Population mobility and retention in HIV care among postpartum women in South Africa

南非产后妇女的人口流动性和艾滋病毒护理保留率

基本信息

批准号：
9041682
负责人：
Kate Clouse
金额：
$ 14.32万
依托单位：
VANDERBILT UNIVERSITY MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-04-01 至 2019-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9041682
关键词：
Address Adherence Adult Africa Africa South of the Sahara Aftercare Behavioral Birth Birth Place Caring Cellular Phone Cessation of life Characteristics Child Clinic Continuity of Patient Care Data Data Collection Data Linkages Databases Development Development Plans Drops Epidemiologist Face Fingerprint Frequencies Future Geographic Information Systems Goals HIV HIV Seropositivity HIV diagnosis Health Health Services Accessibility Healthcare High Risk Woman Home environment Incentives Individual Infant Intervention Interview K-Series Research Career Programs Knowledge Laboratories Length of Stay Life Link Location Maps Mentored Research Scientist Development Award Mentors Mentorship Mothers Motivation Movement Nature Outcome Participant Patients Pattern Persons Population Postpartum Period Postpartum Women Pregnancy Pregnant Women Primary Health Care Professional Organizations Province Qualitative Research Reading Recording of previous events Registries Reporting Research Research Activity Research Methodology Research Personnel Research Proposals Research Training Rural Services Smart Card Social Welfare South Africa Staging System Time Training Training Activity Training Programs Training Support Travel Woman Work career development coping design effective intervention experience follow-up health care availability health care service utilization high risk implementation science improved meetings novel patient population pregnant public health relevance residence skills social social stigma theories voucher

项目摘要

DESCRIPTION (provided by applicant): The proposed 4-year career development award will combine mentorship, training and research activities to enable me to develop the skills necessary to become an independent investigator in the field of HIV implementation science. In the latter years of this K award, I will submit a competitive R01 application to design and conduct an intervention to retain HIV-positive, postpartum women in care. My prior work found that pregnant HIV-positive women in South Africa are at particularly high risk of dropping out of care soon after delivery, but additional research is needed in order to develop targeted, effective interventions to improve continuity of care. Key unresolved questions that my research seeks to address are the lack of information about the characteristics of mobility within this population and the impact of population mobility on retention in postpartum HIV care. The K-related training program is a critical component of my career development plan, and includes mentorship meetings, didactic coursework, directed readings and discussions, seminars, and professional society meetings. As an epidemiologist, I am highly competent in quantitative analysis, but I require additional training in social and behavioral theory, selected qualitative research methods and geographic information systems (GIS) in order to address existing research questions that will inform future interventions. My K-supported research proposal has 3 AIMS: 1) to determine the frequency of "clinic shopping" and identify factors associated with clinic switching using existing databases; 2) to characterize mobility and health care utilization among pregnant and postpartum HIV-positive women; and 3) to determine the effect of mobility on retention in HIV care and adherence to ART. Project activities will take place in Johannesburg, South Africa, using existing HIV clinic data for Aim 1 and primary data collection at Witkoppen Health and Welfare Centre, a primary care clinic, for Aims 2 and 3. RELEVANCE: My work addresses a substantial knowledge gap related to population mobility and retention in HIV care among a specific population (peripartum women) at highest risk of dropping out of HIV care. Addressing these gaps will accelerate the creation of novel interventions to improve continuity of care for women in Africa. My project aims and training objectives align to enable me to develop the skills and experience to become an independent investigator with the guidance of my highly experienced mentorship committee.

描述（由申请人提供）：拟议的 4 年职业发展奖将结合指导、培训和研究活动，使我能够在本年的最后几年发展成为艾滋病毒实施科学领域的独立研究者所需的技能。 K 奖，我将提交一份竞争性 R01 申请，以设计和实施一项干预措施，以将艾滋病毒呈阳性的产后妇女留在护理中。我之前的工作发现，南非艾滋病毒呈阳性的孕妇退出护理的风险特别高。交货后不久，但另外需要进行研究，以便制定有针对性的、有效的我的研究试图解决的关键未解决问题是缺乏有关该人群流动性特征的信息，以及人口流动性对产后艾滋病毒护理保留的影响。作为一名流行病学家，我在定量分析方面非常有能力，但我需要社会和行为理论方面的额外培训。 , 选定的定性研究方法和地理信息系统 (GIS)，以解决现有的研究问题，为未来的干预措施提供信息。My K 支持的研究提案有 3 个目标：1) 确定“诊所购物”的频率并确定与诊所转换相关的因素。现有数据库；2) 描述孕妇和产后艾滋病毒阳性妇女的流动性和医疗保健利用情况；以及 3) 确定流动性对艾滋病毒护理的保留和坚持接受抗逆转录病毒治疗的影响项目活动将在南非约翰内斯堡进行。，利用现有的目标 1 的艾滋病毒诊所数据以及目标 2 和 3 在初级保健诊所 Witkoppen 健康和福利中心收集的主要数据。相关性：我的工作解决了与人口流动性和特定人群中艾滋病毒护理保留相关的重大知识差距（围产期妇女）退出艾滋病毒护理的风险最高，解决这些差距将加速制定新的干预措施，以改善对非洲妇女的护理连续性，使我能够发展技能和经验。到在我经验丰富的导师委员会的指导下成为一名独立调查员。