Synthesizing Best Practice to Accelerate Access to Emerging HIV Prevention Modalities

综合最佳实践以加速获得新兴艾滋病毒预防方式

• 批准号: 10012324
• 负责人: Sarit A Golub
• 金额: $ 73.68万
• 依托单位: HUNTER COLLEGE
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-04-20 至 2025-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10012324
• 关键词: AIDS prevention; Address; Adherence; Age; Behavior; Centers for Disease Control and Prevention (U.S.); Characteristics; Clinic; Clinical; Clinical Trials; Collaborations; Communicable Diseases; Country; County; Data; Data Collection; Data Reporting; Development; Diffusion; Drug Delivery Systems; Drug Formulations; Eligibility Determination; Ensure; Epidemic; Ethnic Origin; Formulation; Funding; Future; Gender; Geographic Locations; Geography; Goals; Guidelines; HIV; Health; Health Promotion; Individual; Infrastructure; Intervention; Knowledge; Literature; Measures; Medicaid; Methods; Modality; Modeling; Monitor; Online Systems; Oral; Outcome; Output; Patients; Phase; Policies; Population; Prevention; Prevention strategy; Primary Health Care; Process; Provider; Public Health; Race; Research; Research Personnel; Schools; Seminal; Service delivery model; Site; Specific qualifier value; Speed; Standardization; System; Telemedicine; Testing; Theoretical model; Time; To specify; Training; Work; base; biobehavior; clinical development; clinical practice; clinical research site; data standards; design; evidence base; flexibility; health equity; implementation science; improved; innovation; novel; patient population; pre-exposure prophylaxis; prevention service; programs; response; screening; service delivery; sexual identity; success; tool; uptake

7. PROJECT SUMMARY/ABSTRACT There are a myriad of new HIV pre-exposure prophylaxis (PrEP) drug formulations and delivery modalities under clinical development, and it is expected that a range of biomedical HIV prevention options will soon be available. To enable these options to have maximum public health impact there is an urgent need to create biobehavioral infrastructure (i.e., empirically validated knowledge, guidelines, and tools) that will: a) allow the integration of these new options into existing PrEP delivery systems; b) support adherence and retention in an emerging HIV prevention service system; and c) promote health equity by ensuring that new prevention options expand HIV prevention coverage to highest priority populations. However, limited research exists that integrates lessons from existing implementation efforts for oral PrEP and develops data-driven tools that can be used by research and clinical practice to accelerate diffusion of proven prevention strategies. In response to that need, the specific aims of this project are to: (1) Synthesize intervention components of PrEP service delivery models in seven federally designated Ending the HIV Epidemic (EtHE) hotspot counties across the US, representing diverse geographical contexts, patient populations, and delivery settings; (2) Operationalize a set of PrEP service delivery process and outcome metrics than can be used to assess fidelity to service delivery models for daily oral PrEP and emerging modalities and measure progress toward enhancing biomedical prevention uptake, persistence, and equitable coverage; and (3) Define universal and modality- specific pre-implementation and implementation activities necessary for settings to integrate emerging prevention options into clinical practice. This project builds on the past work of the investigative team in oral PrEP demonstration and implementation projects, development/testing of novel prevention modalities, and dissemination of evidence-based implementation tools for clinical practice. To accomplish our aims, we will apply two seminal theoretical models from the implementation science literature, and collaborate with seven clinical partners in seven EtHE hotspots across the US, as well as a CDC-funded Capacity Building Assistance (CBA) provider who delivers PrEP training and technical assistance to sites across the country. The knowledge generated by this project will not only advance the field of implementation science, but also create tangible tools that can help clinics, heath systems, and policy decision makers improve PrEP implementation outcomes at a population level. This project has the potential to make a significant and sustained impact on the quality of future implementation efforts, and the speed with which new modalities are effectively disseminated to highest priority populations.

7。项目摘要/摘要 有无数新的HIV预防前预防（PREP）药物制剂和递送方式 在临床开发下，预计一系列的生物医学艾滋病毒预防选择很快就会 可用的。为了使这些选择具有最大的公共卫生影响，迫切需要创建 生物行为基础设施（即经验验证的知识，准则和工具）将：a）允许允许 将这些新选项集成到现有的准备交付系统中； b）支持依从性和保留 新兴的HIV预防服务系统； c）通过确保新的预防来促进健康平等 期权将HIV预防覆盖范围扩大到最高优先级人群。但是，存在有限的研究 从现有的口头准备工作中整合了经验教训，并开发了数据驱动的工具 可以通过研究和临床实践来加速验证的预防策略的扩散。响应 这需要该项目的具体目的是：（1）合成准备服务的干预组件 七个联邦指定的交付模型结束了整个HIV流行（ETHE）热点县 美国，代表各种地理环境，患者人群和交付环境； （2）操作 一组准备服务交付过程和结果指标比用于评估服务的忠诚度 每日口服准备和新兴方式的交付模型，并衡量增强的进度 生物医学预防，持久性和公平覆盖范围； （3）定义通用和模态 - 设置集成新兴所需的特定预料前和实施活动 预防临床实践的选择。该项目以口头调查团队的过去工作为基础 准备演示和实施项目，新型预防方式的开发/测试以及 传播基于循证的实施工具进行临床实践。为了实现我们的目标，我们将 应用实施科学文献中的两个开创性理论模型，并与七个合作 美国七个Ethe Hotpots的临床合作伙伴以及CDC资助的能力建筑援助 （CBA）提供者向全国各地的网站提供预备培训和技术援助。知识 该项目生成的不仅会推进实施科学领域，还将创造有形的 可以帮助诊所，卫生系统和政策决策者的工具改善准备成果 在人口层面。该项目有可能对 未来的实施努力，以及有效传播新方式的速度 优先人群。