Enhancing communication on relationship preservation, safer conception and PrEP to promote HIV testing

加强关系维护、更安全受孕和 PrEP 方面的沟通，以促进艾滋病毒检测

基本信息

批准号：
10619813
负责人：
Emily Anne Hurley
金额：
$ 22.13万
依托单位：
CHILDREN'S MERCY HOSP (KANSAS CITY, MO)
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-01-01 至 2025-11-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10619813
关键词：
AIDS prevention Adult Africa South of the Sahara Attitude Awareness Caring Child Client Clinic Communication Communities Conceptions Counseling Couples Data Development Disclosure Epidemic Family Fright Future General Population Goals HIV HIV Seropositivity Health care facility Heterosexuals Horizontal Disease Transmission Hospitals Human immunodeficiency virus test Individual Infection Intervention Intervention Trial Interview Learning Link Mediator Methods Names National Institute of Mental Health Outcome Pamphlets Partner Notification Pathway interactions Persons Phase Prevention Printing Protocols documentation Provider Public Health Randomized Randomized, Controlled Trials Recommendation Reporting Research Risk Self Disclosure Services Site Structure Surveys System Telephone Testing Training Uganda Vertical Transmission Work acceptability and feasibility aged antenatal care antiretroviral therapy child bearing condoms cost effective home test insight meetings member men who have sex with men multi-component intervention novel pilot trial pre-exposure prophylaxis preservation prevent programs service uptake sex success transmission process treatment as usual uptake

AIDS prevention Adult Africa South of the Sahara Attitude Awareness Caring Child Client Clinic Communication Communities Conceptions Counseling Couples Data Development Disclosure Epidemic Family Fright Future General Population Goals HIV HIV Seropositivity Health care facility Heterosexuals Horizontal Disease Transmission Hospitals Human immunodeficiency virus test Individual Infection Intervention Intervention Trial Interview Learning Link Mediator Methods Names National Institute of Mental Health Outcome Pamphlets Partner Notification Pathway interactions Persons Phase Prevention Printing Protocols documentation Provider Public Health Randomized Randomized, Controlled Trials Recommendation Reporting Research Risk Self Disclosure Services Site Structure Surveys System Telephone Testing Training Uganda Vertical Transmission Work acceptability and feasibility aged antenatal care antiretroviral therapy child bearing condoms cost effective home test insight meetings member men who have sex with men multi-component intervention novel pilot trial pre-exposure prophylaxis preservation prevent programs service uptake sex success transmission process treatment as usual uptake

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项目摘要

PROJECT SUMMARY Optimizing uptake of HIV testing is critical to meeting 95-95-95 goals in sub-Saharan Africa. As 30% of new infections in occur within married or cohabitating couples, maximizing testing among individuals who are or may someday be in serious heterosexual relationships has been identified as one of the most cost-effective strategies to curb the epidemic. Childbearing is highly valued throughout Sub-Saharan Africa, and fears of relationship dissolution and loss of the ability to have children remain significant barriers to HIV testing. The expanding availability of pre-exposure prophylaxis (PrEP) presents an opportunity to counter these fears with strategic communication (NOT-MH-21-105) that reassure couples of their ability to have a healthy family even if one or both members are HIV positive. Our long-term objective is to leverage the growing availability of PrEP to determine if and how a communication strategy focused on relationship preservation and safer conception can increase testing and entry into treatment (antiretroviral therapy) or prevention (PrEP) among partnered individuals in Uganda. We recently successfully piloted this communication strategy within Uganda’s assisted partner notification program (APN). In this R34, we will: (1) conduct formative research to expand the communication strategy into a multi-component intervention with broader reach; and (2) conduct a pilot trial of the intervention, PrEPing Healthy Families. To achieve Aim 1, we will work with a community advisory board (CAB) of providers to a) create communication materials (brochures, scripts) and counseling protocols tailored to clients and partners across the array of couples’ testing pathways in APN and antenatal care (ANC). As CAB providers pilot materials and tracking systems with clients and partners during this development phase, study staff will conduct field observations and qualitative interviews focused on feasibility and acceptability, informing revised intervention materials. To achieve Aim 2, we will collect baseline data at APN and ANC clinics within two large public healthcare facilities over nine months. Sites will then be randomized to implement PrEPing Healthy Families or their existing communication approach (usual care) over the next nine months. We will collect mixed-methods data on feasibility and acceptability through intervention tracking in APN/ANC registers, client exit surveys, and qualitative interviews with clients, partners and providers. Through register extraction, we will examine limited efficacy on outcomes that would be relevant to a larger trial (partner HIV testing, client service uptake initiation of PrEP/ART), and explore potential moderators. Overall, results will yield important insights in a promising new communication strategy (NOT-MH-21-105) that may connect more individuals to the HIV cascades of care for treatment or prevention and prepare us for a large-scale, cluster randomized controlled trial to determine impact on testing and initiation of PrEP/ART.

项目摘要优化对艾滋病毒测试的吸收对于在撒哈拉以南非洲实现95-95-95的进球至关重要。作为新的30％已婚或同居夫妇内部发生的感染，最大程度地提高了或有一天有一天会处于严重的异性恋关系中已被确定为最具成本效益的一种遏制流行病的策略。在整个撒哈拉以南非洲，生育高度受到重视，并担心关系解散和生育能力的丧失仍然是HIV检测的重大障碍。这扩大暴露前预防的可用性（PREP）为反对这些恐惧的机会与战略沟通（非MH-21-105），可以解决他们拥有健康家庭的能力的夫妻如果一个或两个成员为艾滋病毒阳性。我们的长期目标是利用PREP的日益增长的可用性确定沟通策略是否以及如何集中于关系保存和更安全的概念可以增加测试和进入治疗（抗逆转录病毒疗法）或预防（PREP）在乌干达的个人。我们最近在乌干达的协助中成功试行了这种沟通策略合作伙伴通知计划（APN）。在此R34中，我们将：（1）进行格式研究以扩展沟通策略融入具有更广泛范围的多组分干预措施；（2）进行试点试验干预措施，为健康的家庭准备。为了实现目标1，我们将与社区顾问委员会合作（驾驶室）提供者到a）创建量身定制的通信材料（小册子，脚本）和咨询协议在APN和ATNATALATAL CARE（ANC）中的各种夫妻测试途径中的客户和合作伙伴。作为在此开发阶段，驾驶室提供商的试点材料和跟踪系统与客户和合作伙伴，学习人员将进行现场观察和定性访谈，重点是可行性和可接受性，通知修订的干预材料。为了实现目标2，我们将在APN和ANC收集基线数据九个月内两个大型公共医疗机构的诊所。然后将随机实施站点在接下来的九个月内准备健康的家庭或他们现有的沟通方法（通常的护理）。我们将通过APN/ANC中的干预跟踪收集有关可行性和可接受性的混合方法数据登记册，客户退出调查以及与客户，合作伙伴和提供者的定性访谈。通过注册提取，我们将研究与更大试验有关的结果有限的效率（伴侣艾滋病毒测试，PREP/ART的客户服务吸收计划），并探索潜在的主持人。总体而言，结果会在有希望的新沟通策略（NOT-MH-21-105）中产生重要的见解，该策略可能连接更多个人到治疗或预防的艾滋病毒护理级联随机对照试验，以确定对PREP/ART的测试和主动性的影响。