Bringing South African Men into HIV Counseling and Testing (HCT) and Care

让南非男性接受艾滋病毒咨询和检测 (HCT) 和护理

• 批准号: 9319824
• 负责人: Thomas J. Coates
• 金额: $ 50.27万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-07-07 至 2020-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9319824
• 关键词: Acquired Immunodeficiency Syndrome; Address; Affect; Africa South of the Sahara; African; Area; Attention; Bedside Testings; Behavioral; CD4 Positive T Lymphocytes; Caring; Case Management; Child; Communities; Cost Effectiveness Analysis; Counseling; Diagnosis; Economics; Ensure; Family; Female; Gender; HIV; HIV Infections; HIV Seropositivity; HIV diagnosis; Health; High Prevalence; Home environment; Household; Human immunodeficiency virus test; Individual; Infection; Intervention; Joints; Life Expectancy; Link; Maintenance; Morbidity - disease rate; National Institute of Mental Health; Outcome; Population; Prevention; Process; Quality of life; Randomized; Research; Resources; South Africa; South African; Testing; Time; Uganda; Viral; Viral Load result; Woman; Women' s Health; Work; antiretroviral therapy; base; community intervention; cost; design; disability-adjusted life years; evidence base; falls; improved; incremental cost-effectiveness; innovation; intervention effect; male; male health; men; mortality; point of care; public health relevance; standard of care; transmission process

 DESCRIPTION (provided by applicant): The ultimate objective of this research is to provide evidence-based strategies to improve treatment of HIV+ men. Treatment as prevention (TasP) can only work through a three step process: (1) Testing a significant proportion of the population, (2) linkage to care and (3) maintaining in care a significant proportion of HIV+ individuals to the point of viral suppression. The benefits of increased testing, linkage to and maintenance in care for men would be enormous. We propose a study that combines structural and individual level interventions and integrates the results to address our overall objective of maintenance in care to the point of viral suppression. Aim 1: In a cluster-randomized study, we will investigate whether male-centered mobilization and testing increases the population-level percentage of men who have been tested (within the last 12 months) by more than 10 absolute percentage points. Aim 2: In the individually-randomized design, we will investigate whether POC CD4 testing and individualized case management improves linkage to care (immediately following diagnosis) and viral suppression (12 months later) over POC CD4 testing alone and standard of care. Aim 3: Integrate the results of the two trial components (Aims 1 and 2) to evaluate the joint effect of the interventions on the percentage of HIV+ men who are effectively tested, linked to care and maintained with undetectable VL. The benefits of increased testing, linkage to and maintenance in care for men would be enormous. Men would remain healthier longer, could work and support their families, contribute to rather than deplete household economic resources, raise their children, and they would be less likely to transmit HIV to female partners

 描述（由申请人提供）：本研究的最终目标是提供基于证据的策略来改善 HIV+ 男性的治疗。治疗即预防 (TasP) 只能通过三个步骤来发挥作用：(1) 对很大一部分进行检测。人口，(2) 与护理的联系，以及 (3) 维持相当比例的艾滋病病毒感染者的护理，直至病毒受到抑制。我们建议，增加检测、与护理的联系和维持护理的好处将是巨大的。结合结构和目标 1：在一项整群随机研究中，我们将调查以男性为中心的动员和测试是否会增加人群水平的百分比。接受测试（在过去 12 个月内）超过 10 个绝对百分点的男性 目标 2：在单独随机设计中，我们将调查 POC CD4 测试和个体化病例管理是否改善了与护理的联系。 （诊断后立即）和病毒抑制（12 个月后）优于单独 POC CD4 检测和护理标准 目标 3：整合两个试验组成部分（目标 1 和 2）的结果，以评估干预措施对接受有效检测、与护理相关并保持检测不到 VL 的 HIV 阳性男性的百分比 增加对男性的检测、与护理的联系和维持的好处将是巨大的，男性将保持更长时间的健康，可以工作和养家糊口，做出贡献。与其耗尽家庭经济资源，不如抚养孩子，这样他们就不太可能将艾滋病毒传染给女性伴侣