Expanded Testing, Linkage, and Treatment for HIV Prevention Among MSM in China

扩大中国男男性接触者艾滋病毒预防的检测、联系和治疗

• 批准号: 8143063
• 负责人: STEN H. VERMUND
• 金额: $ 22.65万
• 依托单位: VANDERBILT UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-08-01 至 2014-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8143063
• 关键词: AIDS prevention; Accounting; Acquired Immunodeficiency Syndrome; Adherence; Awareness; Behavior Therapy; Behavioral; CD4 Lymphocyte Count; Caring; Centers for Disease Control and Prevention (U.S.); China; Chinese People; Cities; Clinical Trials; Clinical Trials Data Monitoring Committees; Clinical Trials Design; Clinical trial protocol document; Communities; Contracts; Counseling; Data; Documentation; Epidemiology; Event; Future; Goals; Good Clinical Practice; Government; Grant; Guidelines; HIV; HIV Infections; HIV vaccine; Health; Incidence; Individual; International; Intervention; Life; Link; Male Circumcision; Manuals; Mediation; Methods; Modeling; Monitor; Outcome Assessment; Persons; Population; Prevention; Prevention Research; Prevention approach; Preventive Intervention; Procedures; Prophylactic treatment; Protocols documentation; Randomized Clinical Trials; Relative (related person); Research; Research Priority; Risk; Risk Behaviors; Risk Reduction; Services; Site; Testing; Time; Training; Viral Load result; Virus; Western Europe; antiretroviral therapy; authority; base; behavior change; care seeking; community intervention; data management; efficacy testing; follow-up; good laboratory practice; high risk; human subject; implementation trial; improved; innovation; intervention program; mathematical model; men; men who have sex with men; patient oriented; prevent; prospective; rectal microbicide; response; success; theories; transmission process; trend; trial comparing

DESCRIPTION (provided by applicant): The success of global HIV control efforts for men who have sex with men (MSM) will depend on how effective and sustainable the interventions are, but also how efficiently the intervention programs are implemented. A testable hypothesis is that a package of prevention interventions may have a substantial impact even if single approaches are less impressive. We further hypothesize that combination interventions will be even more sustainable than isolated interventions, due to improved community support of a popular package of services. One package of HIV-specific interventions has been termed "test-and-linkage-to-care" (TLC). The theory behind TLC is that the increase in the proportion of HIV-infected persons who know their status, are bridged to HIV combination antiretroviral therapy (cART)-based care, and who adhere to cART will reduce the amount of virus circulating in a community. TLC integrated with risk reduction intervention and formulated at the individual-level can facilitate one's engagement and commitment in care, reducing infectiousness to others at the same time that personal health is enhanced and restored. TLC seeks to reduce "community viral load," reducing the risk to uninfected persons by reducing the infectiousness of HIV-infected individuals. Our goal in this one-year clinical trial planning (R34) grant is to prepare for a community-level randomized clinical trial (RCT) to test the efficacy of our multicomponent TLC intervention package to reduce HIV incidence among MSM in China. By collaborating with Chinese CDC networks and local MSM community based organizations, we will develop all documents required for initiation of an RCT, complete all local, federal, and international human subjects and regulatory approvals necessary for implementation of the trial, and identify clinical trial sites and establish community advisory boards for a clinical trial. At the end of the study, we will have a RCT protocol ready for testing two research hypotheses: (1) MSM in communities receiving 24 months of TLC intervention will achieve a reduction in HIV incidence relative to MSM in standard prevention communities; and (2) TLC intervention will improve secondary and intermediary indicators of treatment success and risk reduction, compared to the standard prevention approaches. PUBLIC HEALTH RELEVANCE: Our study proposal represents an innovative adaptation of an integration of biomedical and behavioral methods of HIV prevention whose promise is supported by epidemiological data, but has never been tested in a clinical trial design in China. This grant will prepare a clinical trial in which men who have sex with men (MSM) in China who are unaware of their status will be tested and those HIV-infected MSM will benefit from prolonged life by available cART. The patient-centered prevention will be able to target the unrecognized individuals with HIV infections or at high risk of contracting HIV such that the further transmission can be prevented effectively.

描述（由申请人提供）：全球对男男性行为者（MSM）的艾滋病控制工作的成功将取决于干预措施的有效性和可持续性，但也取决于干预方案的实施效率。一个可检验的假设是，一揽子预防干预措施可能产生重大影响，即使单一的方法不那么令人印象深刻。我们进一步假设，由于社区对一揽子流行服务的支持得到改善，联合干预措施将比孤立的干预措施更具可持续性。一套针对艾滋病毒的干预措施被称为“检测-联系-护理”（TLC）。TLC背后的理论是，了解自己状况的艾滋病毒感染者比例的增加，能够接受以艾滋病毒抗逆转录病毒联合疗法（cART）为基础的护理，并坚持cART的人将减少社区中传播的病毒数量。TLC与降低风险干预相结合，并在个人层面制定，可促进个人参与和承诺护理，减少对他人的传染性，同时增强和恢复个人健康。TLC旨在减少“社区病毒载量”，通过降低艾滋病毒感染者的传染性来降低未感染者的风险。

项目成果

Country level homophobia and protective sexual health behaviours among HIV negative or untested men who have sex with men in 45 countries.

45 个国家艾滋病毒呈阴性或未经检测的男男性行为者中的国家级恐同症和保护性性健康行为。

• DOI: 10.1080/09540121.2020.1766662
• 发表时间: 2020
• 期刊: AIDS care
• 影响因子: 1.7
• 作者: Melendez-Torres,GJ;Noori,Teymur;Pharris,Anastasia;Spiteri,Gianfranco;Garner,Alex;Alba,Beatrice;Bourne,Adam
• 通讯作者: Bourne,Adam