Zikhethele - choose for you: evaluating choice-based antiretroviral therapy support for patients returning to HIV care after treatment interruption in South Africa

Zikhethele - 为您选择：评估对南非治疗中断后返回艾滋病毒护理的患者的基于选择的抗逆转录病毒治疗支持

• 批准号: 10295062
• 负责人: Tamsin Kate Phillips
• 金额: $ 9.31万
• 依托单位: UNIVERSITY OF CAPE TOWN
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-23 至 2026-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10295062
• 关键词: AIDS prevention; AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Adherence; Adult; Africa South of the Sahara; Aftercare; Area; Attention; Award; Behavioral; Behavioral Research; Caring; Clinic; Clinical; Communities; Community Health; Contraceptive Agents; Data; Development; Effectiveness; Effectiveness of Interventions; Ensure; Epidemiologist; Epidemiology; Evaluation; Family Planning; Fellowship; Funding; Future; Goals; Growth; Guidelines; HIV; Health; Health Services; Health behavior; Individual; International; Interruption; Intervention; Intervention Studies; Interview; Investigation; K-Series Research Career Programs; Leadership; Measurement; Mentors; Mentorship; Methods; North Carolina; Outcome; Output; Patient Care; Patient Preferences; Patients; Pennsylvania; Policies; Population; Public Health; Qualitative Methods; Qualitative Research; Randomized; Research; Research Methodology; Research Personnel; Research Priority; Resources; Role; Scientist; Self Efficacy; Series; Services; South Africa; Structure; Surveys; Time; Training; Treatment outcome; United States National Institutes of Health; Universities; Viral; Woman; antiretroviral therapy; arm; base; behavior measurement; behavioral economics; career; career development; design; empowerment; evidence base; experience; experimental study; gender behavior; high risk; i(19); implementation measures; implementation science; improved; informant; innovation; mHealth; men; multidisciplinary; patient oriented; peer support; pilot trial; preference; satisfaction; secondary outcome; skills; social; therapy adherence; therapy design; therapy development; tool

PROJECT SUMMARY People living with HIV (PLH) are likely to cycle into and out of antiretroviral therapy (ART) services over time. Even after return to HIV care (RTC), PLH who have interrupted treatment remain vulnerable to attrition and poor treatment outcomes. A range of evidence-based ART support interventions exist including community- based and mobile health (mHealth) ART support interventions. The overarching goals of this proposal are to understand existing RTC practices, incorporate patient preference to refine a community-based and mHealth ART support intervention, and examine the role of choice in delivering RTC ART support. Candidate: Dr. Phillips is an HIV epidemiologist with training in quantitative research methods and experience with field research implementation in South Africa. She is applying for a five-year Fogarty Emerging Global Leader Award to obtain the additional training, mentorship and experience required to become a leading independent investigator capable of obtaining R-series funding. Mentoring: She has assembled an exceptional multidisciplinary team with extensive expertise in HIV intervention research in sub-Saharan Africa (SSA). Drs. Myer (University of Cape Town (UCT)) and Chi (University of North Carolina (UNC)) will serve as primary mentors providing complementary expertise on HIV intervention research and implementation science. Drs Maman (UNC) and Knight (UCT), co-mentors, are social scientists with expertise in qualitative and behavioral research particularly in the context of intervention design and evaluation. Dr. Thirumurthy (University of Pennsylvania: expertise in behavioral economics and measuring patient preference), Dr. Bekker (UCT: expertise in HIV care interventions and preference trials for contraceptive and HIV prevention methods), Dr. Hosseinipour (UNC: expertise in clinical, health service and implementation science with long-term adult HIV care in SSA) and Dr. Clouse (Vanderbilt University: expertise in mHealth intervention research in South Africa) will provide scientific advice in these areas. Training: Specific training in intervention design and evaluation – specifically incorporating implementation science, social and behavioral methods, and patient preference – will be achieved through intensive mentored training and formal coursework. This, combined with the experience gained through implementing my research aims, will establish Dr. Phillips’ independent research career investigating interventions to support lifelong HIV care. Research: The specific aims of this research are to: 1) characterize existing practices for providing RTC ART support and patient experience following RTC, 2) refine existing community-based and mHealth ART support interventions based on RTC patient preferences for modifiable attributes, and 3) determine the feasibility, acceptability and preliminary impact of offering a choice of ART support intervention to RTC patients. The results of this study will inform our understanding of RTC ART support including the role of patient choice. They will provide preliminary data needed to apply for an R01 to conduct a patient preference trial to rigorously examine the impact of patient choice in ART support delivery.

项目摘要 随着时间的推移，艾滋病毒感染者（PLH）可能会周期性地接受和退出抗逆转录病毒治疗（ART）服务。 即使在恢复艾滋病毒护理（RTC）后，中断治疗的艾滋病毒携带者仍然容易流失， 治疗效果差。一系列基于证据的抗逆转录病毒治疗支持干预措施存在，包括社区- 基于基础的和移动的保健（mHealth）抗逆转录病毒疗法支持干预措施。本提案的总体目标是 了解现有的RTC实践，结合患者偏好，以完善基于社区的移动健康 ART支持干预，并检查选择在提供RTC ART支持中的作用。候选人： 菲利普斯是一名艾滋病流行病学家，受过定量研究方法的培训， 在南非进行研究。她正在申请为期五年的Fogarty新兴全球领导者 该奖项旨在获得成为领先独立人士所需的额外培训、指导和经验 有能力获得R系列资金的调查员。指导：她已经组装了一个特殊的 在撒哈拉以南非洲（SSA）的艾滋病毒干预研究方面拥有广泛专业知识的多学科团队。Drs. Myer（开普敦大学（UCT））和Chi（北卡罗来纳州大学（UCT））将担任主要 导师提供艾滋病毒干预研究和实施科学方面的补充专业知识。Drs Maman（Maman）和Knight（UCT），共同导师，是社会科学家，在定性和行为方面具有专业知识。 研究，特别是在干预措施的设计和评估方面。Thirumurthy博士（哥伦比亚大学） 宾夕法尼亚州：行为经济学和测量患者偏好的专业知识），贝克博士（UCT： 在艾滋病护理干预和避孕和艾滋病预防方法的偏好试验），博士。 Hosseinipour（Hosseinipour）：在长期成人艾滋病毒的临床，卫生服务和实施科学方面的专业知识 和Clouse博士（范德比尔特大学：南非移动健康干预研究的专业知识） 将在这些领域提供科学建议。培训：干预措施设计和评价方面的具体培训- 特别是结合实施科学，社会和行为方法，和病人的喜好-将 通过强化辅导培训和正式课程来实现。这一点，结合经验， 通过实现我的研究目标所获得的，将建立菲利普斯博士的独立研究生涯 调查干预措施，以支持终身艾滋病毒护理。研究：本研究的具体目的是：1） 描述RTC后提供RTC ART支持和患者体验的现有实践，2）完善 基于RTC患者偏好的现有社区和移动医疗ART支持干预措施， 可修改的属性，以及3）确定提供选择的可行性，可接受性和初步影响 对RTC患者进行ART支持干预。这项研究的结果将有助于我们了解RTC ART支持包括患者选择的作用。他们将提供申请R 01所需的初步数据 进行一项患者偏好试验，严格检查患者选择在ART支持提供中的影响。