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RCT to reduce HIV acquisition and viral load among migrants, Rakai, Uganda

RCT to reduce HIV acquisition and viral load among migrants, Rakai, Uganda
旨在减少乌干达拉凯移民中艾滋病毒感染和病毒载量的随机对照试验
批准号:
10408017
负责人:
Larry William Chang
金额:
$58.2万
依托单位:
依托单位国家:
美国
项目类别:
财政年份:
2018
资助国家:
美国
项目状态:
已结题
起止时间:
2018-08-01 至 2024-05-31

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中文摘要
翻译
项目概要(摘要) 乌干达的Rakai健康科学方案提议建立一个执行科学界, 随机对照试验(CRCT)的一种新的干预措施,以新移民的个人(“欢迎在- 未来的邻居”[WIN]),以优化其与艾滋病毒预防综合服务的快速联系。RHSP 数据显示,在移民后的头36个月内,与居民相比,艾滋病毒阴性的移民 感染艾滋病毒的风险增加,艾滋病毒阳性的移民未充分利用抗逆转录病毒疗法 增加了进一步传播的风险。基于理论的WIN干预包括社区 提高认识,以社区为基础的WIN童子军(WINs),以及加强的,有区别的诊所服务, 移民。WINs将进行积极的社区监测,以迅速识别和欢迎移民, 向他们提供有关热电联产可用性和居民高使用率的信息(以“正常化”吸收), 利用动机访谈方法鼓励采用卫生防护中心,将移民转介到免费服务, 提供医疗券,使他们能够获得优先诊所服务,并跟踪移民, 进一步鼓励参与卫生防护中心。具体目的:目的1:随机分配40个单独匹配的 与WIN干预或对照组的比例为1:1。每组中15-49岁的移民将 接受基线调查和2次随访调查,间隔约18个月。主要终点是艾滋病毒感染率, 最初HIV阴性的入境者(每组n ~ 3,800 py),HIV阳性的病毒载量抑制(每组n ~740)。 还将比较CHP覆盖率和性行为(次要结果)。目标2a:使用 混合方法(深度访谈,过程和调查数据)和RE-AIM(范围,有效性, 采用、实施、维护),以(i)必要时指导临时干预调整;(ii)解释 试验结果;及(iii)将研究成果转化为未来的行动。目标2b:进行成本研究, 关于负担能力和可持续性的信息。创新和影响:这种新颖的干预将迅速 让移民中的弱势优先人群参与进来,以优化卫生保健方案和艾滋病毒在乌干达农村地区的影响。
英文摘要
PROJECT SUMMARY (ABSTRACT) The Rakai Health Sciences Program (RHSP), Uganda, proposes an implementation science community- randomized controlled trial (CRCT) of a novel intervention to newly in-migrated individuals (“Welcome In- coming Neighbor” [WIN]), to optimize their rapid linkage to combination HIV prevention (CHP) services. RHSP data show that within the first 36 months after in-migration, compared to residents, HIV-negative in-migrants are at increased risk of HIV acquisition and HIV+ in-migrants underutilize antiretroviral therapy (ART) increasing the risk of onward transmission. The theory-based WIN intervention includes community sensitization, community-based WIN scouts (WINs), and enhanced, differentiated clinic services for in- migrants. WINs will conduct active community surveillance to rapidly identify and welcome in-migrants, provide them with information about the availability of CHP and high rates of use by residents (to “normalize” uptake), utilize a motivational interviewing approach to encourage CHP adoption, refer in-migrants to free services, provide vouchers enabling them to receive priority clinic services, and follow-up in-migrants to assess and further encourage engagement in CHP. Specific Aims: Aim 1: To randomize 40 individually matched communities in a 1:1 ratio to the WIN intervention or control arm. In-migrants aged 15-49 in each arm will undergo a baseline and 2 follow-up surveys at ~18-month intervals. Primary end points are HIV incidence in initially HIV-negative in-migrants (n ~3,800 py per arm), and viral load suppression in HIV+ (n ~740 per arm). CHP coverage rates and sexual behaviors will also be compared (secondary outcomes). Aim 2a: To use a mixed methods approach (in-depth interviews, process & survey data) and RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) to (i) guide interim intervention adaptation as necessary; (ii) interpret trial results; and, (iii) translate the research into future action. Aim 2b: To conduct cost studies to provide information on affordability and sustainability. Innovation and Impact: This novel intervention will rapidly engage a vulnerable priority population of in-migrants, to optimize CHP and HIV impact in rural Uganda.
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Epidemiology and Impact of the HIV, NCD, and Urbanization Syndemic in Africa
  • 批准号:
    10540800
  • 项目类别:
  • 资助金额:
    $156.65万
  • 财政年份:
    2021
  • 负责人:
    Larry William Chang
  • 依托单位:
Epidemiology and Impact of the HIV, NCD, and Urbanization Syndemic in Africa
  • 批准号:
    10159610
  • 项目类别:
  • 资助金额:
    $156.69万
  • 财政年份:
    2021
  • 负责人:
    Larry William Chang
  • 依托单位:
Epidemiology and Impact of the HIV, NCD, and Urbanization Syndemic in Africa
  • 批准号:
    10338192
  • 项目类别:
  • 资助金额:
    $159.95万
  • 财政年份:
    2021
  • 负责人:
    Larry William Chang
  • 依托单位:
Hard-to-Reach Populations: Implications for Ending the AIDS Epidemic
  • 批准号:
    10385844
  • 项目类别:
  • 资助金额:
    $61.27万
  • 财政年份:
    2019
  • 负责人:
    Larry William Chang
  • 依托单位:
海外基金