Dyadic-Based Diagnosis, Care, & Prevention for HIV Discordant Couples in Tanzania

基于二元的诊断、护理、

基本信息

批准号：
8846365
负责人：
Michael D Sweat
金额：
$ 66.49万
依托单位：
MEDICAL UNIVERSITY OF SOUTH CAROLINA
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-08-01 至 2020-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8846365
关键词：
AIDS prevention Abstinence Acquired Immunodeficiency Syndrome Adherence Affect Africa South of the Sahara Baseline Surveys Behavioral Biometry Caring Characteristics Client Clinic Clinic Visits Clinical Data Collaborations Communities Community Health Systems Cost Analysis Counseling Country Couples Data Diagnosis Enrollment Epidemic Expenditure Fingerprint Fright Funding Goals HIV HIV Infections HIV Seropositivity HIV prevention trial HIV risk Health Benefit Health system Household Human immunodeficiency virus test Incidence Individual Intervention Intervention Studies Lead Link Maps Measurement National Institute of Mental Health Observational Study Pattern Policies Population Positioning Attribute Prevention Prevention program Preventive Intervention Privacy Prophylactic treatment Public Health Qualitative Research Randomized Randomized Controlled Trials Research Research Design Research Infrastructure Risk Risk Factors Risk Reduction Rural Safety Savings Services Site Specificity Surveys System Tanzania Testing Time Universities Viral Load result Work aged base comparative condoms cost cost effective economic cost experience improved innovation novel strategies phase III trial prevention service programs prospective public health relevance service utilization transmission process treatment center uptake

项目摘要

DESCRIPTION (provided by applicant): Despite 20 years of considerable HIV prevention efforts in Sub Saharan Africa the epidemic continues to have devastating impacts. The advent of expansion of treatment and care for AIDS in the region has provided important and lifesaving services, but has also added complexity to coordination and service delivery across prevention and care efforts. How to best combine intervention strategies (prevention, treatment, care, behavioral, biomedical) is a pressing question in the field. We believe that the best way to combine interventions is based on synergy, with intervention components directly reinforcing one another, not just whether programs occur simultaneously. In addition, needs are great and services limited. To achieve the maximum population-level reduction in HIV incidence it is important that those at greatest risk of transmitting and acquiring HIV receive more intensive interventions. We propose to conduct a prospective observational study of 1700 couples aged 18-45 years in Kisarawe, Tanzania who will be provided an intervention that offers: (1) HIV self-testing kits and pre-test counseling provided at the household, (2) linkage to a counseling and referral center for those who test positive, (3) facilitated enrollment to care and treatment for couples with confirmed HIV infection; and (4) access to pre-exposure prophylaxis for the negative partner in a HIV sero-discordant couple. A baseline and 18- month survey will be administered to all 1700 couples (3400 individuals), with a HIV and test conducted at 18-months. Positive partners who engaged in care as a dyad will have a CD4 and viral load test conducted at 18 months. All HIV sero-discordant couples identified through self-testing and entering care (estimated to be 50 couples) will also be administered an additional 6- and 12-month survey, and we will collect ongoing clinical data from each clinic visit. Biometric data (fingerprint) will be collected at enrollment, and all encounters with the counseling and referral center, and HIV treatment center, to allow linking of utilization of services with survey data. The study will position the project to advance to an appropriately powered randomized controlled trial should compelling efficacy be found, and safety and acceptance be established.

描述（由申请人提供）：尽管 20 年来，撒哈拉以南非洲地区做出了巨大的艾滋病毒预防工作，但该流行病继续产生破坏性影响。该地区艾滋病治疗和护理的扩大提供了重要的救生服务，但也带来了破坏性影响。预防和护理工作的协调和服务提供变得更加复杂。如何最好地结合干预策略（预防、治疗、护理、行为、生物医学）是该领域的一个紧迫问题。协同作用，干预措施的各个组成部分之间直接相互促进，而不仅仅是计划是否同时进行。此外，为了最大限度地降低艾滋病毒感染率，最重要的是让那些传播和感染艾滋病毒的风险最大的人接受治疗。我们建议对坦桑尼亚 Kisarawe 的 1700 名 18-45 岁的夫妇进行一项前瞻性观察研究，他们将得到集中提供的干预措施：(1) 在家庭中提供艾滋病毒自我检测套件和检测前咨询。 , (2) 为检测呈阳性的人与咨询和转诊中心建立联系，(3) 为确诊感染艾滋病毒的夫妇提供护理和治疗便利，以及 (4) 为艾滋病毒血清阴性的伴侣提供暴露前预防服务； - 不一致的夫妇将对所有 1700 对夫妇（3400 人）进行基线和 18 个月的调查，并在 18 个月时进行艾滋病毒检测。将在 18 个月时进行 CD4 和病毒载量测试，所有通过自我检测和进入护理机构确定的 HIV 血清不一致的夫妇（估计为 50 对夫妇）还将接受额外的 6 个月和 12 个月的调查。将在每次就诊以及与咨询和转诊中心以及艾滋病毒治疗中心的所有接触中收集生物识别数据（指纹），以便将服务的利用与调查数据联系起来。如果发现令人信服的功效，并建立安全性和可接受性，研究将使该项目进入适当动力的随机对照试验。