International Epidemiology Databases to EvaluateAIDS (IeDEA) Renewal 4

项目概要/摘要 西非是艾滋病毒流行的沉重负担，约有 350 万艾滋病毒感染者 （艾滋病毒携带者）。尽管呼吁采取行动支持该地区获得普遍检测和治疗，但西非 面临重大挑战，确保根据最新的联合国艾滋病规划署的规定，提供连续的艾滋病毒护理 建议。为了应对这些核心挑战，IeDEA 西非合作机构依靠独特的 西非的队列网络，其使命是进行假设驱动的流行病学研究 艾滋病毒感染者（包括成人、青少年和艾滋病毒感染者）获得护理以及预后和结果方面的障碍 受照顾的儿童以及感染艾滋病毒的儿童。我们的五年研究计划将重点关注科学问题 贡献群体很难单独回答说英语和说英语的人之间独特的伙伴关系 该地区的法语国家。我们计划的总体具体目标是： 1) 确定 描述与艾滋病毒护理连续性相关的个人和结构性障碍，从艾滋病毒检测到保留 在整个西非的护理和病毒抑制领域，2) 利用我们现有的网络建立一个队列 IeDEA 西非的艾滋病毒重点人群（包括女性性工作者和男男性行为者）的数量，3) 确定非传染性疾病的负担并评估其与艾滋病毒感染的相互作用。我们的 合作支持了该地区最强大的流行病学和临床研究基础设施之一 地区近 40,000 名成年人（包括 883 名 HIV-2 和 843 名 HIV-1/2）和 15,814 名儿童（6,515 名儿童）的住房数据 七个国家中接触艾滋病毒的儿童、7,041 名接受抗逆转录病毒治疗的儿童和 2,258 名尚未接受抗逆转录病毒治疗的感染艾滋病毒儿童 该地区（贝宁、布基纳法索、科特迪瓦、加纳、马里、多哥和塞内加尔）。下一轮将涉及 8 个国家（贝宁、布基纳法索、科特迪瓦、加纳、马里、尼日利亚、塞内加尔和 多哥）。其中，8家诊所是新的合作中心。 IeDEA 西非合作是 法国波尔多大学与 PACCI 项目主办的区域办事处进行协调， 位于科特迪瓦阿比让的研究型非政府组织。这个研究团队有一个 在观察性艾滋病毒研究方面拥有长期的经验，包括西非的大规模前瞻性队列研究。 每年将根据标准化程序从附属队列收集数据并进行合并 在波尔多的协调中心。参与中心的能力建设将包括为当地提供资金 人力资源、数据质量培训、现场技术支持和年度会议，以加强 技术和科学网络。在本资助周期完成后，我们打算解决重大研究 差距包括更好地了解影响西非艾滋病毒感染者的各种合并症。我们的队伍将是 更能代表该地区的艾滋病毒流行情况，并将捕获关键人群的重要数据以供参考 针对这些弱势群体采取针对性干预措施。

PROJECT SUMMARY/ABSTRACT West Africa holds a significant burden of the HIV epidemic with approximately 3.5 million people living with HIV (PLHIV). Despite calls for action to support access to universal test and treat in the region, West Africa experience major challenges ensuring a continuum of HIV care in adequacy with the latest UNAIDS recommendations. To address these core challenges, the IeDEA West Africa Collaboration relies on a unique network of cohorts in West Africa with a mission to conduct hypothesis-driven epidemiological research on barriers in access to care as well as on the prognosis and outcomes of PLHIV, including adults, adolescents and children in care, as well as HIV-exposed children. Our five-year research plan will focus on scientific questions that contributing cohorts can hardly answer separately with a unique partnership between English-speaking and French-speaking countries in the region. The overarching specific aims of our program will be: 1) To identify an describe individual and structural barriers associated with the continuum of HIV care, from HIV testing to retention in care and viral suppression throughout West Africa, 2) To leverage our existing network to establish a cohort of HIV Key Populations including female sex workers and men who have sex with men in IeDEA West Africa, 3) To determine the burden of non-communicable diseases and evaluate their interplay with HIV infection. Our collaboration has supported one of the most robust epidemiological and clinical research infrastructure in the region, housing data on close to 40,000 adults (including 883 HIV-2 et 843 HIV-1/2) and 15,814 children (6,515 children exposed to HIV, 7,041 on ART and 2,258 children living with HIV not already on ART) in seven countries in the region (Benin, Burkina Faso, Côte d’Ivoire, Ghana, Mali, Togo and Senegal). The next round will involve 21 HIV clinical centers in eight countries (Benin, Burkina Faso, Cote d’Ivoire, Ghana, Mali, Nigeria, Senegal and Togo). Among them, eight clinics are new collaborating centers. The IeDEA West Africa collaboration is coordinated at the University of Bordeaux, France with a regional Office hosted by the PACCI program, a research-oriented non-governmental organization situated in Abidjan, Côte d’Ivoire. This research team has a long-lasting experience in observational HIV research including large-scale prospective cohorts in West Africa. Data will be collected from affiliated cohorts every year according to standardized procedures and will be merged at the coordinating center in Bordeaux. Capacity building in participating centers will include funding for local human resources, training on data quality, on-site technical support and annual meetings to reinforce the technical and scientific network. At the completion of this funding cycle, we intend to address major research gaps including a better knowledge the various comorbidities affecting PLHIV in West Africa. Our cohorts will be more representative of the regional HIV epidemic and will capture important data on Key Populations to inform target interventions for these vulnerable groups.