West Africa Self-Sampling HPV Based Cervical Cancer Control Program (WA-SS-HCCP) for WLWHA: Barriers, challenges, and needs

西非 WLWHA 基于 HPV 的自我采样宫颈癌控制计划 (WA-SS-HCCP)：障碍、挑战和需求

• 批准号: 10541742
• 负责人: JANE Louise HOLL
• 金额: $ 69.26万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-07 至 2027-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10541742
• 关键词: AIDS/HIV problem; Address; Adoption; Africa; Africa South of the Sahara; African; Cancer Control; Caring; Cervical; Cervical Cancer Education; Cervical Cancer Screening; Cessation of life; Clinic; Clinic Visits; Clinical; Collaborations; Collection; Communication; Community Health Aides; Competence; Counseling; Country; Cytology; DNA; Data; Diagnostic; Diagnostic tests; Early Diagnosis; Early treatment; Face; Female; Funding; HIV; HIV Infections; HIV Seronegativity; HPV-High Risk; Health system; Home; Human Papilloma Virus Vaccination; Human Papillomavirus; Human papilloma virus infection; Human papillomavirus 16; Immune Evasion; Immunosuppression; Incidence; Income; Infrastructure; Knowledge; Laboratories; Learning; Logistics; Maintenance; Mali; Malignant Neoplasms; Malignant neoplasm of cervix uteri; Methods; Muslim population group; Needs Assessment; Nigeria; Oncogene Activation; Patients; Persons; Prevalence; Prevention strategy; Process; Religion; Religion and Spirituality; Reporting; Research; Resources; Risk; Risk Assessment; Sampling; Secure; Sexually Transmitted Diseases; Site; Specimen; Surveys; Swab; Target Populations; Temperature; Test Result; Testing; Time; Training; Transportation; United States National Institutes of Health; Vagina; Woman; Women' s Health; base; care systems; cervical cancer prevention; cervical carcinogenesis; cervicovaginal; co-infection; collaborative approach; cost; cost effective; dashboard; early screening; effectiveness evaluation; evidence base; experience; health care settings; hospital laboratories; human papilloma virus oncogene; implementation fidelity; implementation framework; implementation strategy; improved; low and middle-income countries; novel; programs; sample collection; scale up; screening; social; social culture; social stigma; success; webinar

PROJECT SUMMARY/ABSTRACT Worldwide, 70% of new HIV infections every year occur in Sub-Saharan Africa (SSA), home to 74% of people living with HIV/AIDS (PLWHA), of whom over 50% are women. Furthermore, the highest rates of cervical cancer (CC) incidence and related death also occur in SSA, where approximately 60% of all CC cases are in women living with HIV/AIDS (WLWHA). Human Papillomavirus (HPV), amajor cause of CC, is the most common sexually transmitted infection in SSA and nearly all WLWHA worldwide who develop CC are co- infected with HPV. CC is largely preventable by HPV vaccination and cervical screening for early detection and treatment. In high income countries (HICs), these strategies have led to a steep decline in CC; however they remain largely inaccessible to women in low- and middle-income countries (LMICs). Self-sampling-based HPV (SS-HPV) tests have been shown to be a cost-effective and feasible approach to identifying women infected with high-risk HPV strains (hr-HPV) who need more advanced diagnostic tests and treatment. However, SS- HPV testing has not been widely implemented in most LMICs, including SSA despite high HIV prevalence. Leveraging our decade-long, extensive, and successful training partnership and research collaborations in Mali and Nigeria, we propose to implement a novel West African Self-Sampling HPV-Based Cervical Cancer Control Program (WA-SS-HCCP). The project capitalizes on existing strengths and resources including the HIV systems of care with Community Health Workers (CHWs) who have established relationships with WLWHA and can provide HPV and CC education/counseling and SS specimen collection guidance, rapid transportation of specimens to hospital laboratories, personalized delivery of test results directly to the women, and facilitation of clinic referrals for women with hr-HPV for advanced diagnostics and treatment. The study will conduct in-depth assessment of barriers, challenges, and needs to contextually adapt, implement, and evaluate the effectiveness and success of WA-SS-HCCP. The specific aims are to (1) Assess barriers and needs for contextual adaptations of WA-SS-HCCP among WLWHA in Mali and Nigeria, using qualitative risk assessment and observation methods; (2) Contextually adapt, using a learning collaborative approach (e.g., monthly webinars, rapid-cycle small tests of change) and an implementation framework (e.g., training to competency of CHWs, data coordination across settings, implementation dashboard) to optimize the WA-SS- HCCP across all four sites; and (3) Conduct a dual evaluation of the effectiveness (e.g., % WLWHA fully screened and % change in) and implementation (e.g., reach, adoption, implementation fidelity, and maintenance or sustainability) and develop a “WA-SS-HCCP Scale-Up Toolkit” for wide dissemination of this “detect-to-treat” program that can be expanded to HIV- women and across LMICs.

项目总结/文摘