Hybrid STTR intervention for heterosexuals using anonymous HIV testing and confidential linkage to care: a single arm exploratory trial using respondent-driven sampling.
Hybrid STTR intervention for heterosexuals using anonymous HIV testing and confidential linkage to care: a single arm exploratory trial using respondent-driven sampling.
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DOI：
10.1186/s12889-015-2451-5
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发表时间：
2015-11-16
影响因子：
4.5
通讯作者：
BCAP Collaborative Research Team
中科院分区：
文献类型：
--
作者：
Gwadz M;Cleland CM;Leonard NR;Kutnick A;Ritchie AS;Banfield A;Hagan H;Perlman DC;McCright-Gill T;Sherpa D;Martinez BY;BCAP Collaborative Research Team
据估计，美国 120 万艾滋病毒感染者中，有 14% 不知道自己的状况。然而，这一比例不大的未确诊艾滋病毒感染者与所有新感染病例的 44-66% 有关。因此，需要创新的干预方法来寻找和测试那些未确诊的艾滋病毒感染者，并将他们与高保留率的艾滋病毒治疗联系起来，这种方法被称为“寻找、测试、治疗和保留”(STTR)。本协议描述了一种创造性的“混合”STTR 方法，该方法使用匿名 HIV 检测，然后进行保密护理联系，重点关注 HIV 高风险 (HHR) 的异性恋者，他们的检测频率不及其他高危人群，且诊断较晚。这是一项单臂探索性干预疗效试验。该研究分为两个阶段：第一阶段是寻找和测试 HHR，第二阶段是及时将发现的感染者与艾滋病毒治疗联系起来，并保持较高的保留率。我们将招募居住在贫困和艾滋病毒流行率较高的城市地区的非裔美国人/黑人和拉丁裔成人 HHR。将通过受访者驱动的抽样（一种同行招募方法）来招募参与者。 “寻求和测试”阶段由简短、方便、单次、匿名的艾滋病毒咨询和测试会议组成。 “治疗和保留”部分将使新诊断出的艾滋病毒感染者进入保密研究阶段，并使用一套称为护理导航的程序将他们与艾滋病毒初级保健联系起来。参与者将接受为期 6 个月的跟踪，并对结果进行客观评估（使用医疗记录和生物标志物）。未确诊的艾滋病毒感染是一个重大的公共卫生问题。虽然匿名艾滋病毒检测是艾滋病毒检测组合的重要组成部分，但它通常不包括与护理的联系。本研究有可能产生一种创新、简短、具有成本效益且可复制的 STTR 干预措施，从而减少艾滋病毒/艾滋病方面的种族/民族差异。 ClinicalTrials.gov，NCT02421159，2015 年 4 月 15 日注册。
An estimated 14 % of the 1.2 million individuals living with HIV in the U.S. are unaware of their status. Yet this modest proportion of individuals with undiagnosed HIV is linked to 44–66 % of all new infections. Thus innovative intervention approaches are needed to seek out and test those with undiagnosed HIV, and link them to HIV treatment with high retention, an approach referred to as “Seek, Test, Treat, and Retain” (STTR). The present protocol describes a creative “hybrid” STTR approach that uses anonymous HIV testing followed by confidential care linkage, focused on heterosexuals at high risk (HHR) for HIV, who do not test as frequently as, and are diagnosed later, than other risk groups. This is a single-arm exploratory intervention efficacy trial. The study has two phases: one to seek out and test HHR, and another to link those found infected to HIV treatment in a timely fashion, with high retention. We will recruit African American/Black and Latino adult HHR who reside in urban locations with high poverty and HIV prevalence. Participants will be recruited with respondent-driven sampling, a peer recruitment method. The “Seek and Test” phase is comprised of a brief, convenient, single-session, anonymous HIV counseling and testing session. The “Treat and Retain” component will engage those newly diagnosed with HIV into a confidential research phase and use a set of procedures called care navigation to link them to HIV primary care. Participants will be followed for 6 months with objective assessment of outcomes (using medical records and biomarkers). Undiagnosed HIV infection is a major public health problem. While anonymous HIV testing is an important part of the HIV testing portfolio, it does not typically include linkage to care. The present study has potential to produce an innovative, brief, cost-effective, and replicable STTR intervention, and thereby reduce racial/ethnic disparities in HIV/AIDS. ClinicalTrials.gov, NCT02421159, Registered April 15, 2015.