Implementing Assisted Partner Services to HIV Test and Treat Men in Western Kenya

在肯尼亚西部实施艾滋病毒检测和治疗男性辅助合作伙伴服务

• 批准号: 10155081
• 负责人: CAREY FARQUHAR
• 金额: $ 64.57万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-06-23 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10155081
• 关键词: Acquired Immunodeficiency Syndrome; Address; Adopted; Adult; Advocate; Africa South of the Sahara; African; Attention; Caring; Clinical Research; Counseling; Country; County; Couples; Data; Diagnosis; Effectiveness; Effectiveness of Interventions; Elements; Ensure; Epidemic; Europe; Feasibility Studies; Female; Female Adolescents; Goals; Government; Guidelines; HIV; HIV Infections; HIV-infected adolescents; Health; Health care facility; Health system; Human immunodeficiency virus test; Individual; Institution; Intervention; Kenya; Knowledge; Life; Link; Measures; Methods; Modeling; Outcome; Persons; Plasma; Policy Maker; Population; Positioning Attribute; Prevalence; Principal Investigator; Public Health; Qualitative Methods; RNA; Randomized Clinical Trials; Reporting; Research; Research Personnel; Resources; Services; Sexual Partners; System; Testing; Training; Universities; Viral; Washington; Woman; Work; World Health Organization; base; care systems; case finding; cost; cost effectiveness; effectiveness evaluation; effectiveness study; experience; girls; health difference; high risk; implementation science; improved; indexing; male; male health; meetings; member; men; multidisciplinary; prevent; programs; scale up; service intervention; service programs; success; testing services; transmission process; treatment program; treatment services; uptake; young woman

It is estimated that >50% of HIV-infected Kenyans are unaware of their status and men are significantly less likely to test and link to care than women. Unless more attention is focused on men, Kenya and other sub- Saharan African countries with high HIV prevalence will not achieve UNAIDS 90-90-90 goals by 2020. This proposal addresses low uptake of HIV testing and poor linkage to care and treatment services among men in sub-Saharan Africa. The overarching goal is to demonstrate using implementation science methods that assisted partner services (aPS) is a safe and effective strategy to increase the proportion of men living with HIV who know their serostatus and that aPS will improve male engagement in HIV treatment programs. The study will be based in two counties in Kenya with the highest HIV prevalence in the nation: Homa Bay (27% prevalence) and Kisumu (18.7% prevalence) and be conducted by an experienced and collaborative team with an exceptionally strong track record in HIV partner testing research and implementation science in Kenya. Principal Investigator Carey Farquhar (University of Washington [UW]) will work closely with a multidisciplinary group of investigators and consultants from UW, PATH, Kenya's Ministry of Health, and the National AIDS and STI Control Program (NASCOP), and build on a successful randomized clinical trial of assisted partner services (aPS) conducted by UW and NASCOP from 2012-2015. The proposed research also leverages PATH's vast experience providing HIV testing and treatment in government facilities through the APHIAplus program, as well as PATH's recent mapping of >21,000 adolescent girls and young women for services as part of the DREAMS initiative in western Kenya. The specific aims are as follows:  AIM 1: Determine aPS effectiveness by demonstrating that aPS improves HIV testing, identifies new HIV infections, and promotes linkage, treatment and viral suppression among male partners when implemented among women and adolescent girls in government facilities in Kenya.  AIM 2: Evaluate fidelity, feasibility, and cost/cost-effectiveness when implementing aPS at 38 APHIAplus facilities and 9 “safe spaces” established by the DREAMS initiative in western Kenya. Using a mixed methods approach in this real-world setting, we will obtain data critical to national and regional scale-up. For Aim 1, we will offer aPS to more than 8,000 HIV-infected adolescent girls and women and all of their male partners; if a male partner is HIV-infected aPS will also be offered to his female partners. For Aim 2, we will use quantitative and qualitative methods to collect and evaluate data from a subset of facilities that are high and low performers, determine “necessary” elements of aPS at the level of implementation, and conduct a feasibility study, including analyses of acceptability, integration, demand, technical efficiency and cost data. In this way, the UW/PATH/MOH team will work towards building capacity in Kenya to effectively implement and sustain a model aPS program that could be replicated across sub-Saharan Africa.

据估计，> 50％的艾滋病毒感染的肯尼亚人没有意识到自己的地位，而男性则明显较少 可能比女性进行测试和链接。除非有更多关注的重点是男人，肯尼亚和其他子 艾滋病毒率高的撒哈拉非洲国家到2020年将无法实现90-90-90的目标。 提案解决了艾滋病毒测试的低摄取以及与护理和治疗服务的不良联系 撒哈拉以南非洲的男人。总体目标是证明使用实施科学方法 协助合作伙伴服务（APS）是一种安全有效的策略，以增加生活的男性比例 与艾滋病毒了解他们的血清，APS将改善男性参与艾滋病毒治疗计划。 这项研究将基于肯尼亚的两个县，艾滋病毒率高于全国：霍马湾 （患病率为27％）和Kisumu（18.7％患病率），由经验丰富的协作性进行 团队在HIV合作伙伴测试研究和实施科学方面具有出色的良好记录 肯尼亚。首席研究员凯里·法夸（Carey Farquhar）（华盛顿大学[UW]）将与 UW，PATH，肯尼亚卫生部的多学科研究人员和顾问组 国家艾滋病和STI控制计划（NASCOP），并以成功的随机临床试验为基础 UW和NASCOP从2012 - 2015年进行的辅助合作伙伴服务（APS）。拟议的研究也 利用路径的丰富经验，通过通过 Aphiaplus计划，以及Path最近的绘制> 21,000名青少年女孩和年轻女性的地图 服务是肯尼亚西部梦想倡议的一部分。具体目的如下： 目标1：通过证明AP改善艾滋病毒测试，确定新艾滋病毒来确定AP的有效性 实施后，感染并促进男性伴侣之间的联系，治疗和病毒抑制 在肯尼亚政府设施中的妇女和青少年女孩中。 目标2：在38 Aphiaplus实施AP时评估忠诚度，可行性和成本/成本效益 Dreams倡议在肯尼亚西部建立的设施和9个“安全空间”。使用混合 方法方法在这种现实世界中，我们将获得对国家和区域规模至关重要的数据。 对于AIM 1，我们将为8,000多名艾滋病毒感染的青少年女孩和女性及其所有男性提供APS 合作伙伴；如果男性伴侣是艾滋病毒感染的AP，也将向其女性伴侣提供。对于目标2，我们将 使用定量和定性方法来收集和评估来自高的设施子集的数据 和低性能的人，确定APS在实施级别上的“必要”元素，然后进行 可行性研究，包括可接受性，整合，需求，技术效率和成本数据的分析。在 这样，UW/PATH/MOH团队将致力于在肯尼亚建立能力，以有效地实施和 维持可以在撒哈拉以南非洲进行复制的模型APS计划。