Adapting and coping during the war in Ukraine: lived experiences of older adults with HIV and their healthcare providers

乌克兰战争期间的适应和应对：感染艾滋病毒的老年人及其医疗保健提供者的生活经历

• 批准号: 10614174
• 负责人: Julia Rozanova
• 金额: $ 18.67万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-06-15 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10614174
• 关键词: Acquired Immunodeficiency Syndrome; Administrative Supplement; Age-Years; Aging; Area; Biometry; COVID-19 pandemic; Caring; Child; Clinic; Collaborations; Communities; Country; Data; Deterioration; Diagnosis; Elderly; Elements; Ensure; Europe; Exposure to; Family; Fright; Funding; Gerontology; Goals; Grant; Guidelines; HIV; Health; Health Personnel; Healthcare; Home; Human Resources; Intervention; Interview; Knowledge; Laws; Link; Longitudinal Surveys; Manuals; Measures; Mental Health; Mental Health Services; Parents; Participant; Patients; Persons; Process; Provider; Public Health; Questionnaires; Recording of previous events; Research; Research Personnel; Resource-limited setting; Resources; Risk Behaviors; Running; Sampling; Scientist; Social support; Strategic Planning; Surveys; Telephone; Time; Training; Trust; Ukraine; War; Woman; Work; Zygote Intrafallopian Transfer; acceptability and feasibility; addiction; base; beneficiary; care outcomes; care systems; caregiving; coping; evidence base; experience; improved outcome; low and middle-income countries; man-made disasters; meetings; men; payment; peer; pet animal; physical conditioning; pilot test; shared decision making; stressor; treatment as usual; treatment strategy; virtual; working group

Since the war in Ukraine began on February 24, 2022, experts have warned of possible collapse of the HIV care system and a loss of decades of hard-earned gains in high-priority areas like HIV and addiction care. Older people with HIV require tailored intervention for linkage and re-linkage to HIV care. Our parent R21 grant focuses on tailoring Peer Navigation to OPWH in Ukraine to create PROST (Peer-Run Optimal Strategy for Treatment or “To your health” in Ukrainian), and pilot test it to (re-) engage OPWH in HIV care. To date, using the ADAPT- ITT framework, we adapted FHI PN manual to build PROST PN for Ukrainian OPWH. Our remaining aims include a pilot RCT of PROST vs. treatment as usual (TAU) to measure acceptability and feasibility; and using the data from the pilot to conduct dyadic analyses of peers and beneficiaries to understand shared decision-making and linkage to care outcomes. As the war in Ukraine is ongoing, it is essential to understand how OPWH and HIV and other healthcare providers cope and add to PROST PN manual a chapter based on this knowledge for how PN may help OPWH (re) link to HIV care during humanitarian crisis. Phone interviews we conducted in Kyiv in April 2022 suggest that HIV and addiction care doctors remain in post during the war, and OPWH do not evacuate due to sentimental attachment to home, fear of moving to a strange place, mobility limitations, having few resources and nobody to support them in evacuation, caregiving responsibilities for frail family or pets, and desire to stay close to their trusted HIV and other healthcare providers. In this Administrative Supplement, we propose to develop a chapter for the PROST manual on OPWH Peer Navigation during humanitarian crisis, based on analyses of lived experiences of OPWH and their clinicians in Kyiv. In-depth interviews with a purposive sample of 25 OPWH and HIV, addiction, and 10 mental healthcare providers in Kyiv will examine what is involved in surviving and giving and receiving HIV care in humanitarian crisis. Findings will inform the questions added to Wave 4 of the longitudinal survey of 123 OPWH participants in Kyiv. Wave 3 completed just before the war offers an opportunity to understand changes in OPWH's physical and mental health, social support, risky behaviors, and participation in HIV and other healthcare since the war began. Our Community Working Group (CWG) comprising OPWH and clinicians in Ukraine will guide the inclusion of findings into the new chapter of PN manual. Feasibility is high as our collaboration with EIPHP, CWG, Kyiv AIDS Center, and Kyiv Addiction Treatment Clinic stays robust. All colleagues are well, all clinicians remain in post and physically in Kyiv. We continue weekly Zoom team meetings to discuss ongoing fieldwork and strategic plans. We can interview and survey OPWH entirely by phone (and process payments for their time online). Drawing on Ukrainian colleagues' partnerships with the Ministry of Health of Ukraine, Ukrainian Alliance for Public Health, and large NGOs supporting PWH, we will present the PN manual for humanitarian setting to these stakeholders, to promote developing national guidelines for PN in HIV care. It will help ensuring that LMICs in humanitarian crises may achieve the 4th 90.

自 2022 年 2 月 24 日乌克兰战争爆发以来，专家警告艾滋病毒护理可能崩溃 系统以及在艾滋病毒和老年人成瘾护理等高度优先领域几十年来之不易的成果的损失。 艾滋病毒感染者需要量身定制的干预措施，以与艾滋病毒护理联系和重新联系，我们的母公司 R21 拨款重点是。 为乌克兰的 OPWH 量身定制 Peer Navigation，以创建 PROST（Peer-Run Optimal Strategy for Treatment） 或乌克兰的“为了您的健康”），并进行试点测试以（重新）让 OPWH 参与艾滋病毒护理。 ITT 框架，我们改编了 FHI PN 手册来为乌克兰 OPWH 构建 PROST PN。 PROST 与常规治疗 (TAU) 的试点随机对照试验，以衡量可接受性和可行性并使用数据； 从试点到对同行和受益人进行二元分析，以了解共同决策和 由于乌克兰战争仍在继续，了解 OPWH 和 HIV 之间的关系至关重要。 和其他医疗保健提供者应对这一问题，并在 PROST PN 手册中添加了基于此知识的一章，以了解如何 PN 可能会帮助 OPWH 在人道主义危机期间（重新）与艾滋病毒护理联系起来。 2022 年 4 月建议艾滋病毒和毒瘾护理医生在战争期间留在岗位，OPWH 不撤离 由于对家的感情、害怕搬到陌生的地方、行动不便、很少有 支持他们疏散的资源和人员、照顾脆弱家庭或宠物的责任以及愿望 在本行政补充文件中，我们建议与他们信任的艾滋病毒和其他医疗保健提供者保持密切联系。 为 PROST 手册编写关于人道主义危机期间 OPWH 对等导航的一章，基于 对基辅 OPWH 及其弟子的生活经历进行分析，对有目的的样本进行深入访谈。 基辅的 25 名 OPWH 和艾滋病毒、成瘾以及 10 名精神保健提供者将检查其中涉及的内容 人道主义危机中的生存和给予以及艾滋病毒护理的调查结果将为添加的问题提供信息。 对基辅 123 名 OPWH 参与者进行的纵向调查的第 4 波在战前完成。 有机会了解 OPWH 的身心健康、社会支持、危险行为、 自战争开始以来，我们的社区工作组 (CWG) 参与艾滋病毒和其他医疗保健工作。 由 OPWH 和乌克兰群众组成的人员将指导将调查结果纳入 PN 手册的新章节。 我们与 EIPHP、CWG、基辅艾滋病中心和基辅成瘾治疗诊所的合作具有很高的可行性 所有同事都很好，所有团都留在基辅，我们每周继续。 Zoom 团队会议讨论正在进行的实地工作和战略计划 我们可以采访和调查 OPWH。 完全通过电话（并利用乌克兰同事的合作伙伴关系处理在线时间的付款）。 与乌克兰卫生部、乌克兰公共卫生联盟以及支持感染者卫生保健的大型非政府组织合作， 我们将向这些利益相关者介绍人道主义环境的 PN 手册，以促进国家发展 艾滋病毒护理中的 PN 指南将有助于确保处于人道主义危机中的中低收入国家实现第四个 90。

项目成果

Human costs of healthcare resilience during the war in Ukraine: Lessons from addiction and HIV treatment.

乌克兰战争期间医疗保健复原力的人力成本：成瘾和艾滋病毒治疗的教训。

• 发表时间: 2023-12-21
• 作者: Rozanova, Julia;Zaviryukha, Irina;Deac, Alexandra A;Zeziulin, Oleksandr;Kiriazova, Tetiana;Earnshaw, Valerie;Rich, Katherine M;Shenoi, Sheela V;Skipper, Harry;Yariy, Volodymyr;Strang, Sir John
• 通讯作者: Strang, Sir John

The Lived Experience of a Newly Diagnosed Older Person With HIV in Ukraine.

乌克兰一名新诊断的艾滋病毒老年人的生活经历。

• 发表时间: 2021
• 影响因子: 3.2
• 作者: Allen, Amy;Zaviryukha, Irina;Kiriazova, Tetiana;Shenoi, Sheela;Rozanova, Julia
• 通讯作者: Rozanova, Julia

Treatment System Adaptations during War: Lessons from Ukrainian Addiction Treatment Providers.

战争期间治疗系统的调整：乌克兰成瘾治疗提供者的经验教训。

• 发表时间: 2023
• 影响因子: 2
• 作者: Deac, Alexandra A;Zaviryukha, Irina;Rozanova, Julia;Zeziulin, Oleksandr;Kiriazova, Tetiana;Shenoi, Sheela;Peycheva, Anna;Solórzano de Souza, Renata;Skipper, Harry;Abubakar, Asmau A;Gustilo, V Benjamin;Thornicroft, Graham;Dellamura, Paula;Rich
• 通讯作者: Rich

The Initial Response to COVID-19 Disruptions for Older People with HIV in Ukraine.

乌克兰艾滋病毒感染者对 COVID-19 干扰的初步应对措施。

• 发表时间: 2022-12-06
• 作者: Rozanova, Julia;Rich, Katherine M;Altice, Frederick L;Shenoi, Sheela V;Zaviryukha, Irina;Kiriazova, Tetiana;Mamedova, Elmira;Shipunov, Oleksandr;Yariy, Volodymyr;Deac, Alexandra;Zeziulin, Oleksandr
• 通讯作者: Zeziulin, Oleksandr