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Innovative strategies to increase ART Initiation and viral suppression among HIV+ men in Malawi

提高马拉维艾滋病毒男性的抗逆转录病毒治疗启动和病毒抑制的创新策略

基本信息

批准号：
10189742
负责人：
Kathryn L Dovel
金额：
$ 14.52万
依托单位：
UNIVERSITY OF CALIFORNIA LOS ANGELES
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-09-16 至 2024-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10189742
关键词：
Address Adopted Adverse event Africa South of the Sahara Area Baseline Surveys Biometry Caring Characteristics Client Clinical Trials Counseling Country Data Development Development Plans Diagnostic Reagent Kits Disclosure Effectiveness Effectiveness of Interventions Enrollment Ensure Epidemic Ethics Female Focus Groups Fright Goals HIV HIV Seropositivity Health Personnel Health Services Accessibility Health care facility Home Home visitation Human immunodeficiency virus test Individual Intervention Interview Knowledge Location Maintenance Malawi Mentored Research Scientist Development Award Mentors Mentorship Modeling Newly Diagnosed Outcome Population Privacy Public Health Randomized Controlled Trials Research Research Activity Research Personnel Research Training Resources Respondent Risk Sample Size Scientist Service delivery model Services Sexual Partners Social Sciences Statistical Methods Testing Therapeutic Intervention Time Training Viral Woman antiretroviral therapy arm barrier to care base career development clinical practice coping cost evidence base experience home test improved indexing informant innovation male men multidisciplinary novel strategies pilot trial primary outcome randomized trial retention rate secondary outcome self testing seroconversion service delivery skills social social observations social stigma standard care standard of care success testing services theories treatment services

项目摘要

Project Summary Men continue to be missed by HIV testing and treatment services. Index partner testing is a critical strategy for reaching men. Index HIV self-testing (HIVST), whereby ART clients take HIVST kits home to their sexual partners for testing, is a new strategy that dramatically increases index testing among men, and is being taken to scale across Malawi. However, only 25% of men identified as HIV-positive through Index HIVST initiate ART after 6- months. Innovative strategies to increase ART initiation and retention among men are urgently needed. The overarching goal of the proposed K01 is to develop and pilot a home-based ART intervention (ART initiation + 3-months ART care) to increase ART initiation (primary outcome) and 6-month viral suppression (secondary outcome) among men who test HIV-positive through Index HIVST in Malawi. Candidate: I am a social scientist with a background in HIV research in sub-Saharan Africa. My long-term goal is to transition from observational social science to clinical trials research in innovative HIV service delivery models among hard-to-reach populations, such as men. I am applying for a five-year K01 award to obtain training, mentorship, and research experience. Mentoring: I have an exceptional multi-disciplinary mentoring team with extensive experience in HIV care and management and clinical trials in the region. The team has complementary expertise in social science and clinical trials in HIV service delivery models (Dr. Thomas Coates – Primary Mentor), best practices in HIV care and management and differentiated models of care in Malawi (Drs. Judith Currier and Risa Hoffman), scalability and sustainability of interventions (Dr. Sundeep Gupta – Malawi-based), and advanced biostatistics (Dr. Ron Brookmyer). Career Development: To achieve my long-term goals, we have developed a detail plan to build skills in four additional areas: (1) best clinical practices for ART care and maintenance; (2) clinical trials in novel approaches to HIV service delivery; (3) advanced statistical methods; and (4) ethics in clinical trials research in low-resource settings. Research Activities: The specific aims accompanying the career development plan are to: (1) Develop a home-based ART intervention for male partners tested through Index HIVST, using in-depth interviews with male Index HIVST users (n=15-20) and their partners (n=15-20), and focus group discussions with key informants (n=18-30). (2) Determine the potential effectiveness of home-based ART versus standard facility-based ART (on ART initiation (primary outcome) and 6-month viral suppression (secondary outcome) among male Index HIVST users in a pilot trial with 200 HIV-positive men. Expected Outcomes: Results from this study will inform definitive trial to test home-based ART services for men identified as HIV-positive through index HIVST strategies. The project will also give me the additional skillsets needed to become an independent investigator in clinical trials.

项目总结