Social support to retain adolescents living with HIV in care and improve ART adherence

摘要 职业目标：我致力于成为一名行为健康科学家，结合心理科学 与公共卫生有关。我的目标是开发干预措施，改善青少年艾滋病患者的预后。 全球艾滋病毒(ALWH)。职业发展：这个职业发展奖将提高我的分析能力 并提供社会网络分析、干预开发、测试和评估方面的具体培训。 在这一应用中，我寻求：1)熟练使用社交网络分析来提供干预信息 发展；2)获得基本技能，以开发基于网络的互动社会支持干预，以 保留艾滋病护理中的ALWH，提高抗逆转录病毒治疗的依从性；3)获得使用初步数据所需的培训 从这项提案中收集，以支持一项后续赠款提案，以进行一项更大规模的试验，旨在评估 拟议的干预措施。研究项目：与其他年龄段相比，南非的ALWH最少 坚持药物治疗方案，导致艾滋病毒相关发病率、死亡率、服药率上升 耐药性和艾滋病毒传播。为了改善ALWH的成果，我们必须找到创新和 吸引他们的方法，使他们继续接受艾滋病毒护理。拟议研究的总体目标是促进知识的发展 关于ALH的社会网络在其治疗相关结果中的作用，并开发基于网络的、 社会支持干预，使他们继续接受艾滋病毒护理，并增加抗逆转录病毒治疗的依从性。首先，我将进行一次 ALWH的以自我为中心的社交网络分析，以确定其社交网络的关键成员如何影响 他们对艾滋病毒护理的保留和对抗逆转录病毒治疗的坚持。接下来，我将使用ALWH的数据进行定性分析 及其网络成员确定最佳做法，以促进干预、可接受性和可行性。然后, 我将使用参与性方法调整两种基于网络的干预措施，以适应目标人群和 增加他们在艾滋病毒护理和抗逆转录病毒治疗方面的依从性。最后，我将在开普敦进行一项试点研究， 南非对干预行动进行评估。指导：我将与一位成就卓著、多学科的人一起工作 专家团队将在拟议的项目过程中为我提供支持。我的导师是约翰博士 Bartlett(杜克大学)、Michael Sweat(MUSC全球健康中心)、Linda-Gail Bekker(Desmond Tutu) 开普敦大学艾滋病毒中心)、迈克尔·雷尔夫(杜克大学)和卡尔·拉特金(约翰·霍普金斯大学 彭博公共卫生学院)和我的顾问是北卡罗来纳大学的奥黛丽·佩蒂福博士和约瑟夫·塔克博士 (北卡罗来纳大学)。未来的发展方向。该奖项还将通知未来的NIH拨款申请(R34和R01)，以优化 并在更大的研究样本中评估干预措施。

ABSTRACT Career Goal: I am committed to a career as a behavioral health scientist, integrating psychological science with public health. My goal is to develop interventions that improve outcomes among adolescents living with HIV (ALWH) globally. Career Development: This career development award will enhance my analytical skills and provide specific training in social network analysis, and intervention development, testing, and evaluation. In this application, I seek to: 1) gain proficiency in the use of social network analysis to inform intervention development; 2) gain essential skills to develop an interactive, network-based, social support intervention to retain ALWH in HIV care and improve ART adherence; 3) obtain the training needed to use preliminary data gathered from this proposal to support a follow up grant proposal for a larger trial aimed at evaluating the proposed intervention. Research Project: Compared to other age groups, South African ALWH are least adherent to medication regimens, resulting in elevated rates of HIV-related morbidity, mortality, medication resistance, and HIV transmission. To improve the outcomes of ALWH, we must identify innovative and engaging methods to retain them in HIV care. The overall goal of the proposed study is to advance knowledge on the role of ALWHs’ social networks in their treatment-related outcomes and develop a network-based, social support intervention to retain them in HIV care and increase ART adherence. First, I will conduct an egocentric social network analysis of ALWH to determine how key members of their social networks influence their retention in HIV care and ART adherence. Next, I will conduct qualitative analysis using data from ALWH and their network members to identify best practices to facilitate intervention acceptability and feasibility. Then, I will use participatory methods to adapt two network-based interventions to fit the target population and increase their retention in HIV care and ART adherence. Lastly, I will conduct a pilot study in Cape Town, South Africa to evaluate the intervention. Mentorship: I will work with a highly accomplished, multidisciplinary team of experts who will support me over the course of the proposed project. My mentors are Drs. John Bartlett (Duke University), Michael Sweat (MUSC Center for Global Health), Linda-Gail Bekker (Desmond Tutu HIV Centre, University of Cape Town), Michael Relf (Duke University), and Carl Latkin (Johns Hopkins Bloomberg School of Public Health) and my advisors are Drs. Audrey Pettifor (UNC) and Joseph Tucker (UNC). Future Directions. This award will also inform future NIH grant applications (R34 and R01) to optimize and evaluate the intervention in a larger study sample.