Optimizing Delivery of ART/PrEP for HIV Prevention through Qualitative Research

通过定性研究优化 ART/PrEP 的实施以预防艾滋病毒

• 批准号: 8602643
• 负责人: ELLY T KATABIRA
• 金额: $ 53.2万
• 依托单位: HARVARD MEDICAL SCHOOL
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-09 至 2017-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8602643
• 关键词: AIDS prevention; AIDS/HIV problem; Address; Adherence; Africa; Africa South of the Sahara; African; Anti-Retroviral Agents; Attention; Caring; Categories; Clinical Trials; Controlled Clinical Trials; Country; Couples; Data; Data Collection; Development; Economics; Effectiveness; Ensure; Evaluation; Future; Guidelines; HIV; HIV-1; Hand; Individual; Intervention; Interview; Investigation; Joints; Link; Methods; Oral; Participant; Prevention; Preventive Intervention; Prophylactic treatment; Provider; Public Health; Qualitative Evaluations; Qualitative Research; Quantitative Evaluations; Research; Risk Reduction Behavior; Safety; Sampling; Uganda; World Health Organization; antiretroviral therapy; base; comparative; condoms; contextual factors; cost; design; efficacy trial; experience; insight; member; public health relevance; response; scale up; social; success; tool; transmission process; treatment adherence

DESCRIPTION (provided by applicant): The year 2011 marked a turning point in the three-decade search for effective HIV prevention interventions. In 2011, both early antiretroviral therapy (ART) in HIV-infected individuals and oral antiretroviral pre-exposure prophylaxis (PrEP) in uninfected individuals demonstrated high efficacy for protection against HIV transmission when used by members of HIV-1 serodiscordant couples in sub-Saharan Africa. ART and PrEP for prevention are now considered among the most promising strategies for reducing the spread of HIV. Attention is now turning to development of approaches to delivering these new prevention tools. The Partners Demonstration Project is the first-ever demonstration to deliver ART/PrEP for prevention to HIV-1 serodiscordant couples in Africa. The demonstration uses a "bridging strategy" of delivery in which ART is offered to HIV-infected partners eligible for treatment, and PrEP is offered to HIV-uninfected partners as a "bridge" to ART initiation. We propose a qualitative evaluation of the bridging strategy, to inform future global implementation and scale- up of ART/PrEP for prevention in Africa. The project takes place in Kampala, Uganda. The evaluation draws upon multiple participant groups and data collection methods for in-depth investigation. We will carry out multiple qualitative interviews with 48 couples purposefully sampled to represent various bridging strategy experiences. Interviews will be joint (partners together) and individual (partners separately), and linked to key bridging strategy transitions. Forty interviews with Demonstration Project providers and 40 observations of Project activities of care will also be conducted. An inductive, content-focused, comparative analytic approach will allow us to characterize couples' experiences of the bridging strategy and responses to ART/PrEP for prevention (Aim 1), couples' relationship dynamics (Aim 2), provider challenges (Aim 3), and broader social, cultural and economic contextual influences (Aim 4).

描述(由申请者提供)：2011年标志着三十年来寻找有效的艾滋病毒预防干预措施的转折点。2011年，撒哈拉以南非洲艾滋病毒感染者的早期抗逆转录病毒疗法(ART)和非感染者的口服抗逆转录病毒暴露前预防(PrEP)在撒哈拉以南非洲艾滋病毒-1血清不一致夫妇中使用时，都显示出预防艾滋病毒传播的高效效果。ART和PrEP预防现在被认为是减少艾滋病毒传播的最有希望的战略之一。现在，人们的注意力正转向制定提供这些新的预防工具的方法。伙伴示范项目是向非洲艾滋病毒-1血清不一致夫妇提供ART/PrEP预防的第一个示范项目。该演示采用了一种“搭桥策略”，向有资格接受治疗的艾滋病毒感染者提供抗逆转录病毒治疗，并向未感染艾滋病毒的伙伴提供PrEP，作为启动抗逆转录病毒疗法的“桥梁”。我们建议对衔接战略进行一次定性评估，以便为未来在全球实施和扩大非洲预防抗逆转录病毒治疗/预防艾滋病方案提供信息。该项目在乌干达的坎帕拉进行。评价借鉴了多个参与者群体和数据收集方法，以进行深入调查。我们将对48对夫妇进行多次定性访谈，以代表不同的搭桥策略经验。面谈将是联合的(合作伙伴一起)和个人(单独的合作伙伴)，并与关键的桥梁战略过渡联系在一起。还将对示范项目提供者进行40次访谈，并对CARE项目活动进行40次观察。一种归纳的、注重内容的比较分析方法将使我们能够描述夫妻在搭桥战略方面的经验和对ART/PrEP预防(目标1)、夫妻关系动态(目标2)、提供者挑战(目标3)以及更广泛的社会、文化和经济背景影响(目标4)的反应。