Addressing the Intimate Partner Violence and HIV Syndemic in Kampala, Uganda: Implementation Science for Intervention Optimization and Adaptation

摘要： 这份申请概述了一个跨学科、实施科学的项目，该项目与INSTALL 合作伙伴暴力预防和艾滋病毒护理，将支持F31申请者完成学位论文 对加州大学全球卫生系实施科学博士学位的要求 华盛顿。申请者的培训目标包括培养高级定量和定性技能 研究设计和分析；加强多学科培训方法；深化责任培训 进行国际研究，发展出版记录和演讲技巧。要实现这些目标 为了实现目标，申请者组建了一支在亲密伴侣暴力、艾滋病毒治疗方面具有专业知识的导师团队 以及预防、实施科学、行为科学和流行病学。导师制团队成员 建立了合作和指导博士生的记录。这项新提出的研究 将利用赞助商正在进行的由NIMH资助的项目，该项目名为 乌干达公共卫生诊所将改善艾滋病毒血清不一致夫妇的艾滋病毒和抗逆转录病毒治疗结果 (R01MH110296；PI：Heffron)，一项持续的以夫妻为基础的综合ART/PrEP(暴露前预防) 乌干达坎帕拉的分娩干预。这份F31提案概述了涉及艾滋病毒护理和治疗的研究 参与这项家长研究的设施和提供者收集新数据，以指导 同时针对共生和交叉的全球健康的优化实施策略 艾滋病毒和亲密伴侣暴力(IPV)的挑战。该项目将通知优化和适应 在资源有限的情况下为IPV和艾滋病毒的治疗和预防提供综合服务。为此， 拟议的F31研究将利用定量、定性和实施科学研究 制定战略以优化和调整应对IPV/HIV的实施的方法 更好地描述了在夫妻范围内IPV和艾滋病毒之间的复杂联系。 目标1将评估在艾滋病毒护理环境中执行国家IPV指南的程度。目标2将 确定在艾滋病毒护理环境中实施国家IPV指南的提供者层面的障碍和促进者。目标 3将在HIV血清不一致者中评估IPV与对ART和PrEP的依从性之间的联系 情侣。在达到建议的目标后，F31申请者将非常适合从事学术生涯。 研究和编写建议，以进一步开发和测试以夫妇为基础的干预措施， 将IPV预防和治疗纳入现有艾滋病毒预防和治疗方案。

ABSTRACT: This application outlines an interdisciplinary, implementation science project related to the integration of intimate partner violence prevention and HIV care that will support the F31 applicant to complete dissertation requirements for an Implementation Science PhD through the Department of Global Health at the University of Washington. The applicant's goals for training include building skills for advanced quantitative and qualitative research design and analysis; reinforcing multidisciplinary training approaches; deepening training in responsible conduct for international research and, developing publication record and presentation skills. To achieve these goals, the applicant has assembled a team of mentors with expertise in intimate partner violence, HIV treatment and prevention, implementation science, behavioral sciences and epidemiology. Mentorship team members have established track records of collaboration and mentoring PhD candidates. The novel proposed research will leverage the Sponsor's ongoing NIMH-funded project entitled “Integrated PrEP and ART delivered in Ugandan public health clinics to improve HIV and ART outcomes for HIV serodiscordant couples” (R01MH110296; PI:Heffron), an ongoing couples-based, integrated ART/PrEP (pre-exposure prophylaxis) delivery intervention in Kampala, Uganda. This F31 proposal outlines research involving HIV care and treatment facilities and providers engaged with this parent study to collect novel data in order to guide the development of optimized implementation strategies for concurrently targeting the co-occurring and intersecting global health challenges of HIV and intimate partner violence (IPV). This project will inform the optimization and adaptation of integrated service offerings for IPV and HIV treatment and prevention in limited-resource settings. To this end, the proposed F31 research will leverage quantitative, qualitative and implementation science research approaches to elaborate strategies for optimizing and adapting implementations that address the IPV/HIV syndemic and better characterize the complex association between IPV and HIV within the context of couples. Aim 1 will evaluate the extent to which national IPV guidelines are implemented in HIV care settings. Aim 2 will identify provider-level barriers and facilitators to implementing national IPV guidelines in HIV care settings. Aim 3 will evaluate the association between IPV and adherence to ART and PrEP among HIV-serodiscordant couples. Upon achieving the proposed aims, the F31 applicant will be well-suited to pursue a career in academic research and prepare proposals to further the development and testing of couples-based interventions that integrate IPV prevention and treatment into existing HIV prevention and treatment programs.