Peer PrEP referral + HIV self-test for PrEP initiation among young Kenyan women

同行 PrEP 转介 肯尼亚年轻女性启动 PrEP 的 HIV 自检

• 批准号: 10460627
• 负责人: Katrina Frances Ortblad
• 金额: $ 24.9万
• 依托单位: FRED HUTCHINSON CANCER CENTER
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-04-01 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10460627
• 关键词: AIDS prevention; Address; Adherence; Adopted; Adoption; African; Award; Behavioral; Behavioral Research; Behavioral Sciences; Blood; Clinic; Communities; Country; Development; Development Plans; Educational workshop; Epidemic; Faculty; Female; Focus Groups; Frequencies; Goals; Government; HIV; HIV Infections; HIV risk; Health system; Healthcare; Human immunodeficiency virus test; Hybrids; Incidence; Individual; International; Intervention; Interview; Kenya; Knowledge; Learning; Measures; Mentors; Methods; Modeling; Outcome; Pamphlets; Participant; Phase; Population; Positioning Attribute; Publications; Qualitative Research; Randomized; Research; Research Personnel; Research Training; Risk; Self Efficacy; Spottings; Testing; Training; Universities; Washington; Woman; Work; base; behavior influence; budget impact; career development; cost; design; effectiveness implementation study; effectiveness outcome; effectiveness-implementation randomized trial; experience; female sex worker; follow-up; global health; implementation framework; implementation outcomes; implementation research; implementation science; implementation strategy; innovation; male; meetings; multidisciplinary; novel; peer; pilot test; post-doctoral training; pre-doctoral; pre-exposure prophylaxis; preference; preventive intervention; randomized trial; scale up; self testing; skills; social; social stigma; symposium; tenure track; theories; two-arm trial; young woman

ABSTRACT The overall goal of this proposed K99/R00 award is to support my research training so that I can develop into an independent researcher whose work focuses on novel delivery models for effective HIV prevention interventions that operate outside of healthcare clinics. My pre-doctoral, doctoral, and post-doctoral training have given me over a decade of experience in global HIV research and expertise in quantitative methods, randomized trials, HIV self-testing, peer-based interventions, fieldwork, and pre-exposure prophylaxis (PrEP) for HIV prevention. This K99/R00 proposal outlines an intentional training and career development plan that builds on and expands my research skills and experiences so that I can become a competitive applicant for a tenured-track faculty position in an interdisciplinary department, such as global health, at a leading research university. Training plan: To complete my research toolkit and transition to independence, I have assembled a multidisciplinary team of expert mentors from the US and Kenya. Together, we have designed a robust training plan that includes regular mentored meetings and relevant advanced coursework, seminars, workshops, and mentoring groups at the University of Washington and international scientific conferences. The specific training goals for the K99 phase of this award are to: 1) learn how to apply the most commonly used frameworks, strategies, and theories in implementation and behavioral research; 2) develop new and complementary skills in costing methods and qualitative research; 3) conduct formative research and a pilot to develop and refine a peer PrEP referral + HIV self-test (HIVST) delivery model for PrEP initiation among young Kenyan women; and 4) transition to scientific independence by building a publication record in implementation and behavioral science. Research plan: PrEP for HIV prevention is highly effective. However, in Kenya, where the government offers PrEP free of change, few young women at high HIV risk are initiating PrEP. We propose developing, piloting, and testing an innovative model that might overcome barriers to PrEP initiation among young Kenyan women: peer PrEP referral + HIVST delivery. The specific aims of the proposed research are to: 1) develop a peer PrEP referral + HIVST delivery model to facilitate PrEP initiation among young Kenyan women using in-depth interviews with young women informed by implementation frameworks and behavioral theory (Y1); 2) pilot the proposed delivery model and refine the model using focus group discussions with pilot participants informed by implementation frameworks (Y2); 3) test the effect and implementation of the refined delivery model on PrEP initiation and other outcomes (including other metrics of PrEP adoption, model fidelity, and costs) using a hybrid randomized trial (Y3-5). This proposed K99/R00 research directly builds on my previous research experiences, enables me to gain new skills in implementation and behavioral research, addresses one of the greatest challenges to PrEP scale-up today, and will inform an R01 proposal for a community-randomized trial and budget impact analysis.

摘要 这个建议的K99/R00奖项的总体目标是支持我的研究培训，使我能够发展成为一名 独立研究员，其工作重点是有效的艾滋病毒预防干预措施的新交付模式 在医疗诊所以外运营的公司。我的博士前、博士后和博士后培训给了我 十多年来在全球艾滋病毒研究方面的经验和在定量方法、随机试验、 艾滋病毒自我检测、基于同伴的干预、实地工作和暴露前预防(PrEP)以预防艾滋病毒。 这份K99/R00建议书概述了在基础上和扩展基础上的有目的的培训和职业发展计划 我的研究技能和经验，这样我才能成为终身教职的有竞争力的申请人 在一流研究型大学的跨学科系任职，如全球健康。 培训计划：为了完成我的研究工具包并过渡到独立，我已经组装了一个 来自美国和肯尼亚的多学科专家导师团队。我们共同设计了一个强大的培训 计划，包括定期指导会议和相关的高级课程、研讨会、研讨会和 在华盛顿大学和国际科学会议上的指导小组。具体的培训 该奖项K99阶段的目标是：1)学习如何应用最常用的框架， 战略，以及实施和行为研究方面的理论；2)发展新的和补充的技能 成本计算方法和定性研究；3)进行形成性研究和试点，以发展和提炼同行 肯尼亚年轻妇女PrEP启动的Prep转诊+艾滋病毒自检(HIVST)交付模式；以及4) 通过建立实施和行为科学的出版记录来过渡到科学独立。 研究计划：预防艾滋病毒的准备工作非常有效。然而，在肯尼亚，政府提供了 如果没有变化，很少有感染艾滋病毒高危的年轻女性开始实施PrEP。我们建议开发、试点、 并测试一种创新模式，该模式可能会克服肯尼亚年轻女性启动PrEP的障碍： 对等PrEP推荐+HIVST交付。拟议研究的具体目标是：1)开发对等PrEP 转诊+HIVST分娩模式，以促进肯尼亚年轻妇女使用深度技术启动PrEP 与了解实施框架和行为理论的年轻妇女进行访谈(Y1)；2)试点 建议的交付模式，并使用与试点参与者的焦点小组讨论来改进模型，这些参与者被告知 实施框架(Y2)；3)测试精细化交付模式对PrEP的效果和实施情况 使用混合解决方案的启动和其他结果(包括PrEP采用、模型保真度和成本的其他指标) 随机试验(Y3-5)。这项建议的K99/R00研究直接建立在我之前的研究经验基础上， 使我能够在实施和行为研究方面获得新技能，解决了最伟大的 目前PrEP扩展面临的挑战，并将向R01建议提供社区随机试验和预算 影响分析。