Peer delivered HIV/syphilis self-testing with assisted partner notification services for men who have sex with men (MSM) in Uganda

同伴为乌干达的男男性行为者 (MSM) 提供艾滋病毒/梅毒自我检测以及辅助伴侣通知服务

• 批准号: 10751075
• 负责人: Stephen Okoboi
• 金额: $ 10.99万
• 依托单位: INFECTIOUS DISEASES INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-15 至 2028-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10751075
• 关键词: AIDS prevention; Address; Adoption; Adult; Advocate; Affect; Africa South of the Sahara; Award; Behavior; Behavioral Sciences; Budgets; Caring; Client; Clinic; Clinical Trials Design; Collaborations; Communicable Diseases; Counseling; Coupled; Data; Development Plans; Diagnosis; Discipline of Nursing; Discrimination; Disease Progression; Effectiveness; Epidemiology; Evaluation; Friends; General Population; Goals; Grant; Guidelines; HIV; Head; Health; Health Care Sector; Health Personnel; Health Services Accessibility; Health care facility; Healthcare; Human immunodeficiency virus test; Incidence; Infection; Influentials; Intervention; Interview; Joints; Letters; Link; Literature; Mentors; Methods; Modeling; Newly Diagnosed; Observational epidemiology; Partner Notification; Persons; Positioning Attribute; Postdoctoral Fellow; Prevalence; Prevention; Prevention Research; Preventive; Process; Productivity; Randomized; Recommendation; Research; Research Personnel; Research Training; Respondent; Risk; Route; Sampling; Service delivery model; Services; Sexual Partners; Sexually Transmitted Diseases; Social Network; Supervision; Syphilis; Syphilis Serodiagnosis; Testing; Training; Uganda; Universities; Work; World Health Organization; Zimbabwe; acceptability and feasibility; aged; antiretroviral therapy; arm; career development; civil society; condoms; cost; cost effective; cost effectiveness; cost estimate; design; economic evaluation; effectiveness evaluation; empowerment; global health; health care settings; health economics; human subject protection; improved; innovation; intervention delivery; male; men; men who have sex with men; microcosting; multidisciplinary; peer; peer influence; peer support; performance tests; pilot test; pre-exposure prophylaxis; primary outcome; psychosocial; randomized trial; rapid testing; self testing; sexual risk behavior; skills; social stigma; standard of care; testing services; testing uptake; transmission process; treatment arm; uptake

PROJECT SUMMARY/ABSTRACT The overall goal of the proposed K43 Emerging Global Leader Award is to support Dr. Stephen Okoboi’s research training to develop as an independent global health HIV researcher. Dr. Okoboi is currently a postdoctoral fellow and Deputy Head of Research at Makerere University Infectious Disease Institute in Uganda. Conducting the proposed studies in this application will facilitate his training goals to: 1) gain expertise in behavioural science methods to better understand the processes and preventive behaviours underlying peer delivery of HIV and syphilis self-tests combined with assisted partner notification (APN) services, 2) gain expertise in the design and conduct of randomized trials in real world settings, and 3) acquire advanced skills in health economic evaluation. This proposal builds on the unique skills he already has in epidemiology and nursing while leveraging a multidisciplinary team of mentors to ultimately become a productive and influential independent investigator in HIV prevention research. The research goal of this proposal is to conduct a rigorous proof-of-concept evaluation to assess the feasibility, acceptability, preliminary effectiveness, and cost effectiveness of peer delivered HIV and syphilis self-testing coupled with assisted partner notification services. Men who engage in sexual relations with other men (MSM) are disproportionately affected by HIV and syphilis. In Uganda, MSM HIV prevalence is 13.2% versus 4.7% in similarly aged males, while syphilis prevalence is 8.3% versus 5.8% in males aged 15-64 years. Syphilis and HIV transmission share common transmission routes and syphilis increases risk of HIV acquisition, transmission, and disease progression. The World Health Organization recommends dual HIV/syphilis testing for MSM, but uptake of facility-based testing is low because of stigma and discrimination in healthcare settings. Differentiated service delivery models, such as peer delivered HIV/syphilis self-tests and linkage to care for those who test positive, could circumvent health facility stigma and other structural barriers to accessing care. However, no studies to our knowledge have evaluated the effectiveness of peer delivered HIV/syphilis self-testing linked to partner services for MSM. To address this research gap, Dr. Okoboi will conduct formative research to inform the implementation of peer-delivered HIV/syphilis self-tests combined with APN for Ugandan MSM (Aim 1), conduct a randomized trial to pilot test the preliminary effectiveness of peer delivered HIV/syphilis self-tests and APN relative to standard of care (Aim 2), and estimate the cost implications of peer-delivered HIV/syphilis self-testing and APN compared to facility-based testing (Aim 3). Dr. Okoboi’ s research goals correspond with his training goals, and at the completion of this award, he will be in an excellent position to submit an R01 application to further advance HIV prevention research for MSM in sub-Saharan Africa.

项目摘要/摘要 拟议的K43新兴全球领导奖的总体目标是支持Stephen Okoboi博士 研究培训是发展为独立的全球健康艾滋病毒研究员。 Okoboi博士目前是 Makerere大学传染病研究所的博士后研究员和副研究主管 乌干达。在此应用中进行拟议的研究将促进他的培训目标：1） 行为科学方法的专业知识，以更好地了解过程和预防行为 与辅助伴侣通知（APN）相结合的艾滋病毒和梅毒自我测验的基本同伴交付 服务，2）在现实世界中的随机试验的设计和行为方面获得专业知识，以及3）获取 健康经济评估的高级技能。这项建议以他已经拥有的独特技能为基础 流行病学和护士，同时利用多学科的导师团队最终成为一个 艾滋病毒预防研究中的生产性和有影响力的独立研究者。这个研究目标 建议是进行严格的概念验证评估，以评估可行性，可接受性， 同伴发射的艾滋病毒和梅毒自我测试的初步有效性和成本效益与 辅助合作伙伴通知服务。与其他男人发生性关系的男人（MSM）是 受艾滋病毒和梅毒的影响不成比例。在乌干达，MSM HIV患病率为13.2％，为4.7％ 同样年龄的男性，而梅毒患病率为15-64岁的男性为8.3％，而梅毒患病率为5.8％。梅毒和 艾滋病毒传播共享常见传播路线和梅毒会增加收购艾滋病毒的风险， 传播和疾病进展。世界卫生组织建议双HIV/梅毒测试 对于MSM，但是由于医疗保健的污名和歧视，对基于设施的测试的吸收很低 设置。差异化的服务交付模型，例如同伴送达的艾滋病毒/梅毒自我测试以及与 照顾那些测试阳性的人，可以规避医疗机构的污名和其他结构性障碍 访问护理。但是，据我们所知，尚无研究评估交付的同伴的有效性 艾滋病毒/梅毒自我测试链接到MSM的合作伙伴服务。为了解决这一研究差距，Okoboi博士将 进行形成性研究，以告知同伴分配的艾滋病毒/梅毒自我测验的实施 使用乌干达MSM的APN（AIM 1），进行随机试验以试行测试 相对于护理标准（AIM 2），同行提供了艾滋病毒/梅毒自我测试和APN，并估计成本 与基于设施的测试相比，同伴分配的艾滋病毒/梅毒自我测试和APN的含义（AIM 3）。 Okoboi博士的研究目标与他的培训目标相对应，并且在完成此奖项时，他将 在提交R01申请的良好位置，以进一步推进MSM的HIV预防研究 在撒哈拉以南非洲。