Understanding individual- and social network-level factors affecting infant HIV testing to design social network interventions to increase testing of HIV-exposed infants

了解影响婴儿艾滋病毒检测的个人和社交网络层面的因素，以设计社交网络干预措施，以增加对艾滋病毒暴露婴儿的检测

• 批准号: 10259284
• 负责人: Alison B Comfort
• 金额: $ 14.51万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-01 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10259284
• 关键词: AIDS prevention; AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; Adult; Affect; Africa South of the Sahara; African; Age; Age-Months; Applied Research; Behavior; Birth History; Cessation of life; Characteristics; Child; Communities; Country; Data; Data Collection; Disclosure; Effectiveness; Ensure; Epidemic; Exposure to; Family; Feasibility Studies; Focus Groups; Foundations; Goals; Grant; HIV; HIV Infections; HIV Seropositivity; Health; Health behavior; Human immunodeficiency virus test; Individual; Infant; Influentials; Infrastructure; Intervention; Interview; Investigation; Knowledge; Link; Longitudinal Studies; Maps; Measures; Medical Records; Mentorship; Methods; Mothers; Nulliparity; Parents; Pathway Analysis; Pathway interactions; Pattern; Positioning Attribute; Prevention; Public Health; Qualitative Research; Recording of previous events; Research; Research Methodology; Research Personnel; Research Priority; Role; Social Network; Social support; Space Models; Surveys; Testing; Training; Uganda; United States National Institutes of Health; Woman; behavior change; care seeking; career; cohort; design; econometrics; experience; implementation framework; implementation science; improved; infant infection; innovation; intimate partner violence; learning network; member; mortality; novel; novel strategies; peer; peer influence; peer learning; prevent; reproductive; social; social engagement; social norm; social stigma; theories; therapy design; therapy development; uptake; working group

PROJECT SUMMARY/ABSTRACT More than one million infants are exposed to HIV each year in high-burden sub-Saharan African countries. Yet only 60% of HIV-exposed infants are tested as recommended by two months of age. The key barriers to infant HIV testing – stigma/non-disclosure, lack of access and poor social support – may be more effectively overcome through interventions that engage women's social networks, the patterns of relationships women have with family, peers, and other community members. Social networks make salient contextual norms and enable peer learning, social support, and social engagement, all of which can affect health behaviors. There remains a scientific gap in applying social network analysis to infant HIV testing. Until this gap is addressed, there will also remain an implementation knowledge gap on how to design interventions that engage social networks to prompt infant HIV testing. The central hypothesis of this proposed grant is that social networks can influence women's decisions to test their infants for HIV. The primary objective of this K01 application is to understand how women's individual- and social network-level characteristics affect infant HIV testing to design and assess the feasibility of a social network intervention to improve infant HIV testing. The approach leverages the infrastructure from an ongoing longitudinal study (R01MH113494, PI: Tsai) with complete social network data from all adults living in 8 villages of Mbarara, Uganda and extends new primary data collection to all HIV-positive, reproductive-age women and their children born during the study period. The grant will achieve the following specific aims: 1) estimate individual- and social-network level correlates of infant testing through social network analysis exploring the roles of peer influence, social norms, social support and social engagement; 2) conduct in-depth qualitative interviews among women and integrate findings with quantitative data to understand how social network mechanisms affect infant testing and develop a conceptual framework of infant testing; 3) design and assess feasibility, acceptability, fidelity, reach and preliminary effectiveness of a social network intervention to prompt infant HIV testing. My long-term goal is to become an independent researcher with expertise in developing social network interventions to enhance HIV treatment and prevention among women and children in sub-Saharan Africa. This K01 proposal will supplement my prior training and experience with additional training and mentorship from a team of senior researchers with expertise in social networks, qualitative and mixed methods, and implementation science applied to the context of HIV. I will obtain integrated training, mentorship, and preliminary data for an R01 proposal to empirically test a novel intervention to overcome the public health problem of low infant HIV testing. The key innovation of this proposed study is that it is one of the first to apply social network theory and analysis to infant HIV testing. This contribution will have significant public health impact by increasing uptake of HIV testing for the nearly one half million exposed/undiagnosed infants in sub-Saharan Africa who are not tested by two months of age.

项目概要/摘要 在高负担的撒哈拉以南非洲国家，每年有超过一百万婴儿感染艾滋病毒。 只有 60% 的艾滋病毒暴露婴儿在两个月大时接受了检测，这是婴儿面临的主要障碍。 艾滋病毒检测——耻辱/不公开、缺乏机会和社会支持不佳——可能更有效 通过参与妇女社交网络的干预措施，克服妇女的关系模式 与家人、同龄人和其他社区成员的交往 社交网络制定了显着的情境规范和规则。 促进同伴学习、社会支持和社会参与，所有这些都会影响健康行为。 在将社交网络分析应用于婴儿艾滋病毒检测方面仍然存在科学差距，直到这一差距得到解决。 在如何设计吸引社会参与的干预措施方面，也仍存在知识执行差距。 这项资助的核心假设是社交网络可以促进婴儿艾滋病毒检测。 影响妇女对其婴儿进行艾滋病毒检测的决定 该 K01 应用程序的主要目标是： 了解女性的个人和社会网络层面的特征如何影响婴儿艾滋病毒检测，以设计 并评估社交网络干预改善婴儿艾滋病毒检测的可行性。 利用正在进行的纵向研究（R01MH113494，PI：Tsai）的基础设施和完整的社会 乌干达姆巴拉拉 8 个村庄的所有成年人的网络数据，并将新的主要数据收集范围扩展到 所有艾滋病毒呈阳性的育龄妇女及其在研究期间出生的孩子将获得补助金。 实现以下具体目标：1）估计婴儿测试的个人和社交网络水平相关性 通过社交网络分析探索同伴影响、社会规范、社会支持和社会影响的作用 2) 对女性进行深入的定性访谈，并将调查结果与定量相结合 用于了解社交网络机制如何影响婴儿测试并开发概念框架的数据 3) 设计和评估婴儿测试的可行性、可接受性、保真度、范围和初步有效性 社交网络干预促使婴儿进行艾滋病毒检测 我的长期目标是成为一名独立的人。 具有开发社交网络干预措施以加强艾滋病毒治疗和预防的专业知识的研究人员 这项 K01 提案将补充我之前的培训和经验。 拥有由具有社会专业知识的高级研究人员团队提供的额外培训和指导的经验 我将在艾滋病毒背景下应用网络、定性和混合方法以及实施科学。 获得 R01 提案的综合培训、指导和初步数据，以对小说进行实证测试 干预措施克服了婴儿艾滋病毒检测率低的公共卫生问题，这是本次的关键创新。 拟议的研究是最早将社交网络理论和分析应用于婴儿艾滋病毒检测的研究之一。 通过增加近一半人口的艾滋病毒检测率，这一贡献将对公共卫生产生重大影响 撒哈拉以南非洲有 100 万暴露/未确诊的婴儿在两个月大时未接受检测。