The 4 Youth by Youth (4YBY) pragmatic trial to enhance HIV self-testing uptake and sustainability: Study protocol in Nigeria.
The 4 Youth by Youth (4YBY) pragmatic trial to enhance HIV self-testing uptake and sustainability: Study protocol in Nigeria.
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DOI：
10.1016/j.cct.2021.106628
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发表时间：
2022-03
影响因子：
2.2
通讯作者：
Ezechi, Oliver
中科院分区：
文献类型：
--
作者：
Iwelunmor, Juliet;Tucker, Joseph D.;Obiezu-Umeh, Chisom;Gbaja-Biamila, Titilola;Oladele, David;Nwaozuru, Ucheoma;Musa, Adesola Z.;Airhihenbuwa, Collins O.;Muessig, Kathryn;Rosenberg, Nora;BeLue, Rhonda;Xian, Hong;Conserve, Donaldson F.;Ong, Jason J.;Zhang, Lei;Curley, Jamie;Nkengasong, Susan;Mason, Stacey;Tang, Weiming;Bayus, Barry;Ogedegbe, Gbenga;Ezechi, Oliver
关键词：
世界卫生组织建议将艾滋病毒自我检测作为艾滋病毒检测的另一种方法，尼日利亚政府支持这一政策建议。然而，如何有效提高尼日利亚青年的吸收率和可持续性尚不得而知。本研究的目标是开展一项全动力I型混合有效性-实施试验，以测试青年友好型实施科学战略在提高尼日利亚青年对艾滋病毒传播技术的吸收和可持续性方面的有效性。我们的4 Youth by Youth （4YBY）战略包含四个核心要素：1)艾滋病毒传播包，包括艾滋病毒传播工具包和照片验证系统；2)参与式学习社区；3)点对点支持和技术援助；4)现场监督和绩效反馈，以提高艾滋病毒感染的吸收和可持续性，并加强与青年友好型卫生诊所的联系，以便在需要时进行艾滋病毒确诊检测、性传播感染（即梅毒、淋病、衣原体和肝炎）检测、性传播感染治疗和PrEP转诊。利用楔形分步、集群随机对照试验，从尼日利亚14个州和4个地缘政治区域的32个地方政府区域招募了一组14 - 24岁的全国青年，将接受4YBY实施战略。此外，经济评估将探讨每个质量调整生命年获得的增量成本。这项研究将增加有限的“如何做”的文献，在资源有限的背景下，针对传统上在实施科学文献中代表性不足的青年人口，实施科学战略。研究结果还将优化由年轻人自己主导和为年轻人服务的艾滋病毒传播技术的吸收和可持续性。该研究已在ClinicalTrials.gov注册NCT04710784（2021年1月15日）。
The World Health Organization recommends HIV self-testing (HIVST) as an additional approach to HIV testing and the Nigerian government is supportive of this policy recommendation. However, effectively increasing uptake and sustainability among Nigerian youth is unknown. The goal of this study is to conduct a full-powered type I hybrid effectiveness-implementation trial to test the effectiveness of youth-friendly implementation science strategies in increasing uptake and sustainability of HIVST led by and for Nigerian youth. Our 4 Youth by Youth (4YBY) strategy combines four core elements: 1) HIVST bundle consisting of HIVST kits and photo verification system; 2) a participatory learning community; 3) peer to peer support and technical assistance; and 4) on-site supervision and performance feedback to improve uptake and sustainability of HIVST and enhance linkage to youth-friendly health clinics for confirmatory HIV testing where needed, sexually transmitted infection (STI) testing (i.e. syphilis, gonorrhea, chlamydia, and hepatitis, STI treatment, and PrEP referral. Utilizing a stepped-wedge, cluster-randomized controlled trial, a national cohort of youth aged 14–24 recruited from 32 local government areas across 14 states and four geo-political zones in Nigeria will receive the 4YBY implementation strategy. In addition, an economic evaluation will explore the incremental cost per quality adjusted life year gained. This study will add to the limited “how-to-do it literature” on implementation science strategies in a resource-limited setting targeting youth population traditionally underrepresented in implementation science literature. Study findings will also optimize uptake and sustainability of HIVST led by and for young people themselves. This study is registered in ClinicalTrials.gov NCT04710784 (on January 15, 2021).
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