Ukubandakanya abesilisisa: HIV self-testing for Partners of HIV-uninfected Postpartum Women to facilitate PrEP and ART uptake to promote HIV treatment and prevention

Ukubandakanya abesilisisa：为未感染艾滋病毒的产后妇女的伴侣进行艾滋病毒自我检测，以促进 PrEP 和 ART 的采用，从而促进艾滋病毒治疗和预防

• 批准号: 10762152
• 负责人: Lynn T Matthews
• 金额: $ 62.3万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-08 至 2026-09-07
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10762152
• 关键词: AIDS prevention; Acute; Address; Africa South of the Sahara; Awareness; Behavior; Behavioral Model; Behavioral Research; Breast Feeding; Caring; Child; Client satisfaction; Clinic; Counseling; Coupled; Couples; Data; Diagnosis; Diagnostic Reagent Kits; Effectiveness; Enrollment; Family; Feedback; Female; Female of child bearing age; Focus Groups; Fright; Funding; Gender; HIV; HIV Infections; HIV diagnosis; Health; Health protection; Human immunodeficiency virus test; Incidence; Individual; Infant; Information Centers; Information Distribution; Intervention; Interview; Lead; Learning; Link; Masculine; Measures; Modification; Mothers; Oral; Outcome; Perception; Postpartum Period; Postpartum Women; Pregnancy; Prevalence; Prevention; Prevention strategy; Privacy; Province; Questionnaires; Randomized; Reporting; Reproductive Health; Research; Retinal blind spot; Risk; Schedule; Sexual Partners; South Africa; Standardization; Structure; System; Tenofovir; Test Result; Testing; Time; United States National Institutes of Health; Viral; Woman; Work; acceptability and feasibility; antiretroviral therapy; arm; catalyst; follow-up; high risk; infection rate; intervention mapping; male; men; novel; offspring; perinatal HIV; perinatal period; perinatal women; pilot trial; post intervention; post pregnancy; pre-exposure prophylaxis; preference; pregnant; prevent; primary outcome; self testing; social stigma; standard of care; success; transmission process; treatment arm; uptake; AIDS prevention; Acute; Address; Africa South of the Sahara; Awareness; Behavior; Behavioral Model; Behavioral Research; Breast Feeding; Caring; Child; Client satisfaction; Clinic; Counseling; Coupled; Couples; Data; Diagnosis; Diagnostic Reagent Kits; Effectiveness; Enrollment; Family; Feedback; Female; Female of child bearing age; Focus Groups; Fright; Funding; Gender; HIV; HIV Infections; HIV diagnosis; Health; Health protection; Human immunodeficiency virus test; Incidence; Individual; Infant; Information Centers; Information Distribution; Intervention; Interview; Lead; Learning; Link; Masculine; Measures; Modification; Mothers; Oral; Outcome; Perception; Postpartum Period; Postpartum Women; Pregnancy; Prevalence; Prevention; Prevention strategy; Privacy; Province; Questionnaires; Randomized; Reporting; Reproductive Health; Research; Retinal blind spot; Risk; Schedule; Sexual Partners; South Africa; Standardization; Structure; System; Tenofovir; Test Result; Testing; Time; United States National Institutes of Health; Viral; Woman; Work; acceptability and feasibility; antiretroviral therapy; arm; catalyst; follow-up; high risk; infection rate; intervention mapping; male; men; novel; offspring; perinatal HIV; perinatal period; perinatal women; pilot trial; post intervention; post pregnancy; pre-exposure prophylaxis; preference; pregnant; prevent; primary outcome; self testing; social stigma; standard of care; success; transmission process; treatment arm; uptake

PROJECT SUMMARY Perinatal women in South Africa (SA) have one of the highest HIV infection rates in the world, and are almost exclusively infected via sexual contact from male partners. The postpartum period is an increased time of risk for HIV. If women become HIV infected at the end of pregnancy or during the postpartum period, HIV may be transmitted to the infant via breastfeeding. Women and men in partnerships in SA do not always know each other’s HIV statuses. This can make HIV prevention difficult, particularly in SA, where men are less likely to be tested for HIV than women. HIV-uninfected women have the option of using pre-exposure prophylaxis (PrEP) to help them remain HIV-uninfected; men with HIV (MWH) who know their status, and who take treatment effectively, are unlikely to transmit HIV to their female partners. Men are now able to test themselves for HIV using HIV self-test (HIVST) kits; use of these kits has the potential to circumvent barriers to traditional, clinic- based HIV testing, such as concerns about stigma or privacy, or competing demands, like busy work schedules. Our earlier work suggests that men are willing to engage in behaviors to protect their female partners from HIV during attempts to conceive in order to protect their offspring, including HIV testing. Providing HIV-uninfected women with HIVST kits for male partner distribution and HIV prevention counseling during the early postpartum period may help women remain HIV-uninfected during this time of increased risk, and may also identify MWH and help those men engage in HIV care. Thus, this study has the following objectives: (1) to refine the content of a combination intervention to promote HIVST for Partners and PrEP uptake for HIV-uninfected Postpartum Women (“H4P”) via focus group discussion feedback from women and men in SA who have had a child in the past year (N = up to 10 women and 10 men); (2) to conduct a randomized pilot trial of the H4P intervention for postpartum HIV-uninfected women (N = 60 and their male partners) in KwaZulu-Natal, SA, who report a partner of unknown serostatus. All women will receive HIVST kits and standardized health information for distribution to male partners; those randomized to the H4P intervention arm will also receive PrEP uptake counseling, and male partners will receive reproductive health-centered information about why HIV testing is important. Feasibility and acceptability will be assessed. (3a) To evaluate preliminary effectiveness by calculating, across intervention/control arms at three months post-intervention, the proportion of women initiating PrEP among those whose partners test positive, do not test, or do not share a test result, and the proportion of men with a positive test who link to HIV care. (3b) To conduct individual qualitative interviews with a subset of enrolled women and their partners (N = up to 10-15 women and men) in the intervention arm to explore opportunities to optimize the intervention.

项目摘要 南非的围产期妇女（SA）是世界上最高的HIV感染率之一，几乎是 通过男性伴侣的性接触专门感染。产后期是增加风险时间 艾滋病毒。如果妇女在怀孕结束时或产后感染了艾滋病毒，艾滋病毒可能是 通过母乳喂养传播给婴儿。与SA合作的男女并不总是知道每个 他人的艾滋病毒状况。这可能会使艾滋病毒预防困难，尤其是在SA中，男人不太可能成为 对艾滋病毒的测试比女性。艾滋病毒未感染的妇女可以选择使用预防前预防（PREP） 帮助他们保持艾滋病毒未感染；患有艾滋病毒（MWH）的男性知道自己的地位，并接受治疗 有效地，不太可能将艾滋病毒传递给其女性伴侣。男人现在能够为艾滋病毒测试 使用艾滋病毒自我测试（HIVST）套件；这些套件的使用有可能规避传统诊所的障碍 基于艾滋病毒的艾滋病毒测试，例如对污名或隐私或竞争要求的担忧，例如忙碌的工作 时间表。我们较早的工作表明，男人愿意从事保护女性的行为 艾滋病毒的伴侣在试图保护其后代的尝试中，包括艾滋病毒测试。 提供艾滋病毒未感染的妇女使用HIVST套件进行男性伴侣分发和艾滋病毒预防咨询 在产后早期，可能有助于妇女在这一风险增加的时期内对艾滋病毒未感染， 并可能识别MWH并帮助这些人从事艾滋病毒护理。那就是这项研究以下 目标：（1）完善组合干预的内容，以促进合作伙伴和准备的HIVST 通过焦点小组讨论妇女的反馈和 在SA中的男性在过去一年中育有孩子（n =多达10名女性和10名男性）； （2）进行 产后艾滋病毒未感染的女性H4P干预的随机试验试验（n = 60及其男性 Partners）在SA的夸祖鲁 - 纳塔尔（Kwazulu-Natal），他报告了未知血清的合伙人。所有妇女都会收到HIVST套件 和标准化的健康信息，以分配给男性伴侣；那些随机进行H4P干预 ARM还将获得预摄取咨询，男性伴侣将获得以健康为中心的 有关为什么艾滋病毒测试很重要的信息。将评估可行性和可接受性。 （3a）评估 在干预后三个月的干预/控制臂计算，通过计算初步有效性 在伴侣测试阳性，不测试或不共享伴侣测试的妇女中，妇女的比例是 测试结果，以及与艾滋病毒护理相关的阳性测试的男性比例。 （3b）进行个人 在一部分已入学的妇女及其伴侣（n =最多10-15名男性和男性）的定性访谈中 干预部门探索优化干预措施的机会。