; Morbidity - disease rate; Outcome; Partner Notification; Patients; Phase; Positioning Attribute; Postdoctoral Fellow; Pregnant Women; Prevention; Prevention Research; Prevention approach; Prevention program; Randomized Controlled Trials; Recruitment Activity; Research; Research Activity; Research Personnel; Research Training; Resources; Sample Size; Scientific Advances and Accomplishments; Services; Sexual Partners; Sexual Transmission; Sexually Transmitted Diseases; Specific qualifier value; Testing; Time; Training Activity; Treatment outcome; Vertical Disease Transmission; Viral; Woman; World Health Organization; antiretroviral therapy; base; care seeking; career; condoms; cost effective; design; experience; improved; male; member; men; mortality; pregnant; prevent; professor; programs; protective behavior; skills; standard of care; theories; therapy design; trend

DESCRIPTION (provided by applicant): Candidate: I am an infectious diseases epidemiologist committed to reducing HIV incidence in resource- limited settings through combination HIV prevention. My career goal is to be an epidemiology professor with a robust combination HIV prevention research portfolio. As an epidemiologist with behavioral science exposure, I am well positioned to achieve this goal. However, to compete successfully for R01 funding, I would benefit from a brief period of mentored training and research. I have extensive experience in the design and analysis of behavioral research, but limited experience in the design and delivery of theory-driven behavioral interventions. In a two-year mentored phase, both my training and research activities will focus on cultivating skills for designing and delivering theory-driven behavioral intervention. I have assembled an exceptional team of mentors to support this goal: Dr. William C. Miller (primary mentor), Dr. Mina Hosseinipour (primary co- mentor), and Drs. Nuala McGrath, Carol Golin, and Suzanne Maman (co-mentors). All members of the team have prolific scientific accomplishments and extensive experience in the design, implementation and evaluation of combination HIV prevention approaches in sub-Saharan Africa. They are committed to supporting me and collaborating with each other. Mentored Phase Research (K99, years 1-2): In sub-Saharan Africa, strategies to increase HIV testing among men and engage them in HIV prevention, care, and treatment are urgently needed. Such engagement can have treatment benefits for HIV-infected men, prevention benefits for HIV-uninfected men, and treatment benefits for their HIV-infected female partners. Option B+, Malawi s program for providing immediate, lifelong combination antiretroviral therapy (cART) to all HIV-infected pregnant women at the time of diagnosis, is a promising setting for engaging male partners in care. Within Option B+, I will develop an intervention that uses contract partner notification to recruit male partners and then engage them in a couple-based intervention with their HIV-infected female partner (Aim 1). The intervention will be guided by formative research and the dyad-level Interdependence Theory and aimed at improving linkage to care for HIV-infected male partners, preventing HIV acquisition for HIV-uninfected male partners, and promoting cART retention for HIV-infected female partners. Independent Phase Research (R00, Years 3-5): I will conduct a randomized controlled trial (N=500 couples) to assess intervention effectiveness at one year. I will assess whether the intervention increases HIV testing and linkage to care among HIV-infected male sex partners (Aim 2); identifies HIV-discordant couples, and decreases the likelihood of HIV exposure for HIV- uninfected male sex partners (Aim 3); and improves cART retention and viral suppression for all female partners (Aim 4). Future Directions: The R00 results will inform an R01 with longer-term viral suppression and HIV-incidence outcomes. I will transition from a mentored postdoctoral research associate to an independent investigator capable of designing behavioral interventions and leading combination HIV prevention trials.

描述（由申请人提供）： 候选人：我是一名传染病流行病学家，致力于通过预防HIV组合降低资源有限设置中的艾滋病毒发病率。我的职业目标是成为具有强大组合HIV预防研究组合的流行病学教授。作为行为科学曝光的流行病学家，我在实现这一目标方面有好处。但是，为了成功争夺R01资金，我将从短暂的指导培训和研究中受益。我在行为研究的设计和分析方面具有丰富的经验，但是在理论驱动的行为干预措施的设计和交付方面经验有限。在为期两年的指导阶段，我的培训和研究活动都将着重于培养设计和提供理论驱动的行为干预的技能。我已经组建了一支杰出的导师团队来支持这一目标：威廉·C·米勒（William C. Miller）（主要导师），米娜·霍西尼波尔（Mina Hosseinipour）博士（主要合作者）和博士。 Nuala McGrath，Carol Golin和Suzanne Maman（联合官员）。该团队的所有成员在撒哈拉以南非洲的艾滋病毒预防方法的设计，实施和评估方面都具有丰富的科学成就和丰富的经验。他们致力于支持我并彼此合作。指导的阶段研究（K99，1 - 2年）：在撒哈拉以南非洲，迫切需要增加男性艾滋病毒测试并参与艾滋病毒预防，护理和治疗的策略。这种参与可以为感染艾滋病毒的男性带来治疗益处，对艾滋病毒未感染的男性的预防益处以及对艾滋病毒感染的女性伴侣的治疗益处。选项B+，马拉维的计划，用于在诊断时为所有感染HIV的孕妇提供直接的，终生的抗逆转录病毒疗法（CART），是使男性伴侣参与护理的有希望的环境。在选项B+中，我将开发一种干预措施，该干预使用合同伙伴通知招募 男性伴侣，然后与他们的艾滋病毒感染的女性伴侣进行基于夫妻的干预（AIM 1）。干预将由形成性研究和二元级相互依存理论的指导，旨在改善与感染HIV感染的男性伴侣的关联，防止对HIV未感染的男性伴侣获得HIV的艾滋病毒，并促进对感染HIV感染的HIV感染的女性伴侣的货车保留。 独立阶段研究（R00，3-5年）：我将进行一项随机对照试验（n = 500对夫妇），以评估一年的干预效率。我将评估干预措施是否会增加艾滋病毒感染的男性性伴侣的艾滋病毒测试和联系（AIM 2）；识别艾滋病毒遗嘱夫妇，并降低了艾滋病毒未感染的男性性伴侣的艾滋病毒暴露的可能性（AIM 3）；并改善所有女性伴侣的卡车保留和病毒抑制（AIM 4）。未来的方向：R00结果将为R01提供长期抑制和艾滋病毒的结局。我将从指导的博士后研究助理过渡到能够设计行为干预和领先组合艾滋病毒预防试验的独立研究者。

项目成果

Can cash help eliminate mother-to-child HIV transmission?

现金可以帮助消除艾滋病毒母婴传播吗？

• DOI: 10.1016/s2352-3018(16)00003-5
• 发表时间: 2016
• 期刊: The lancet. HIV
• 作者: Pettifor,Audrey;Rosenberg,Nora;Bekker,Linda-Gail
• 通讯作者: Bekker,Linda-Gail

Exploring the Experiences of Women and Health Care Workers in the Context of PMTCT Option B Plus in Malawi.

• DOI: 10.1097/qai.0000000000001273
• 发表时间: 2017-04-15
• 期刊: Journal of acquired immune deficiency syndromes (1999)
• 作者: Cataldo F;Chiwaula L;Nkhata M;van Lettow M;Kasende F;Rosenberg NE;Tweya H;Sampathkumar V;Hosseinipour M;Schouten E;Kapito-Tembo A;Eliya M;Chimbwandira F;Phiri S;PURE Malawi Consortium
• 通讯作者: PURE Malawi Consortium

The effectiveness of interventions to improve uptake and retention of HIV-infected pregnant and breastfeeding women and their infants in prevention of mother-to-child transmission care programs in low- and middle-income countries: protocol for a systemati

低收入和中等收入国家提高感染艾滋病毒的孕妇和母乳喂养妇女及其婴儿的干预措施在预防母婴传播护理计划中的有效性：系统性协议

• DOI: 10.1186/s13643-015-0136-x
• 发表时间: 2015
• 期刊: Systematic reviews
• 影响因子: 3.7
• 作者: PuchalskiRitchie,LisaM;vanLettow,Monique;Hosseinipour,MinaC;Rosenberg,NoraE;Phiri,Sam;Landes,Megan;Cataldo,Fabian;Straus,SharonE;PUREconsortium
• 通讯作者: PUREconsortium

HIV testing to the test: does HIV testing promote HIV prevention in HIV-uninfected adults?

艾滋病毒检测检验：艾滋病毒检测是否能促进未感染艾滋病毒的成年人预防艾滋病毒？

• DOI: 10.1136/sextrans-2016-052640
• 发表时间: 2016
• 期刊: Sexually transmitted infections
• 影响因子: 3.6
• 作者: Rosenberg,NoraE

Recruiting the social contacts of patients with STI for HIV screening in Lilongwe, Malawi: process evaluation and assessment of acceptability.

在马拉维利隆圭招募性传播感染患者的社会联系人进行艾滋病毒筛查：过程评估和可接受性评估。

• DOI: 10.1136/sextrans-2015-052496
• 发表时间: 2016
• 期刊: Sexually transmitted infections
• 影响因子: 3.6
• 作者: Rosenberg,NoraE;Stanley,ChristopherC;Rutstein,SarahE;Bonongwe,Naomi;Kamanga,Gift;Pettifor,Audrey;Mapanje,Clement;Martinson,Francis;Hoffman,IrvingF;Miller,WilliamC
• 通讯作者: Miller,WilliamC