Strategic antiretroviral therapy and HIV testing for youth in rural Africa
为非洲农村青年提供战略性抗逆转录病毒治疗和艾滋病毒检测
基本信息
- 批准号:10469425
- 负责人:
- 金额:$ 190.5万
- 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
- 起止时间:2018-09-01 至 2024-08-31
- 项目状态:已结题
- 来源:
- 关键词:AddressAdherenceAdolescenceAdolescent and Young AdultAdultAffectAfricaAfrica South of the SaharaAfricanAgeAge-YearsBehaviorBehavioralCaringClinicCognitiveCollaborationsCombined Modality TherapyCommunicationCommunitiesCommunity ParticipationContinuity of Patient CareCost Effectiveness AnalysisCounselingCoupledDataDevelopmentDiagnosisEnrollmentEventFamily memberFeedbackFemaleFocus GroupsFrequenciesFutureGenderGoalsGovernmentHIVHIV diagnosisHealthHuman immunodeficiency virus testInterventionInterviewInvestigationKenyaKnowledgeLeftLifeLinkMeasuresMethodsModelingMorbidity - disease rateMotionOutcomePatientsPhasePolicy MakerProcessProviderPublic HealthQualitative MethodsRNARandomizedRandomized Controlled TrialsResearchRiskRuralRural CommunitySocial DevelopmentSocial NetworkStructureTechnologyTestingTimeTrainingTreatment outcomeUgandaViralViral Load resultVisitWorkYouthantiretroviral therapybasecare providerscognitive developmentcommunity based participatory researchcommunity cliniccommunity interventioncommunity settingcomparison interventioncostdesigneffectiveness evaluationefficacy evaluationemerging adultflexibilityfollow-uphigh riskimplementation scienceimprovedinformantinnovationmalemeetingsmicrocostingmortalitypeerpre-exposure prophylaxisprogramsretention ratesocialstandard of caresuccesstheoriestherapy adherencetransmission processuptakeyoung woman
项目摘要
SUMMARY
Despite encouraging gains in HIV treatment outcomes among adults with HIV in Sub-Saharan Africa,
adolescents and young adults(10-24 years of age) living with HIV (AYAH) are being left behind with
young women disproportionately affected. AYAH have worse rates of HIV testing, linkage to care,
retention in care, and dramatically lower rates of HIV viral suppression. Our goal is to evaluate a
strategic ART combination intervention for AYAH (SATURN) in a cluster randomized controlled trial (RCT)
of 1,400 AYAH in 28 clinics in rural Uganda and Kenya. SATURN is an innovative life-stage adapted
approach to improve ART uptake, adherence, retention and virologic suppression among female and male
youth. The life-stage adapted, combination SATURN intervention is based on premise that current
approaches to engaging AYAH are challenged by lack of dynamic flexibility and care adaptation to the
significant trajectories of cognitive, social, and life-stage developmental events that occur in
adolescence and early adulthood. Our intervention is based on behavioral theory, implementation
science, youth/provider input, and process and outcome feasibility and pilot data from the region. In
AIM 1, Phase-I (UG3), we will: a) Implement youth-led HIV testing and linkage programs using a
community-based participatory research (CBPR) to reach AYAH who are undiagnosed or are not engaged in
care b) Initiate the clustered RCT of SATURN intervention compared to standard of care among AYAH in 8
of the planned 28 clinics in rural Uganda and Kenya. In AIM 2, Phase-2 (UH3) we will: Complete RCT
enrollment of AYAH from 28 clinics and compare the rate of retention and virologic suppression at 2
years in SATURN clinics vs control; and 2a) Identify the mechanisms of action, barriers and facilitators of
the SATURN implementation at the community, clinic organization, provider, and patient levels using mixed
methods qualitative and quantitative assessments. 2b) Estimate the incremental costs and gains associated
with SATURN through cost effectiveness analysis. Transition Milestones to move from UG3 to UH3: a)
Enroll at least 400 youth from the first 8 clinics to the SATURN RCT; 2) Of those enrolled, 20% will be new or
out-of-care diagnoses; 3) Achieve at least 70% retention with virologic suppression at 1 year in intervention
communities. This research builds upon highly productive long-standing collaborations between Ministries of
Health in Uganda and Kenya, African and US research organizations, and PEPFAR implementing partners
with local community participation and substantial AYAH targeted formative work in Uganda and Kenya and is
directed at eventual dissemination and sustainability.
总结
尽管撒哈拉以南非洲成年艾滋病毒感染者在艾滋病毒治疗方面取得了令人鼓舞的成果,
感染艾滋病毒的青少年和年轻成年人(10-24岁)
年轻女性受到的影响尤为严重。AYAH的艾滋病毒检测率更低,与护理有关,
保持护理,并显着降低艾滋病毒抑制率。我们的目标是评估一个
一项针对AYAH(SATURN)的策略性ART联合干预的整群随机对照试验(RCT)
在乌干达和肯尼亚农村地区的28个诊所,SATURN是一个创新的生命阶段,
改善女性和男性抗逆转录病毒疗法的使用、坚持、保留和病毒学抑制的方法
青年适应生命阶段的组合SATURN干预基于以下前提:
参与AYAH的方法受到缺乏动态灵活性和护理适应性的挑战,
认知,社会和生命阶段发展事件的重要轨迹,发生在
青春期和成年早期。我们的干预是基于行为理论,
科学、青年/提供者的投入、进程和成果的可行性以及该区域的试点数据。在
目标1,第一阶段(UG 3),我们将:
以社区为基础的参与性研究(CBPR),以接触未确诊或未参与的AYAH。
护理B)在8名AYAH中启动SATURN干预与标准护理相比的整群RCT
计划在乌干达和肯尼亚的农村地区建立28个诊所。在AIM 2 2期(UH 3)中,我们将:完成RCT
从28家诊所招募AYAH,并比较2.5岁时的保留率和病毒学抑制率。
2a)确定SATURN诊所与对照组的作用机制、障碍和促进因素,
SATURN在社区、诊所组织、提供者和患者层面的实施,
方法定性和定量评价。2b)估算相关的增量成本和收益
通过成本效益分析。从UG 3到UH 3的过渡Military:a)
从前8个诊所招募至少400名青年到SATURN RCT; 2)在招募的人中,20%将是新的或
护理外诊断; 3)在干预1年时,通过病毒学抑制实现至少70%的保留率
社区.这项研究建立在各部委之间富有成效的长期合作基础上,
乌干达和肯尼亚的卫生、非洲和美国的研究组织以及PEPFAR执行伙伴
在乌干达和肯尼亚,当地社区参与并开展了大量针对青少年保健协会的形成工作,
以最终传播和可持续性为目标。
项目成果
期刊论文数量(3)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
Two or more significant life-events in 6-months are associated with lower rates of HIV treatment and virologic suppression among youth with HIV in Uganda and Kenya.
乌干达和肯尼亚艾滋病毒感染青年中,六个月内发生的两次或两次以上重大生活事件与艾滋病毒治疗和病毒学抑制率较低有关。
- DOI:10.1080/09540121.2022.2052260
- 发表时间:2023
- 期刊:
- 影响因子:1.7
- 作者:Mwangwa,Florence;Charlebois,EdwinD;Ayieko,James;Olio,Winter;Black,Douglas;Peng,James;Kwarisiima,Dalsone;Kabami,Jane;Balzer,LauraB;Petersen,MayaL;Kapogiannis,Bill;Kamya,MosesR;Havlir,DianeV;Ruel,TheodoreD
- 通讯作者:Ruel,TheodoreD
Remote and Equitable Inductive Analysis for Global Health Teams: Using Digital Tools to Foster Equity and Collaboration in Qualitative Global Health Research via the R-EIGHT Method.
全球卫生团队的远程和公平归纳分析:通过 R-EIGHT 方法使用数字工具促进定性全球卫生研究的公平和合作。
- DOI:10.1177/16094069241236268
- 发表时间:2024
- 期刊:
- 影响因子:5.4
- 作者:Johnson-Peretz,Jason;Arunga,TitusO;Lee,Joi;Akatukwasa,Cecilia;Atwine,Fredrick;Onyango,Angeline;Owino,Lawrence;Camlin,CarolS
- 通讯作者:Camlin,CarolS
A multilevel health system intervention for virological suppression in adolescents and young adults living with HIV in rural Kenya and Uganda (SEARCH-Youth): a cluster randomised trial.
对肯尼亚和乌干达农村地区感染艾滋病毒的青少年和年轻人进行病毒学抑制的多层次卫生系统干预措施(SEARCH-Youth):一项整群随机试验。
- DOI:10.1016/s2352-3018(23)00118-2
- 发表时间:2023
- 期刊:
- 影响因子:0
- 作者:Ruel,Theodore;Mwangwa,Florence;Balzer,LauraB;Ayieko,James;Nyabuti,Marilyn;Mugoma,WafulaErick;Kabami,Jane;Kamugisha,Brian;Black,Douglas;Nzarubara,Bridget;Opel,Fred;Schrom,John;Agengo,George;Nakigudde,Janet;Atuhaire,HellenN;
- 通讯作者:
{{
item.title }}
{{ item.translation_title }}
- DOI:
{{ item.doi }} - 发表时间:
{{ item.publish_year }} - 期刊:
- 影响因子:{{ item.factor }}
- 作者:
{{ item.authors }} - 通讯作者:
{{ item.author }}
数据更新时间:{{ journalArticles.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ monograph.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ sciAawards.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ conferencePapers.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ patent.updateTime }}
Diane V Havlir其他文献
Dynamic choice HIV prevention with cabotegravir long-acting injectable in rural Uganda and Kenya: a randomised trial extension
乌干达和肯尼亚农村地区使用卡博特韦长效注射剂进行动态选择的艾滋病毒预防:一项随机试验扩展
- DOI:
10.1016/s2352-3018(24)00235-2 - 发表时间:
2024-11-01 - 期刊:
- 影响因子:13.000
- 作者:
Moses R Kamya;Laura B Balzer;James Ayieko;Jane Kabami;Elijah Kakande;Gabriel Chamie;Nicole Sutter;Helen Sunday;Janice Litunya;Joshua Schwab;John Schrom;Melanie Bacon;Catherine A Koss;Alex R Rinehart;Maya Petersen;Diane V Havlir;SEARCH Consortium - 通讯作者:
SEARCH Consortium
Diane V Havlir的其他文献
{{
item.title }}
{{ item.translation_title }}
- DOI:
{{ item.doi }} - 发表时间:
{{ item.publish_year }} - 期刊:
- 影响因子:{{ item.factor }}
- 作者:
{{ item.authors }} - 通讯作者:
{{ item.author }}
{{ truncateString('Diane V Havlir', 18)}}的其他基金
A Multisectoral Strategy to Address Persistent Drivers of the HIV Epidemic in East Africa
解决东非艾滋病毒流行的持续驱动因素的多部门战略
- 批准号:
10267216 - 财政年份:2020
- 资助金额:
$ 190.5万 - 项目类别:
A Multisectoral Strategy to Address Persistent Drivers of the HIV Epidemic in East Africa
解决东非艾滋病毒流行的持续驱动因素的多部门战略
- 批准号:
10085144 - 财政年份:2020
- 资助金额:
$ 190.5万 - 项目类别:
A Multisectoral Strategy to Address Persistent Drivers of the HIV Epidemic in East Africa
解决东非艾滋病毒流行的持续驱动因素的多部门战略
- 批准号:
10438844 - 财政年份:2020
- 资助金额:
$ 190.5万 - 项目类别:
Strategic antiretroviral therapy and HIV testing for youth in rural Africa
为非洲农村青年提供战略性抗逆转录病毒治疗和艾滋病毒检测
- 批准号:
10216460 - 财政年份:2018
- 资助金额:
$ 190.5万 - 项目类别:
Strategic antiretroviral therapy and HIV testing for youth in rural Africa
为非洲农村青年提供战略性抗逆转录病毒治疗和艾滋病毒检测
- 批准号:
10252946 - 财政年份:2018
- 资助金额:
$ 190.5万 - 项目类别:
Simplified Isoniazid Preventive Therapy (SPIRIT) Strategy to Reduce TB Burden
减少结核病负担的简化异烟肼预防治疗 (SPIRIT) 策略
- 批准号:
10343685 - 财政年份:2016
- 资助金额:
$ 190.5万 - 项目类别:
Simplified Isoniazid Preventive Therapy (SPIRIT) Strategy to Reduce TB Burden
减少结核病负担的简化异烟肼预防治疗 (SPIRIT) 策略
- 批准号:
10064569 - 财政年份:2016
- 资助金额:
$ 190.5万 - 项目类别:
Reducing Failure-to-Initiate ART: Streamlined ART Start Strategy (START)
减少 ART 启动失败的情况:简化的 ART 启动策略 (START)
- 批准号:
8295938 - 财政年份:2012
- 资助金额:
$ 190.5万 - 项目类别:
Reducing Failure-to-Initiate ART: Streamlined ART Start Strategy (START)
减少 ART 启动失败的情况:简化的 ART 启动策略 (START)
- 批准号:
8705385 - 财政年份:2012
- 资助金额:
$ 190.5万 - 项目类别:
Reducing Failure-to-Initiate ART: Streamlined ART Start Strategy (START)
减少 ART 启动失败的情况:简化的 ART 启动策略 (START)
- 批准号:
8613427 - 财政年份:2012
- 资助金额:
$ 190.5万 - 项目类别:
相似海外基金
I-Corps: Medication Adherence System
I-Corps:药物依从性系统
- 批准号:
2325465 - 财政年份:2023
- 资助金额:
$ 190.5万 - 项目类别:
Standard Grant
Improving Repositioning Adherence in Home Care: Supporting Pressure Injury Care and Prevention
提高家庭护理中的重新定位依从性:支持压力损伤护理和预防
- 批准号:
490105 - 财政年份:2023
- 资助金额:
$ 190.5万 - 项目类别:
Operating Grants
An innovative, AI-driven prehabilitation platform that increases adherence, enhances post-treatment outcomes by at least 50%, and provides cost savings of 95%.
%20创新、%20AI驱动%20康复%20平台%20%20增加%20依从性、%20增强%20治疗后%20结果%20by%20at%20至少%2050%、%20和%20提供%20成本%20节省%20of%2095%
- 批准号:
10057526 - 财政年份:2023
- 资助金额:
$ 190.5万 - 项目类别:
Grant for R&D
CO-LEADER: Intervention to Improve Patient-Provider Communication and Medication Adherence among Patients with Systemic Lupus Erythematosus
共同领导者:改善系统性红斑狼疮患者的医患沟通和药物依从性的干预措施
- 批准号:
10772887 - 财政年份:2023
- 资助金额:
$ 190.5万 - 项目类别:
Nuestro Sueno: Cultural Adaptation of a Couples Intervention to Improve PAP Adherence and Sleep Health Among Latino Couples with Implications for Alzheimer’s Disease Risk
Nuestro Sueno:夫妻干预措施的文化适应,以改善拉丁裔夫妇的 PAP 依从性和睡眠健康,对阿尔茨海默病风险产生影响
- 批准号:
10766947 - 财政年份:2023
- 资助金额:
$ 190.5万 - 项目类别:
Pharmacy-led Transitions of Care Intervention to Address System-Level Barriers and Improve Medication Adherence in Socioeconomically Disadvantaged Populations
药房主导的护理干预转型,以解决系统层面的障碍并提高社会经济弱势群体的药物依从性
- 批准号:
10594350 - 财政年份:2023
- 资助金额:
$ 190.5万 - 项目类别:
Unintrusive Pediatric Logging Orthotic Adherence Device: UPLOAD
非侵入式儿科记录矫形器粘附装置:上传
- 批准号:
10821172 - 财政年份:2023
- 资助金额:
$ 190.5万 - 项目类别:
Antiretroviral therapy adherence and exploratory proteomics in virally suppressed people with HIV and stroke
病毒抑制的艾滋病毒和中风患者的抗逆转录病毒治疗依从性和探索性蛋白质组学
- 批准号:
10748465 - 财政年份:2023
- 资助金额:
$ 190.5万 - 项目类别:
Improving medication adherence and disease control for patients with multimorbidity: the role of price transparency tools
提高多病患者的药物依从性和疾病控制:价格透明度工具的作用
- 批准号:
10591441 - 财政年份:2023
- 资助金额:
$ 190.5万 - 项目类别:
Development and implementation of peer-facilitated decision-making and referral support to increase uptake and adherence to HIV pre-exposure prophylaxis in African Caribbean and Black communities in Ontario
制定和实施同行协助决策和转介支持,以提高非洲加勒比地区和安大略省黑人社区对艾滋病毒暴露前预防的接受和依从性
- 批准号:
491109 - 财政年份:2023
- 资助金额:
$ 190.5万 - 项目类别:
Fellowship Programs