Sustaining Innovative Tools to Expand Youth-Friendly HIV Self-Testing (S-ITEST)

维持创新工具以扩大青少年友好型艾滋病毒自我检测 (S-ITEST)

• 批准号: 10933892
• 负责人: OLIVER CHUKWUJEKWU EZECHI
• 金额: $ 123.52万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2024
• 资助国家: 美国
• 起止时间: 2024-01-24 至 2028-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10933892
• 关键词: Sustaining; Innovative; Tools; Expand; Youth

Many adolescents and young adults (AYA, 14-24 years old) in Nigeria have a substantial HIV risk but do not receive HIV prevention services. While pre-exposure prophylaxis (PrEP), HIV self-testing, sexually transmitted infection (STI) testing, and linkage to AYA-friendly clinical services are essential, they have not been widely implemented or sustained in Nigeria. This underlines the importance of implementation science to increase the adoption and maintenance of HIV prevention services for AYA in diverse settings. Our 4 Youth by Youth (4YBY) program (NICHD UH3HD096929) leveraged participatory implementation strategies like crowdsourcing open calls and designathons and participatory learning communities to develop AYA-led PrEP uptake, HIV self-testing, and STI testing services in Nigeria. The success of this NICHD-funded Prevention and Treatment through a Comprehensive Care Continuum for HIV-affected Adolescents in Resource Constrained Settings Implementation (PATC3H) pilot program facilitated transition to an NICHD U-supported randomized controlled trial underway in 32 local government areas. Interim data demonstrates that the 4YBY program is effective, but how to transition this research study into practice and sustain it overtime for AYA in Nigeria requires further investigation. As a multi-disciplinary research team with proven track record, we propose the following specific aims: (1) To use participatory approaches with Nigerian youth (i.e. crowdsourcing designathons and participatory learning communities) to develop new strategies for sustaining the 4YBY program; (2) To evaluate the effectiveness of a finalist sustainment strategy to sustain core elements of the 4YBY program among at-risk, HIV-negative AYA (14-24 years old) in Nigeria using a cluster randomized control trial in 32 new local areas; (3) To estimate the impact and cost-effectiveness of the overall 4YBY program. We define sustainment based on the continuation of core elements of the 4YBY program at sufficient fidelity, the continuation of intended benefits, and adequate capacity for the continuation of the program. The Youth Participatory Action Research framework and the PEN-3 cultural model will inform our study. Implementation science aspects will be guided by the Proctor’s Implementation Outcomes Framework and the Consolidated Framework for Implementation Research (CFIR). We will also estimate the cost of implementing and sustaining the 4YBY program. We are currently implementing 4YBY in 32 local areas among a general population of AYA for 24 months. Within this cohort, we will integrate the final sustainment strategy and collect data on sustainment over time. In addition, we will recruit 32 new local areas with higher risk (PrEP-eligible) AYA that will either receive the same sustainment strategy alongside 4YBY (16 areas) or a standard 4YBY program (16 areas). Findings from the proposed S-ITEST (Sustaining Innovative Tools to Expand HIV Self- testing) study will be relevant in other settings. S-ITEST responds to high-priority topics identified by the United States National Institutes of Health, NICHD, NIMH, FIC, and OBSSR.

尼日利亚的许多青少年和年轻人（AYA，14-24岁）都有很大的艾滋病毒风险，但没有 接受艾滋病毒预防服务。而暴露前预防（PREP），艾滋病毒自我测试，性传播 感染（STI）测试以及与AYA友好的临床服务的联系至关重要，它们并未广泛 在尼日利亚实施或维持。这强调了实施科学对增加的重要性 在潜水员环境中为AYA的AYA采用和维护艾滋病毒预防服务。我们的四个青年青年 （4YBY）计划（NICHD UH3HD096929）利用参与实施策略，例如众包。 公开通话和设计学者以及参与学习社区，以开发以AYA为主导的PREP吸收HIV 尼日利亚的自我测试和STI测试服务。这种NICHD资助的预防和治疗的成功 通过在资源受限设置中的全面护理连续性 实施（PATC3H）试点计划准备过渡到NICHD U的随机控制 在32个地方政府地区进行了审判。临时数据表明4YBY程序是有效的，但是 如何将这项研究的研究过渡到实践中，并维持在尼日利亚的AYA的加班时间，需要进一步 调查。作为具有良好往绩记录的多学科研究团队，我们提出以下特定 目的：（1）与尼日利亚青年一起使用参与方法（即众包设计记者和 参与学习社区）制定维持4YBY计划的新策略； （2）至 评估决赛持续战略的有效性，以维持4YBY计划的核心要素 在尼日利亚的高风险，HIV阴性AYA（14-24岁）中，使用了32个新的群集随机对照试验 地方地区； （3）估计4yby计划的影响和成本效益。我们定义 基于4yby计划的核心要素的延续，以足够的忠诚度， 延续预期的福利，并有足够的能力来延续该计划。青年 参与式行动研究框架和Pen-3文化模型将为我们的研究提供信息。执行 科学方面将以Proctor的实施成果和合并为指导 实施研究框架（CFIR）。我们还将估计实施成本和 维持4yby计划。我们目前正在一般的32个本地实施4yby AYA人口24个月。在这个队列中，我们将整合最终的维持策略并收集 随着时间的推移维持的数据。此外，我们将招募32个具有较高风险的新地区（符合预选资格） AYA将与4yby（16个区域）或标准4yby一起获得相同的维持策略 计划（16个领域）。提出的最佳S-ittive（维持创新工具以扩大艾滋病毒自我的自我）的发现 测试）研究将在其他环境中相关。对联合国确定的高优势主题的最重要回应 国家卫生研究院，NICHD，NIMH，FIC和OBSR。