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

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.

项目概要 南非 (SA) 的围产期妇女是世界上艾滋病毒感染率最高的国家之一，并且几乎 通过男性伴侣的性接触而感染的时期是唯一增加风险的时期。 如果女性在怀孕末期或产后感染艾滋病毒，则可能会感染艾滋病毒。 通过母乳喂养传染给婴儿 在南澳，伴侣关系中的女性和男性并不总是互相认识。 这可能会使艾滋病毒预防变得困难，特别是在南澳，因为那里男性感染艾滋病毒的可能性较小。 与未感染 HIV 的女性相比，接受 HIV 检测的女性可以选择使用暴露前预防 (PrEP)。 帮助他们保持未感染艾滋病毒的状态；了解自身状况并接受治疗的艾滋病毒感染者 (MWH) 有效地，不太可能将艾滋病毒传播给其女性伴侣，男性现在能够检测自己是否感染艾滋病毒。 使用艾滋病毒自检 (HIVST) 试剂盒；使用这些试剂盒有可能规避传统的临床检测障碍 基于艾滋病毒检测，例如对耻辱或隐私的担忧，或竞争需求，例如繁忙的工作 我们早期的研究表明，男性愿意做出保护女性的行为。 伴侣在尝试怀孕期间免受艾滋病毒感染，以保护其后代，包括进行艾滋病毒检测。 向未感染艾滋病毒的妇女提供艾滋病毒检测工具包，用于男性伴侣分发和艾滋病毒预防咨询 产后早期可能有助于女性在这段风险增加的时期保持不感染艾滋病毒， 还可以识别 MWH 并帮助这些男性参与艾滋病毒护理 因此，本研究有以下内容。 目标：(1) 完善联合干预措施的内容，以促进合作伙伴的 HIVST 和 PrEP 通过焦点小组讨论，未感染艾滋病毒的产后妇女（“H4P”）的吸收 过去一年中生育过孩子的南澳男性（N = 最多 10 名女性和 10 名男性） (2) 进行 针对产后未感染 HIV 的女性（N = 60 及其男性）进行 H4P 干预的随机试点试验 南澳州夸祖鲁-纳塔尔省的伴侣），报告其伴侣血清状况未知。所有女性都将收到 HIVST 试剂盒。 向随机接受 H4P 干预的男性伴侣分发标准化健康信息； 手臂还将接受 PrEP 摄取咨询，男性伴侣将接受以生殖健康为中心的咨询 将评估有关艾滋病毒检测为何重要的信息。 (3a) 进行评估。 通过计算干预/控制组在干预后三个月的初步效果 在伴侣检测呈阳性、未检测或不具有相同基因的女性中，开始 PrEP 的女性比例 测试结果，以及与艾滋病毒护理相关的测试呈阳性的男性比例 (3b) 进行个体化。 对一部分登记的女性及其伴侣（N = 最多 10-15 名女性和男性）进行定性访谈 干预部门探索优化干预的机会。