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）有很大的艾滋病毒风险，但并不 接受艾滋病毒预防服务，同时进行暴露前预防 (PrEP)、艾滋病毒自我检测、性传播。 感染（STI）检测以及与 AYA 友好的临床服务的联系至关重要，但尚未得到广泛应用 这强调了科学实施对于增加 在不同环境中为 AYA 采用和维持艾滋病毒预防服务 Our 4 Youth by Youth。 (4YBY) 计划 (NICHD UH3HD096929) 利用众包等参与式实施策略 公开征集、指定马拉松和参与式学习社区，以发展 AYA 主导的 PrEP 吸收、艾滋病毒 尼日利亚的自我检测和性传播感染检测服务取得了成功。 通过为资源有限环境中受艾滋病毒影响的青少年提供全面的连续护理 实施 (PATC3H) 试点计划促进了向 NICHD U 支持的随机对照的过渡 32 个地方政府地区正在进行的试点 中期数据表明 4YBY 计划是有效的，但 如何将这项研究转化为实践并为尼日利亚的 AYA 持续加班需要进一步研究 作为一个具有良好记录的多学科研究团队，我们提出以下具体建议。 目标：(1) 对尼日利亚青年采用参与式方法（即众包设计马拉松和 (2) 至 评估入围维持战略的有效性，以维持 4YBY 计划的核心要素 在尼日利亚的高危艾滋病毒阴性 AYA（14-24 岁）中使用一项针对 32 个新人群的整群随机对照试验 当地地区；(3) 评估整个 4YBY 计划的影响和成本效益。 以足够保真度延续 4YBY 计划核心要素为基础的维持， 继续提供预期的福利，并有足够的能力继续实施该计划。 参与性行动研究框架和 PEN-3 文化模型将为我们的研究实施提供信息。 科学方面将由 Proctor 的实施成果框架和综合 我们还将估算实施和实施的成本。 维持 4YBY 计划 目前，我们正在 32 个地方实施 4YBY。 在该群体中，我们将整合最终的可持续发展战略并收集 24 个月的 AYA 人口。 此外，我们将招募 32 个新的风险较高的地区（符合 PrEP 资格）。 AYA 将接受与 4YBY（16 个区域）相同的维持策略或标准 4YBY 计划（16 个领域）的研究结果。 测试）研究将与其他环境相关。S-ITEST 响应联合国确定的高优先级主题。 美国国立卫生研究院、NICHD、NIMH、FIC 和 OBSSR。