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

基本信息

批准号：
8846733
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
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-03-01 至 2016-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8846733
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 public health relevance skills standard of care theories therapy design trend

项目摘要

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，致力于通过艾滋病毒综合预防来降低资源有限环境中的艾滋病毒发病率。我的职业目标是成为一名流行病学教授，拥有强大的艾滋病毒预防研究组合。作为一名接触过行为科学的流行病学家，我完全有能力实现这一目标。然而，为了成功竞争 R01 资金，我将受益于短暂的指导培训和研究。我在行为研究的设计和分析方面拥有丰富的经验，但在理论驱动的行为干预措施的设计和实施方面经验有限。在为期两年的指导阶段，我的培训和研究活动都将侧重于培养设计和提供理论驱动的行为干预的技能。我组建了一支出色的导师团队来支持这一目标：William C. Miller 博士（主要导师）、Mina Hosseinipour 博士（主要共同导师）和 Drs. Nuala McGrath、Carol Golin 和 Suzanne Maman（共同导师）。该团队的所有成员在撒哈拉以南非洲地区艾滋病毒综合预防方法的设计、实施和评估方面都拥有丰富的科学成就和丰富的经验。他们致力于支持我并相互合作。指导阶段研究（K99，第 1-2 年）：在撒哈拉以南非洲，迫切需要制定增加男性艾滋病毒检测并使他们参与艾滋病毒预防、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，为未感染艾滋病毒的男性带来预防益处，并为其感染艾滋病毒的女性伴侣带来治疗益处。选项 B+ 是马拉维的一项计划，旨在向所有感染艾滋病毒的孕妇在诊断时提供立即、终身联合抗逆转录病毒治疗 (cART)，对于让男性伴侣参与护理来说，这是一个很有前途的环境。在选项 B+ 中，我将制定一项干预措施，使用合同合作伙伴通知来招募男性伴侣，然后让他们与感染艾滋病毒的女性伴侣一起进行基于夫妇的干预（目标 1）。该干预措施将以形成性研究和二元层面相互依赖理论为指导，旨在改善与艾滋病毒感染男性伴侣的护理联系，防止未感染艾滋病毒的男性伴侣感染艾滋病毒，并促进感染艾滋病毒的女性伴侣保留 cART。独立阶段研究（R00，第 3-5 年）：我将进行一项随机对照试验（N = 500 对夫妇）以评估一年后的干预效果。我将评估干预措施是否会增加艾滋病毒检测以及感染艾滋病毒的男性性伴侣与护理的联系（目标 2）；识别 HIV 不一致的夫妻，并降低未感染 HIV 的男性性伴侣接触 HIV 的可能性（目标 3）；并提高所有女性伴侣的 cART 保留率和病毒抑制能力（目标 4）。未来方向：R00 结果将为 R01 提供长期病毒抑制和 HIV 发病率结果的信息。我将从一名受指导的博士后研究员转变为一名能够设计行为干预措施和领导艾滋病毒预防组合试验的独立研究者。