Promoting HIV Testing and Linkage to Care in Cross-Border Migrants in Lesotho

促进莱索托跨境移民的艾滋病毒检测及其与护理的联系

• 批准号: 10483680
• 负责人: Yael R Hirsch-Moverman
• 金额: $ 19.61万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10483680
• 关键词: AIDS prevention; AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Adherence; Affect; Africa South of the Sahara; African; Age; Agricultural Workers; Appointment; Automobile Driving; Awareness; Belief; COVID-19; COVID-19 pandemic; COVID-19 pandemic effects; Caring; Characteristics; Clinic; Clinical; Collaborations; Communities; Consent; Continuity of Patient Care; Country; Custom; Data; Development; Diagnostic Reagent Kits; Economics; Employment; Epidemic; Event; Face; Female; Focus Groups; Funding; Future; Goals; HIV; HIV Infections; HIV Seropositivity; Health; Health Services Accessibility; Health care facility; Health system; Healthcare; High Prevalence; Human immunodeficiency virus test; Individual; Interruption; Intervention; Interview; Knowledge; Labor Migrations; Legal; Lesotho; Life Style; Link; Location; Measures; Meta-Analysis; Methods; Migrant; Migrant Workers; Nonmigrant; Outcome; Participant; Persons; Phase; Policies; Population; Prevalence; Prevention; Privacy; Public Health; Recommendation; Recording of previous events; Reporting; Research; Science; Services; South Africa; State Interests; Strategic Planning; Surveys; Testing; Typology; United States National Institutes of Health; Viral; Viral Load result; Vulnerable Populations; age group; antiretroviral therapy; barrier to care; base; eligible participant; experience; experimental study; health care availability; health disparity; health service use; home test; improved; innovation; innovative technologies; male; men; migration; multidisciplinary; population based; preference; prevention service; recruit; response; self testing; sex; social; social exclusion; stakeholder perspectives; support tools; testing access; testing services; testing uptake; treatment services; uptake

PROJECT SUMMARY/ABSTRACT In this R21 application (PA-20-145: Innovations in HIV Prevention, Testing, Adherence and Retention to Optimize HIV Prevention and Care Continuum Outcomes), we propose to explore the use of community or home-based testing, including self-testing (HIVST) and preferences for linkage to confirmatory testing and treatment in cross- border migrants in Lesotho, a country with very high HIV prevalence as well as high rates of mobility. Through our research done as part of the Lesotho Population-based HIV Impact Assessment (LePHIA) in 2020, we found that Lesotho has made great gains in terms of HIV viral load suppression overall, but those who had recently migrated were significantly less likely to be virally suppressed, mainly due to lack of awareness. The Ministry of Health has been rolling out HIVST as a strategy to reach men and populations who do not normally access health care. However, an increase in testing is insufficient as a public health strategy if the barriers to treatment mean that knowledge of status does not translate into engagement in antiretroviral treatment and viral suppression, diminishing the clinical and epidemic control benefits. In order to determine the best strategy for increasing testing and linkage to treatment rates in migrants, we aim to determine preferences for confirmatory testing and treatment in cross-border migrants who report that HIV testing outside the facility is acceptable. First, we will conduct formative research to explore determinants of migrant health and to understand the barriers and facilitators to testing and accessing treatment or prevention in cross-border migrants, exploring preferences regarding location, types of services, and opportunities to use health services in South Africa. Second, we will contact participants in the LePHIA 2020 who identified as recent cross-border migrants and consented to be contacted for future research. Eligible participants will be invited to complete a discrete choice experiment (DCE) on their preferences for confirmatory testing after self- or other community-based testing, and linkage to treatment. The proposed study is innovative because it is the first known attempt to use a DCE in a diverse panel of cross-border migrants, recruited from the community rather than at health facilities. We will use findings to develop an intervention to support testing and linkage in cross-border migrants.

项目总结/摘要 在此R21应用程序（PA-20-145：艾滋病毒预防、检测、依从性和保留创新，以优化 艾滋病毒预防和护理连续成果），我们建议探索使用社区或家庭为基础的 测试，包括自我测试（艾滋病毒/艾滋病）和偏好的联系，以确认测试和治疗的交叉， 莱索托是一个艾滋病毒流行率很高、流动性很高的国家，通过我们 作为2020年莱索托基于人口的艾滋病毒影响评估（LePHIA）的一部分，我们发现， 莱索托在总体上抑制艾滋病毒载量方面取得了很大进展，但那些最近移民的人 被病毒抑制的可能性要小得多，这主要是由于缺乏意识。卫生部已 我们一直在推行艾滋病毒/艾滋病防治技术，将其作为一项战略，覆盖通常无法获得医疗保健的男子和人口。 然而，如果治疗障碍意味着， 对艾滋病状况的了解并不能转化为参与抗逆转录病毒治疗和病毒抑制， 减少临床和流行病控制效益。为了确定增加测试的最佳策略， 以及与移民治疗率的联系，我们的目标是确定确认性检测和治疗的偏好， 在跨境移民中，他们报告说，在设施外进行艾滋病毒检测是可以接受的。首先，我们将进行 形成性研究，探索移民健康的决定因素，了解移民健康的障碍和促进因素， 在跨境移民中测试和获得治疗或预防，探索对地点的偏好， 服务类型，以及在南非使用卫生服务的机会。第二，我们将联系参与者， LePHIA 2020被确定为最近的跨境移民，并同意被联系以进行未来的研究。 符合条件的参与者将被邀请完成一个离散选择实验（DCE）， 自我或其他社区检测后的确证性检测，以及与治疗的联系。拟定研究 创新，因为这是第一次尝试在一个多元化的跨境移民小组中使用DCE，招募 而不是在医疗机构。我们将利用研究结果来制定干预措施，以支持测试 与跨境移民的联系。