HIV prevention and care for couples in South Africa

南非夫妇的艾滋病毒预防和护理

基本信息

批准号：
10390420
负责人：
LYNAE A DARBES
金额：
$ 53.95万
依托单位：
UNIVERSITY OF MICHIGAN AT ANN ARBOR
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-07-03 至 2025-04-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10390420
关键词：
AIDS prevention Address Adherence Adult Attention Behavioral Caring Characteristics Clinic Continuity of Patient Care Control Groups Counseling Country Couples Educational Curriculum Epidemic Female Goals HIV HIV Seropositivity Heterosexuals High Prevalence Human immunodeficiency virus test Individual Infection Intervention Learning Life Expectancy Link Literature Mediating Outcome Phase Prevalence Prevention Problem Solving Professional counselor Qualitative Methods Randomized Randomized Controlled Trials Recording of previous events Research Risk Rural Rwanda Sampling Sexual Partners Site South Africa Techniques Testing Training Viral Woman Work Zambia antenatal efficacy evaluation efficacy testing female couples improved innovation intervention effect male male couples men motivational enhancement therapy novel preventive intervention recruit sexual risk behavior transmission process treatment arm trial design uptake

项目摘要

PROJECT SUMMARY/ABSTRACT South Africa remains one of the countries mostly heavily impacted by the HIV epidemic, with an overall estimated adult HIV prevalence of 18% to 30% among female antenatal clinic attendees. There is now substantial evidence that more than 80% of new infections occur within primary male-female partnerships. The high rates of new infections among primary partnerships are attributed to a combination of low levels of HIV testing and a high prevalence of outside sex partners. Recent work by Darbes (MPI), in KwaZulu-Natal (KZN) – the site of the proposed new research – found that among a sample of 330 heterosexual couples, 49% of men and 41% of women had no previous HIV testing history. In 20% of couples, neither partner had ever tested for HIV, despite living in a region with one of the highest adult HIV prevalence globally. Beyond the low levels of HIV testing, recent work also demonstrates significant deficits across the continuum of care in South Africa: recent work by Haber in KZN shows that only 45% of HIV-positive individuals are linked to care, 35% initiate ART, and 33% reach viral suppression. There is increasing evidence of efficacy for couples' focused HIV prevention interventions. Couples HIV Testing and Counseling (CHTC) is a proven strategy to reduce the risk of HIV transmission between partners. However, CHTC focuses only on the first stage of the cascade of HIV care – testing – are there are no interventions that allow couples to pass through the cascade of care together. Using a randomized controlled trial design with 272 couples, we aim to address this gap in HIV prevention and care literature by comparing a package of dyadic focused HIV testing and counseling interventions, against an attention matched control. The proposed RCT will test the efficacy of the dyadic intervention for achieving gains in viral suppression and engagement in HIV care. Heterosexual couples represent a significant yet over- looked risk group in South Africa, and innovative solutions are urgently needed to improve progression across the continuum of HIV care.

项目摘要/摘要南非仍然是大多数受艾滋病毒流行影响的国家之一，总体上在女性产前诊所参加者中，估计成人HIV患病率为18％至30％。现在有大量证据表明，超过80％的新感染发生在主要的男女伙伴关系中。主要伙伴关系之间新感染的高率归因于低水平的组合艾滋病毒测试和外部性伴侣的高流行。 Darbes（MPI）的最新工作，夸祖鲁 - 纳塔尔（KZN） - 拟议的新研究的地点 - 发现在330对异性恋夫妇的样本中，49％男性和41％的女性以前没有HIV测试史。在20％的夫妇中，这两个伴侣都没有曾在全球成年艾滋病毒患病率最高的地区居住在艾滋病毒中测试。超越低点艾滋病毒测试水平，最近的工作还表明了南方的整个护理中的显着定义非洲：哈伯最近在KZN的工作表明，只有45％的艾滋病毒阳性个体与护理有关，35％启动ART，33％达到病毒抑制。有越来越多的证据表明夫妻聚焦艾滋病毒的效率预防干预措施。夫妻艾滋病毒测试和咨询（CHTC）是降低风险的验证策略伴侣之间的艾滋病毒传播。但是，CHTC仅关注艾滋病毒级联的第一阶段护理 - 测试 - 没有干预措施可以让夫妻一起通过一系列的护理。使用272对夫妇使用随机对照试验设计，我们旨在解决预防艾滋病毒和通过比较一揽子二元二元艾滋病毒测试和咨询干预措施与一个护理文献注意匹配的控制。拟议的RCT将测试二元干预的效率在病毒抑制和参与艾滋病毒护理方面的收益。异性恋夫妇代表着重要但过度的在南非看来是风险群体，迫切需要创新的解决方案来改善各个方面的发展艾滋病毒护理的连续性。