Adherence to HIV Treatment Postpartum: The Implications of Transitions Among Women Living with HIV in South Africa

产后坚持艾滋病毒治疗：南非艾滋病毒感染妇女转变的影响

基本信息

批准号：
10223887
负责人：
Jennifer Ann Pellowski
金额：
$ 15.15万
依托单位：
BROWN UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-08-01 至 2023-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10223887
关键词：
AIDS prevention Address Adherence Adult African Area Behavior Behavior Therapy Behavioral Behavioral Research Breast Feeding Caring Clinic Clinical Management Clinical Sciences Country Discipline of obstetrics Educational workshop Epidemiology Equilibrium Evaluation Face Funding Future Goals Gynecology HIV HIV Seropositivity Health behavior Horizontal Disease Transmission Human immunodeficiency virus test Individual Infant Infant Care Infectious Disease Epidemiology Influentials International Intervention Interview K-Series Research Career Programs Lead Life Maternal Health Maternal Mortality Maternal and Child Health Mentors Mentorship Methodology Mothers Motivation Participant Perception Perinatal Epidemiology Perinatal Infection Personal Satisfaction Pharmaceutical Preparations Phase Population Postpartum Period Postpartum Women Pregnancy Pregnant Women Prevention Prevention Research Process Psychologist Public Health Qualitative Methods Randomized Controlled Trials Reading Reproductive Health Research Research Personnel Research Training Resources Risk Role Scientist Self Care Sexual Health Sexual Partners Shapes South Africa South African Special Population Structure Techniques Testing Training United States Vertical Disease Transmission Virus Woman antenatal antiretroviral therapy base behavioral adherence biobehavior career child bearing cohort design experience follow up assessment follow-up improved innovation mortality motherhood postpartum care preference prevent preventive intervention psychosocial public health relevance recruit social social disadvantage social stigma theories therapy adherence therapy development transmission process treatment adherence treatment research uptake

项目摘要

PROJECT SUMMARY Prevention of mother-to-child transmission (PMTCT) efforts have reduced the rates of vertical transmission to 2.7%, however, optimal antiretroviral therapy (ART) adherence remains a difficult goal to reach, particularly postpartum. The contribution of the proposed research is expected to be two-fold: 1) to gain an understanding of how influential contextual, interpersonal, clinic, and individual level factors change during key moments of transition during pregnancy and postpartum and influence ART adherence and 2) to develop bio-behavioral interventions to assist mothers in maintaining their adherence to ART postpartum. Candidate: I am a social psychologist with a background in ART adherence socially disadvantaged groups in the United States. I am applying for a five-year K01 Career Development Award to obtain training, mentorship, and research experience to become an expert in maternal health among women living with HIV in resource limited settings and an independent investigator capable of obtaining R01 funding. Mentoring: I have put together an exceptional mentoring team with extensive experience in HIV treatment and prevention research in South Africa that integrates epidemiology, qualitative methods, and clinical science. Drs. Don Operario and Mark Lurie will serve as co-Primary mentors and bring complementary expertise in international HIV behavioral intervention development and infectious disease epidemiology. In addition to my two Primary mentors, my co- mentors provide expertise in specific content areas and methodologies and are based in both the U.S. and South Africa (ZA). My co-mentorship team includes: Dr. Susan Cu-Uvin (U.S.-based, clinical management of HIV, obstetrics and gynecology), Dr. Landon Myer (ZA-based, perinatal epidemiology, postpartum ART adherence), Dr. Abigail Harrison (U.S.-based, longitudinal qualitative methods, sexual and reproductive health), and Dr. Christopher Colvin (ZA-based, qualitative methods, maternal child health). Training: Specific training in perinatal epidemiology, longitudinal qualitative methods, theory-based interventions, cross-cultural intervention development and evaluation will be achieved through intensive mentored training, coursework, workshops and directed readings and primary ZA research. Guided by my excellent mentorship team, these training and research experiences will establish my independent investigator career as an expert in developing HIV treatment and prevention interventions to address maternal health in high impact, low resource settings, that take into account key moments of transition and change that impact health behaviors. Research: The goals of the proposed project are to (1) identify contextual, interpersonal, clinic, and individual level factors that influence women's HIV treatment adherence during key period of transition during pregnancy and postpartum; (2) evaluate a Transition Theory-based bio-behavioral intervention to improve ART adherence postpartum using a small scale randomized controlled trial; (3) assess participants' experiences of the intervention, perceived usefulness, and identify ways to refine the intervention for future evaluation

项目概要预防母婴传播（PMTCT）工作已降低了垂直传播率然而，传播率达到 2.7%，最佳抗逆转录病毒治疗 (ART) 依从性仍然是一个困难的目标达到，尤其是产后。拟议研究的贡献预计有两方面：1）获得了解有影响力的背景、人际、临床和个人层面因素在治疗过程中如何变化怀孕和产后过渡的关键时刻并影响 ART 依从性和 2) 发展生物行为干预措施可帮助母亲在产后保持对 ART 的依从性。候选人：我是一位社会心理学家，拥有美国社会弱势群体 ART 依从性背景国家。我正在申请为期五年的 K01 职业发展奖以获得培训、指导和成为资源有限的艾滋病毒感染者孕产妇保健专家的研究经验设置和能够获得 R01 资金的独立调查员。指导：我整理了一个杰出的指导团队，在南方艾滋病毒治疗和预防研究方面拥有丰富的经验非洲整合了流行病学、定性方法和临床科学。博士。唐·奥帕里奥和马克卢里（Lurie）将担任联合小学导师，并带来国际艾滋病毒行为方面的补充专业知识干预措施的发展和传染病流行病学。除了我的两位初级会导师之外，我的同事导师提供特定内容领域和方法的专业知识，并且来自美国和南非（ZA）。我的共同指导团队包括：Susan Cu-Uvin 博士（美国，临床管理 HIV、妇产科），Landon Myer 博士（基于 ZA、围产期流行病学、产后 ART 坚持），Abigail Harrison 博士（美国，纵向定性方法，性和生殖健康）和 Christopher Colvin 博士（基于 ZA 的定性方法，孕产妇儿童健康）。培训：具体围产期流行病学、纵向定性方法、基于理论的干预措施、跨文化的培训干预措施的制定和评估将通过强化指导培训、课程作业、研讨会、定向阅读和初级 ZA 研究。在我优秀的导师团队的指导下，这些培训和研究经验将奠定我作为开发专家的独立研究者职业生涯艾滋病毒治疗和预防干预措施，以解决高影响、低资源环境中的孕产妇健康问题，考虑到影响健康行为的过渡和变化的关键时刻。研究：拟议项目的目标是 (1) 确定背景、人际、诊所和个人层面的因素影响妇女在怀孕和产后关键过渡时期的艾滋病毒治疗依从性； (2) 评估基于转变理论的生物行为干预以提高产后 ART 依从性使用小规模随机对照试验； (3) 评估参与者的干预经历，感知有用性，并确定改进干预措施以供未来评估的方法