Zikhethele - choose for you: evaluating choice-based antiretroviral therapy support for patients returning to HIV care after treatment interruption in South Africa

Zikhethele - 为您选择：评估对南非治疗中断后返回艾滋病毒护理的患者的基于选择的抗逆转录病毒治疗支持

• 批准号: 10472733
• 负责人: Tamsin Kate Phillips
• 金额: $ 9.68万
• 依托单位: UNIVERSITY OF CAPE TOWN
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-23 至 2026-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10472733
• 关键词: AIDS prevention; AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Adherence; Adult; Africa South of the Sahara; Aftercare; Area; Attention; Award; Behavioral; Behavioral Research; Caring; Clinic; Clinical; Communities; Community Health; Contraceptive Agents; Data; Development; Effectiveness; Effectiveness of Interventions; Ensure; Epidemiologist; Epidemiology; Evaluation; Family Planning; Fellowship; Funding; Future; Goals; Growth; Guidelines; HIV; Health; Health Services; Health behavior; Individual; International; Interruption; Intervention; Intervention Studies; Interview; Investigation; K-Series Research Career Programs; Leadership; Measurement; Mentors; Mentorship; Methods; North Carolina; Outcome; Output; Patient Care; Patient Preferences; Patients; Pennsylvania; Persons; Policies; Population; Public Health; Qualitative Methods; Qualitative Research; Randomized; Research; Research Methodology; Research Personnel; Research Priority; Resources; Role; Scientist; Self Efficacy; Series; Services; South Africa; Structure; Surveys; Time; Training; Treatment outcome; United States National Institutes of Health; Universities; Viral; Woman; antiretroviral therapy; arm; base; behavior measurement; behavioral economics; career; career development; design; empowerment; evidence base; experience; experimental study; gender behavior; high risk; i(19); implementation measures; implementation science; improved; informant; innovation; mHealth; men; multidisciplinary; patient oriented; peer support; pilot trial; preference; satisfaction; secondary outcome; skills; social; therapy adherence; therapy design; therapy development; tool; AIDS prevention; AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Adherence; Adult; Africa South of the Sahara; Aftercare; Area; Attention; Award; Behavioral; Behavioral Research; Caring; Clinic; Clinical; Communities; Community Health; Contraceptive Agents; Data; Development; Effectiveness; Effectiveness of Interventions; Ensure; Epidemiologist; Epidemiology; Evaluation; Family Planning; Fellowship; Funding; Future; Goals; Growth; Guidelines; HIV; Health; Health Services; Health behavior; Individual; International; Interruption; Intervention; Intervention Studies; Interview; Investigation; K-Series Research Career Programs; Leadership; Measurement; Mentors; Mentorship; Methods; North Carolina; Outcome; Output; Patient Care; Patient Preferences; Patients; Pennsylvania; Persons; Policies; Population; Public Health; Qualitative Methods; Qualitative Research; Randomized; Research; Research Methodology; Research Personnel; Research Priority; Resources; Role; Scientist; Self Efficacy; Series; Services; South Africa; Structure; Surveys; Time; Training; Treatment outcome; United States National Institutes of Health; Universities; Viral; Woman; antiretroviral therapy; arm; base; behavior measurement; behavioral economics; career; career development; design; empowerment; evidence base; experience; experimental study; gender behavior; high risk; i(19); implementation measures; implementation science; improved; informant; innovation; mHealth; men; multidisciplinary; patient oriented; peer support; pilot trial; preference; satisfaction; secondary outcome; skills; social; therapy adherence; therapy design; therapy development; tool

PROJECT SUMMARY People living with HIV (PLH) are likely to cycle into and out of antiretroviral therapy (ART) services over time. Even after return to HIV care (RTC), PLH who have interrupted treatment remain vulnerable to attrition and poor treatment outcomes. A range of evidence-based ART support interventions exist including community- based and mobile health (mHealth) ART support interventions. The overarching goals of this proposal are to understand existing RTC practices, incorporate patient preference to refine a community-based and mHealth ART support intervention, and examine the role of choice in delivering RTC ART support. Candidate: Dr. Phillips is an HIV epidemiologist with training in quantitative research methods and experience with field research implementation in South Africa. She is applying for a five-year Fogarty Emerging Global Leader Award to obtain the additional training, mentorship and experience required to become a leading independent investigator capable of obtaining R-series funding. Mentoring: She has assembled an exceptional multidisciplinary team with extensive expertise in HIV intervention research in sub-Saharan Africa (SSA). Drs. Myer (University of Cape Town (UCT)) and Chi (University of North Carolina (UNC)) will serve as primary mentors providing complementary expertise on HIV intervention research and implementation science. Drs Maman (UNC) and Knight (UCT), co-mentors, are social scientists with expertise in qualitative and behavioral research particularly in the context of intervention design and evaluation. Dr. Thirumurthy (University of Pennsylvania: expertise in behavioral economics and measuring patient preference), Dr. Bekker (UCT: expertise in HIV care interventions and preference trials for contraceptive and HIV prevention methods), Dr. Hosseinipour (UNC: expertise in clinical, health service and implementation science with long-term adult HIV care in SSA) and Dr. Clouse (Vanderbilt University: expertise in mHealth intervention research in South Africa) will provide scientific advice in these areas. Training: Specific training in intervention design and evaluation – specifically incorporating implementation science, social and behavioral methods, and patient preference – will be achieved through intensive mentored training and formal coursework. This, combined with the experience gained through implementing my research aims, will establish Dr. Phillips’ independent research career investigating interventions to support lifelong HIV care. Research: The specific aims of this research are to: 1) characterize existing practices for providing RTC ART support and patient experience following RTC, 2) refine existing community-based and mHealth ART support interventions based on RTC patient preferences for modifiable attributes, and 3) determine the feasibility, acceptability and preliminary impact of offering a choice of ART support intervention to RTC patients. The results of this study will inform our understanding of RTC ART support including the role of patient choice. They will provide preliminary data needed to apply for an R01 to conduct a patient preference trial to rigorously examine the impact of patient choice in ART support delivery.

项目摘要 随着时间的推移，患有艾滋病毒（PLH）的人（PLH）可能会从抗逆转录病毒疗法（ART）服务中循环。 即使返回艾滋病毒护理（RTC），中断治疗的PLH仍然容易受到损耗和 治疗结果不佳。存在包括社区在内的一系列基于证据的艺术支持干预措施 - 基于移动健康（MHealth）艺术支持干预措施。该提议的总体目标是 了解现有的RTC实践，纳入患者的偏爱，以完善社区和MHealth 艺术支持干预，并研究选择在提供RTC艺术支持中的作用。候选人：博士 菲利普斯（Phillips）是一名艾滋病毒流行病学专家 南非的研究实施。她正在申请五年新兴的全球领导者 奖励获得额外的培训，精神训练和经验，以成为领先的独立 能够获得R系列资金的研究者。指导：她聚集了一个非凡的 在撒哈拉以南非洲（SSA）中拥有广泛专业知识的多学科团队（SSA）。博士。 迈尔（开普敦大学（UCT））和Chi（北卡罗来纳大学（UNC））将作为主要 提供有关HIV干预研究和实施科学的完整专业知识的导师。博士 Maman（UNC）和骑士（UCT）是联合学者，是具有定性和行为方面专业知识的社会科学家 特别在干预设计和评估的背景下进行研究。 Thirumurthy博士（大学 宾夕法尼亚州：行为经济学和衡量患者偏爱的专业知识），Bekker博士（UCT： HIV护理干预措施和预防艾滋病毒预防方法的偏好试验专业知识）博士 Hosseinipour（UNC：长期成人艾滋病毒的临床，卫生服务和实施科学专业知识 SSA的护理）和Clouse博士（范德比尔特大学：南非MHealth干预研究专业知识） 将在这些领域提供科学建议。培训：干预设计和评估方面的具体培训 - 特别合并实施科学，社会和行为方法以及患者的偏好 - 将 可以通过深入修复培训和正式课程来实现。这是结合体验 通过实施我的研究目标获得，将建立菲利普斯博士的独立研究生涯 调查干预措施以支持终身艾滋病毒护理。研究：这项研究的具体目的是：1） 表征RTC后提供RTC艺术支持和患者经验的现有实践，2） 基于RTC患者偏好的现有基于社区和MHealth的艺术支持干预措施 可修改的属性，3）确定提供选择的可行性，可接受性和初步影响 RTC患者的艺术支持干预。这项研究的结果将告知我们对RTC的理解 艺术支持，包括患者选择的作用。他们将提供申请R01所需的初步数据 进行患者偏好试验以严格检查患者选择在艺术支持交付中的影响。