Controlled Trial of Game Changers: A Group Intervention to Train HIV Clients to be Change Agents for HIV Prevention in Uganda

游戏规则改变者的对照试验：培训艾滋病患者成为乌干达艾滋病毒预防变革推动者的集体干预

• 批准号: 10543214
• 负责人: Laura M Bogart
• 金额: $ 18.8万
• 依托单位: RAND CORPORATION
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-06 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10543214
• 关键词: AIDS prevention; Address; Adherence; Advocacy; Behavior; Characteristics; Client; Continuity of Patient Care; Data; Disclosure; Epidemic; Evaluation; Frequencies; Funding; Government; Growth; HIV; Human immunodeficiency virus test; Incidence; Individual; Intervention; Life Cycle Stages; Literature; Logistics; Modeling; Outcome; Parents; Participant; Persons; Politics; Prevention; Process; Research; Role; Social Network; Stigmatization; Structure; System; Testing; Time; Training; Trust; Uganda; Unsafe Sex; Viral; behavioral outcome; cost; density; feature detection; follow-up; group intervention; indexing; intervention effect; member; pre-exposure prophylaxis; research study; social stigma; social structure; sociodemographics

ABSTRACT In Uganda, 1.5 million individuals are living with HIV where there are persistent gaps in the HIV care continuum and prevention efforts. Barriers such as government funding and political and cultural challenges, have impeded HIV prevention and have led to projections of rapid increases in HIV incidence. HIV prevention advocacy efforts in which people living with HIV (PLWH) initiate conversations about HIV and provide HIV prevention information to people in their social networks can be a low-cost approach to addressing the epidemic. The assessment of social networks in the context of HIV research to date has been cross-sectional, yet network relationships and memberships are dynamic in that they change over the life course, potentially impacting HIV behavior over the time. Thus, using data from the parent study, the proposed supplement seeks to further understand how, when, and why social networks change over time and their impact on HIV prevention behavior and outcomes. The specific aims are: 1) To examine cross-sectional associations between HIV-related outcomes on the part of index PLWH participants (ART adherence, condomless sex, viral suppression among index participants) with individual-level factors (socio-demographic characteristics, social roles, internalized HIV stigma), dyadic-level relational factors (trust, frequency of contact, HIV disclosure, and HIV prevention advocacy with alters), social network composition (e.g., proportion of alters who are stigmatizing, proportion of alters who use PrEP, proportion of alters who are tested for HIV) and network structure (e.g., density or connections among alters) among the PLWH index participants; and 2) To explore longitudinally, over 12 months, how changes in HIV-related outcomes, individual-level factors, and dyadic-level factors change in conjunction with changes in social network composition (e.g., reduced proportion of alters who are stigmatizing, increased proportion who use PrEP and are tested) and structure (e.g., increased density) over time among the PLWH index participants. The proposed supplement study will use data from the parent study’s first 100 PLWH participants and their alters (approximately 300) at baseline and 6- and 12- month follow-up. We will examine cross-sectional associations of network structure and composition with individual- and dyadic-level factors using bivariate cross-tabulations, and regressions using a feature detection approach. Latent growth models (LGM), parallel process LGM and auto-logistic actor attribute models will be used to assess how the network system impacts HIV outcomes longitudinally. This study could greatly aid ongoing efforts to reduce HIV incidence by providing a deeper understanding of the effects of social network dynamics on HIV outcomes across time.

摘要 在乌干达，有150万艾滋病毒感染者，而艾滋病毒护理连续性持续存在差距 和预防工作。政府资助以及政治和文化挑战等障碍， 这阻碍了艾滋病毒的预防，并导致艾滋病毒发病率预计迅速上升。艾滋病毒预防 艾滋病毒感染者（PLWH）发起关于艾滋病毒的对话并提供艾滋病毒 向社交网络中的人提供预防信息，可以是解决 疫情迄今为止，在艾滋病毒研究背景下对社交网络的评估是跨部门的， 然而，网络关系和会员资格是动态的，因为它们可能会在生命过程中发生变化， 影响艾滋病病毒的传播。因此，利用母研究的数据，拟议的补编力求 进一步了解社交网络如何、何时以及为何随着时间的推移而发生变化，以及它们对艾滋病毒的影响 预防行为和结果。具体目标是：1）检查以下因素之间的横截面关联 指标PLWH参与者的HIV相关结局（ART依从性、无安全套性行为、病毒感染） 指数参与者之间的抑制）与个人层面的因素（社会人口特征，社会 角色，内化的艾滋病毒污名），二元水平的关系因素（信任，接触频率，艾滋病毒披露， 艾滋病毒预防宣传与改变），社会网络组成（例如，改变者的比例 污名化，使用PrEP的改变者比例，接受艾滋病毒检测的改变者比例）和网络 结构（例如，密度或改变之间的连接）之间的PLWH指数参与者;和2）探索 在12个月的时间里，HIV相关结局、个体水平因素和二元水平因素的变化 因素随着社交网络组成的改变而改变（例如，改变比例减少 谁是污名化，增加比例谁使用PrEP和测试）和结构（例如，增加 密度）随时间推移在PLWH指数参与者中。拟议的补充研究将使用来自 母研究的前100名PLWH参与者及其基线时的改变（约300人）和6- 12 - 14 - 16 - 17 - 18 - 19 - 10 - 19 - 1 月随访。我们将研究网络结构和组成的横截面关联， 使用双变量交叉表的个体和二元水平因子，以及使用特征检测的回归 approach.潜在增长模型（LGM），并行处理LGM和自动逻辑演员属性模型将被 用于评估网络系统如何纵向影响艾滋病毒结果。这项研究可以极大地帮助 通过更深入地了解社会网络的影响，不断努力减少艾滋病毒的发病率 艾滋病毒感染的结果。