Social support to retain adolescents living with HIV in care and improve ART adherence

摘要 职业目标：我致力于作为一名行为健康科学家的职业生涯， 公共卫生。我的目标是制定干预措施，改善青少年生活与 艾滋病毒（ALWH）全球。职业发展：这个职业发展奖将提高我的分析能力 并提供社会网络分析、干预开发、测试和评估方面的具体培训。 在这个应用程序中，我寻求：1）熟练使用社会网络分析，以告知干预 发展; 2）获得基本技能，以发展互动的，基于网络的社会支持干预， 在艾滋病毒护理中保留ALWH并提高ART依从性; 3）获得使用初步数据所需的培训 从这一建议中收集到的信息，以支持一项旨在评估 建议干预。研究项目：与其他年龄组相比，南非ALWH最少 坚持药物治疗，导致艾滋病毒相关发病率、死亡率、药物治疗 耐药性和艾滋病毒传播。为了改善ALWH的成果，我们必须确定创新和 采取各种方法，使他们继续接受艾滋病毒护理。拟议研究的总体目标是促进知识 艾滋病毒/艾滋病患者的社交网络在其治疗相关结果中的作用，并建立一个基于网络的， 社会支助干预措施，使他们继续接受艾滋病毒护理，并增加抗逆转录病毒疗法的坚持。首先，我将进行一次 ALWH的自我中心社会网络分析，以确定其社交网络的关键成员如何影响 他们在艾滋病毒护理和抗逆转录病毒疗法坚持中的保留率。接下来，我将使用ALWH的数据进行定性分析 及其网络成员确定最佳做法，以促进干预措施的可接受性和可行性。然后， 我将使用参与式方法，调整两个基于网络的干预措施，以适应目标人群， 增加他们继续接受艾滋病毒护理和坚持抗逆转录病毒疗法的人数。最后，我将在开普敦进行一项试点研究， 南非评估干预措施。导师制：我将与一个高度成就，多学科 专家团队将在拟议项目的过程中支持我。我的导师是约翰博士 巴特利特（杜克大学）、迈克尔·斯瓦特（南加州大学全球健康中心）、琳达-盖尔·贝克（德斯蒙德·图图 艾滋病毒中心，开普敦大学），迈克尔Relf（杜克大学）和卡尔Latkin（约翰霍普金斯 我的顾问是Audrey Pettifor博士和Joseph Tucker博士 （二）。未来的方向。该奖项还将告知未来的NIH拨款申请（R34和R 01），以优化 并在更大的研究样本中评估干预措施。

ABSTRACT Career Goal: I am committed to a career as a behavioral health scientist, integrating psychological science with public health. My goal is to develop interventions that improve outcomes among adolescents living with HIV (ALWH) globally. Career Development: This career development award will enhance my analytical skills and provide specific training in social network analysis, and intervention development, testing, and evaluation. In this application, I seek to: 1) gain proficiency in the use of social network analysis to inform intervention development; 2) gain essential skills to develop an interactive, network-based, social support intervention to retain ALWH in HIV care and improve ART adherence; 3) obtain the training needed to use preliminary data gathered from this proposal to support a follow up grant proposal for a larger trial aimed at evaluating the proposed intervention. Research Project: Compared to other age groups, South African ALWH are least adherent to medication regimens, resulting in elevated rates of HIV-related morbidity, mortality, medication resistance, and HIV transmission. To improve the outcomes of ALWH, we must identify innovative and engaging methods to retain them in HIV care. The overall goal of the proposed study is to advance knowledge on the role of ALWHs’ social networks in their treatment-related outcomes and develop a network-based, social support intervention to retain them in HIV care and increase ART adherence. First, I will conduct an egocentric social network analysis of ALWH to determine how key members of their social networks influence their retention in HIV care and ART adherence. Next, I will conduct qualitative analysis using data from ALWH and their network members to identify best practices to facilitate intervention acceptability and feasibility. Then, I will use participatory methods to adapt two network-based interventions to fit the target population and increase their retention in HIV care and ART adherence. Lastly, I will conduct a pilot study in Cape Town, South Africa to evaluate the intervention. Mentorship: I will work with a highly accomplished, multidisciplinary team of experts who will support me over the course of the proposed project. My mentors are Drs. John Bartlett (Duke University), Michael Sweat (MUSC Center for Global Health), Linda-Gail Bekker (Desmond Tutu HIV Centre, University of Cape Town), Michael Relf (Duke University), and Carl Latkin (Johns Hopkins Bloomberg School of Public Health) and my advisors are Drs. Audrey Pettifor (UNC) and Joseph Tucker (UNC). Future Directions. This award will also inform future NIH grant applications (R34 and R01) to optimize and evaluate the intervention in a larger study sample.