An implementation science protocol of the Women's Health CoOp in healthcare settings in Cape Town, South Africa: A stepped-wedge design.
An implementation science protocol of the Women's Health CoOp in healthcare settings in Cape Town, South Africa: A stepped-wedge design.
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DOI：
10.1186/s12905-017-0433-8
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发表时间：
2017-09-18
期刊：
影响因子：
--
通讯作者：
Dunlap L
中科院分区：
文献类型：
--
作者：
Wechsberg WM;Ndirangu JW;Speizer IS;Zule WA;Gumula W;Peasant C;Browne FA;Dunlap L
艾滋病毒在南非仍然是一个公共卫生紧急事件，特别是在育龄妇女中。为了应对艾滋病毒流行病，联合国艾滋病毒/艾滋病联合规划署提出了到2020年实现无艾滋病一代的90-90-90全球目标。这一目标旨在使90%的艾滋病毒感染者得到诊断；接受持续抗逆转录病毒治疗（ART）检测呈阳性者的90%；90%接受抗逆转录病毒治疗的人病毒受到抑制。确保获得抗逆转录病毒治疗是减少艾滋病毒发病率的重要第一步，特别是在南非使用药物和承担艾滋病毒负担的妇女等弱势群体中。此外，酒精和其他药物的使用以及遭受基于性别的暴力与艾滋病毒感染风险增加和抗逆转录病毒治疗依从性降低有关。然而，自从南非政府批准向所有艾滋病毒感染者提供抗逆转录病毒治疗以来，没有任何研究估计过南非使用药物的妇女的抗逆转录病毒治疗依从率。妇女健康合作社（WHC）是一项以证据为基础、以妇女为重点的行为干预措施，其主要目标是提高技能和知识，以减少药物滥用和艾滋病毒风险，并改善抗逆转录病毒治疗的依从性。《世界卫生大会》已被包装，以便进一步散发。本文描述了用于评估在开普敦卫生诊所和药物滥用康复中心实施WHC干预的可行性和可接受性的研究方案，以减少使用药物并感染艾滋病毒的妇女的艾滋病毒风险行为并提高抗逆转录病毒治疗的依从性。由于在随机试验中证明对艾滋病毒预防和抗逆转录病毒治疗依从性有效的干预措施很少是可持续的，因此需要进行适应和测试干预措施变化的研究，以确定在现实世界的高风险环境中实施这些干预措施的最佳策略。然而，在现实环境中实现存在挑战。因此，在制定和尝试扩大干预措施时，干预措施开发人员应在适应和实施过程之前、期间和之后与关键利益相关者进行接触，考虑其预期实施环境的优势和局限性。NCT 02733003，批准日期为2016年1月21日。
HIV persists as a public health emergency in South Africa, especially among women of childbearing age. In response to the HIV epidemic, the Joint United Nations Programme on HIV/AIDS has put forth the 90–90-90 global goals to achieve an AIDS-free generation by 2020. This goal aspires to have 90% of people living with HIV diagnosed; 90% of those who test positive on sustained antiretroviral therapy (ART); and 90% of those on ART be virally suppressed. Ensuring access to ART is an important first step in reducing HIV incidence, especially among vulnerable populations such as women who use substances and bear the burden of HIV in South Africa. Additionally, alcohol and other drug (AOD) use and exposure to gender-based violence are associated with increased risk of HIV infection and reduced adherence to ART. However, no research has estimated ART adherence rates for women who use substances in South Africa since the government approved the provision of ART to all people living with HIV. The Women’s Health CoOp (WHC) is an evidence-based, woman-focused, behavioral intervention that addresses the intersecting risks of AODs, sex behaviors, and violence and victimization, with the primary goal of increasing skills and knowledge to reduce substance abuse and HIV risks and to improve ART adherence. The WHC has been packaged for further dissemination. This article describes the study protocol used to assess the feasibility and acceptability of implementing the WHC intervention into standard of care in Cape Town health clinics and substance abuse rehabilitation centers to reduce HIV risk behavior and increase ART adherence among women who use substances and are living with HIV. Because few of the interventions that demonstrate efficacy for HIV prevention and ART adherence in randomized trials are sustainable, studies to adapt and test intervention variations are needed to determine the best strategies for implementing them in real-world, high-risk settings. However, implementation in real-world settings presents challenges. Consequently, intervention developers should consider the strengths and limitations of their anticipated implementation setting by engaging with key stakeholders before, during, and after the adaptation and implementation process when developing and attempting to scale-up interventions. NCT 02733003 and date approved 1/21/2016.
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影响因子：
12.7
作者：
Glasgow, RE;Vogt, TM;Boles, SM
通讯作者：
Boles, SM
影响因子：
2.2
作者：
Kekwaletswe CT;Morojele NK
通讯作者：
Morojele NK
影响因子：
4.4
作者：
Kalichman, Seth C.;Simbayi, Leickness C.;Jooste, Sean
通讯作者：
Jooste, Sean
影响因子：
4.8
作者：
Hemming, Karla;Girling, Alan
通讯作者：
Girling, Alan
DOI：
10.1007/s10488-008-0197-4
发表时间：
2009-01
影响因子：
2.6
作者：
Proctor, Enola K.;Landsverk, John;Aarons, Gregory;Chambers, David;Glisson, Charles;Mittman, Brian
通讯作者：
Mittman, Brian