Optimizing Pre-exposure Prophylaxis Use among Adolescent Girls and Young Women Seeking Reproductive Health Care in Kenya

优化肯尼亚寻求生殖保健的少女和年轻妇女的暴露前预防用药

• 批准号: 10509394
• 负责人: Yasaman Zia
• 金额: $ 4.02万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-17 至 2023-06-15
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10509394
• 关键词: AIDS prevention; Address; Adherence; Adolescent; Africa South of the Sahara; Age; Behavioral Research; Behavioral Sciences; Benchmarking; Biological Assay; Caring; Child; Client; Clinic; Collaborations; Counseling; County; Data; Drops; Epidemic; Epidemiologic Methods; Epidemiology; Equation; Face; Family Planning; Family Planning Programs; Fellowship; Female Adolescents; Foundations; Frequencies; Funding; Future; HIV; HIV Infections; HIV Seronegativity; HIV risk; Healthcare; High Risk Woman; Incidence; Individual; Infection; Intervention; Interviewer; Investments; Kenya; Learning; Life; Maternal Health Services; Measurable; Measures; Medical; Medical Research; Mentors; Methods; Modeling; Outcome; Parents; Pattern; Population; Positioning Attribute; Postabortion; Pregnancy; Prevention; Prevention Research; Prevention strategy; Questionnaires; Reproductive Health; Research; Research Institute; Risk; Safety; Savings; Services; Sex Behavior; Sexual Health; Sexual Partners; Shapes; Social support; Specific qualifier value; Standardization; Time; Training; Training Programs; Universities; Urine; Washington; Woman; Work; adolescent sexual health; base; care providers; career; clinical epidemiology; condoms; contextual factors; epidemiology study; experience; health empowerment; high risk; innovation; male; novel; point of care; pre-doctoral; pre-exposure prophylaxis; programs; psychologic; risk perception; scale up; social; tool; unintended pregnancy; uptake; vulnerable adolescent; young woman

PROJECT ABSTRACT This proposal aims to investigate the factors that shape Kenyan adolescent girls and young women's (AGYW) experiences of HIV pre-exposure prophylaxis (PrEP). The “PrEP cascade” specifies measurable benchmarks from which the implementation of PrEP programs can be assessed to optimize and determine program engagement. PrEP cascade outcomes include the frequency of PrEP initiation, refills and adherence at 1-, 3-, and 6-months, and long-term PrEP program retention among HIV-negative individuals with HIV risk. Kenyan AGYW, between the ages of 15-24, face parallel epidemics of HIV and unintended pregnancy and have a ≥2- fold higher incidence of HIV than their male counterparts. Integration of PrEP within post-abortion care (PAC) settings is a crucial step in successfully strengthening the prevention of HIV among AGYW, especially in view of the age-specific social and psychological vulnerabilities of AGYW. Several programs integrating PrEP into family planning or maternal and health services cite frequent PrEP discontinuation, especially among AGYW. This project will leverage an ongoing PrEP scale-up project in PAC clinics in Kenya to identify challenges that AGYW face in PrEP use. This study seeks to address a critical gap in HIV prevention research and PrEP scale-up by: 1) assessing PrEP cascade outcomes in a socioecological framework of individual, interpersonal, and contextual factors; 2) measuring adolescent sexual and reproductive health empowerment, with a novel and adapted tool, in association with PrEP program retention; and 3) evaluating prevention-effective adherence in the alignment between sexual behaviors and PrEP adherence, measured through point-of-care urine assay. By integrating research grounded in behavioral science and clinical epidemiology methods, the research will provide a holistic perspective of adolescent experiences that influence PrEP care and provide new evidence of AGYW in PAC settings, who remain understudied and at high risk of HIV.

项目摘要 这项提议旨在调查影响肯尼亚青春期女孩和年轻妇女(AGYW)的因素 HIV暴露前预防(PrEP)的体会“PrEP级联”规定了可测量的基准 从中可以评估PrEP计划的实施情况，以优化和确定计划 订婚。PREP级联结果包括PrEP启动的频率、1-、3-、 在艾滋病毒阴性、有艾滋病毒风险的个人中保留6个月和长期的PrEP计划。肯尼亚人 年龄在15-24岁之间的AGYW面临着艾滋病毒和意外怀孕的平行流行，并患有≥2- 艾滋病毒的发病率是男性的两倍。将PrEP纳入流产后护理(PAC) 环境是在AGYW中成功加强艾滋病毒预防的关键一步，特别是考虑到 AGYW特定年龄段的社会和心理脆弱性。将PrEP整合到家庭中的几个方案 规划或孕产妇和保健服务提到经常停止实施初级保健方案，特别是在青年妇女中。这 该项目将利用肯尼亚PAC诊所正在进行的PrEP扩大项目，以确定AGYW 面孔在PrEP中的使用。这项研究试图通过以下方式解决艾滋病毒预防研究和PrEP推广方面的一个关键差距： 1)在个人、人际和背景的社会生态框架中评估PrEP级联结果 因素；2)用一种新的和适当的工具衡量赋予青春期性健康和生殖健康的权力， 与PrEP计划保留相关联；以及3)评估预防--在调整中有效遵守 性行为和PrEP依从性之间的关系，通过护理点尿液分析来衡量。通过集成 研究以行为科学和临床流行病学方法为基础，研究将提供一个整体的 透视影响PrEP护理的青少年经历并为PAC中AGYW提供新的证据 环境，这些人仍未得到充分研究，感染艾滋病毒的风险很高。