Engaging men through HIV self-test and differentiated care models to increase ART initiation and viral suppression in Malawi

通过艾滋病毒自检和差异化护理模式吸引男性参与，以增加马拉维的抗逆转录病毒治疗启动和病毒抑制

• 批准号: 10620317
• 负责人: Thomas J. Coates
• 金额: $ 51.54万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-06-17 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10620317
• 关键词: Address; Adverse event; Africa South of the Sahara; Baseline Surveys; Caring; Characteristics; Client; Clinical; Coping Skills; Cost Analysis; Cost Effectiveness Analysis; Decision Making; Diagnostic Reagent Kits; Disclosure; Enrollment; Epidemic; Female; Friends; Fright; Gender; Goals; HIV; HIV Seropositivity; Health Services Accessibility; Home; Human immunodeficiency virus test; Individual; Intention; International; Intervention; Interview; Joints; Knowledge; Location; Malawi; Modeling; Outcome; Perception; Phase; Policies; Population; Privacy; Public Health; Randomized, Controlled Trials; Recommendation; Reporting; Safety; Services; Sexual Partners; Testing; Time; Use Effectiveness; Viral; Viral Load result; Woman; Work; arm; cost; cost comparison; cost effective; cost effectiveness; cost-effectiveness ratio; design; effectiveness testing; experience; high risk men; improved; incremental cost-effectiveness; indexing; innovation; male; men; motivational enhancement therapy; novel strategies; peer; randomized trial; randomized, clinical trials; recruit; scale up; self testing; service delivery; social stigma; sociodemographics; standard of care; testing services; transmission process; treatment services; uptake

Project Summary Men continue to be missed by HIV testing and treatment services. Index partner testing is a critical strategy for reaching men. Index HIV self-testing (HIVST), whereby ART clients take HIVST kits home to their sexual partners for testing, is a new strategy that dramatically increases index testing among men, and is being taken to scale across Malawi. However, only 25% of men identified as HIV-positive through Index HIVST initiate ART after 6- months. Innovative strategies to increase ART initiation and retention among men are urgently needed. The overarching goal of the proposed R01 is to test a home-based ART intervention (ART initiation + 3-months ART care) plus motivational interviewing to increase ART initiation and 6-month viral suppression among men who test HIV-positive through Index HIVST in Malawi. The specific aims are: (1) test the effectiveness of home-based versus facility-based ART on ART initiation and 6-month viral suppression among male partners who test through Index HIVST; (2) Identify predictors of ART initiation and 6-month viral suppression; and (3) Determine the cost and cost-effectiveness of home-based ART versus facility-based among male partners using Index HIVST. The trial will provide urgent information on innovative HIV service delivery strategies for hard-to-reach-populations, such as men. Findings are expected to inform national policy and international recommendations around combined differentiated models that reach across the HIV treatment cascade.

项目摘要 艾滋病毒测试和治疗服务仍然会错过男性。索引合作伙伴测试是一个关键策略 到达男人。索引艾滋病毒自我测试（HIVST），艺术客户将HIVST套件带回家的性伴侣 用于测试是一种新的策略，可显着增加男性之间的索引测试，并且正在进行扩展 整个马拉维。但是，只有25％的男性通过指数HIVST识别为HIV阳性的男性在6-- 月份。迫切需要采取创新的策略来增加男性的艺术启动和保留。这 拟议的R01的总体目标是测试家庭艺术干预措施（艺术启动 + 3个月艺术 护理）加上动机访谈以增加艺术启动和6个月的病毒抑制 通过马拉维通过指数HIVST测试HIV阳性。具体目的是：（1）测试基于家庭的有效性 与基于设施的艺术有关艺术启动的艺术和男性伴侣的6个月病毒抑制 索引HIVST; （2）确定艺术启动和6个月病毒抑制的预测因子； （3）确定成本 使用指数HIVST的男性合作伙伴与基于设施的家庭艺术与基于设施的成本效益。这 试验将提供有关创新的HIV服务提供策略的紧急信息 例如男人。期望调查结果将为国家政策和国际建议提供信息 跨越HIV治疗级联的结合分化模型。

项目成果

Engaging men through HIV self-testing with differentiated care to improve ART initiation and viral suppression among men in Malawi (ENGAGE): A study protocol for a randomized control trial.

• DOI: 10.1371/journal.pone.0281472
• 发表时间: 2023
• 期刊: PloS one
• 影响因子: 3.7

Stakeholder Priorities for ART Initiation and Early Retention Interventions in Malawi: A Qualitative Study Comparing International and National Perspectives.

马拉维的利益相关者优先考虑 ART 启动和早期保留干预措施：一项比较国际和国家观点的定性研究。

• DOI: 10.21203/rs.3.rs-3725505/v1
• 发表时间: 2023
• 期刊: Research square
• 作者: Hariprasad,Santhi;Phiri,Khumbo;Thorp,Marguerite;Holland,Katherine;Nyirenda,Rose;Gupta,Sundeep;Phiri,Sam;Sabin,Lora;Dovel,Kathryn
• 通讯作者: Dovel,Kathryn

Improving ART initiation among men who use HIV self-testing in Malawi: a qualitative study.

• DOI: 10.1002/jia2.25950
• 发表时间: 2022-06
• 期刊: Journal of the International AIDS Society
• 影响因子: 6

South Africa's male homicide epidemic hiding in plain sight: exploring sex differences and patterns in homicide risk in a retrospective descriptive study of postmortem investigations.

南非的男性凶杀流行病隐藏在人们的视线中：在尸检调查的回顾性描述性研究中探讨凶杀风险的性别差异和模式。

• DOI: 10.1101/2023.02.02.23285093
• 发表时间: 2023
• 期刊: medRxiv : the preprint server for health sciences
• 作者: Matzopoulos,R;Prinsloo,M;Mhlongo,S;Marineau,L;Cornell,M;Bowman,B;Mamashela,TA;Gwebushe,N;Ketelo,A;Martin,LJ;Dekel,B;Lombard,C;Jewkes,R;Abrahams,N
• 通讯作者: Abrahams,N

Health care workers' perceptions and bias toward men as HIV clients in Malawi and Mozambique: A qualitative study.

• DOI: 10.1371/journal.pgph.0001356
• 发表时间: 2023
• 期刊: PLOS global public health