Community-based accompaniment with supervised antiretrovirals in Lima, Peru

在秘鲁利马以社区为基础配合监督抗逆转录病毒药物

• 批准号: 8434256
• 负责人: SONYA S SHIN
• 金额: $ 59.14万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-07-17 至 2015-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8434256
• 关键词: Address; Adherence; Adoption; Affect; Anti-Retroviral Agents; Behavior; Clinical; Clinical Trials; Communities; Complex; Control Groups; Cost Effectiveness Analysis; Country; Data; Developing Countries; Development; Directly Observed Therapy; Dose; Eligibility Determination; Enrollment; Evaluation; Failure; HIV; Health; Heterogeneity; Highly Active Antiretroviral Therapy; Income; Individual; Intervention; Life; Link; Mediating; Methods; Modeling; Outcome; Outcome Study; Participant; Patients; Peru; Play; Population Study; Poverty; Publishing; Randomized Controlled Trials; Research; Research Priority; Resources; Review Literature; Risk; Salvage Therapy; Social Network; Social support; Subgroup; Substance abuse problem; Supervision; Target Populations; Testing; Treatment Effectiveness; Treatment Efficacy; United States; Viral Load result; Visit; Vulnerable Populations; Work; antiretroviral therapy; base; cost effective; cost effectiveness; design; experience; improved; innovation; intervention effect; member; psychosocial; public health relevance; randomized trial; scale up; social capital; social stigma; standard care; standard of care; stress management; therapy design; treatment adherence; treatment strategy

DESCRIPTION (provided by applicant): We propose a cluster-randomized trial to assess the impact of community-based DOT-HAART on HIV-positive individuals and community members in Lima, Peru. We will enroll individuals living in extreme poverty who are starting either first-line HAART or salvage therapy due to virologic failure. Those residing in intervention clusters will receive 12 months of DOT-HAART. We aim to 1) assess the proportion with suppressed HIV viral load at 18 and 24 months after starting HAART among those receiving community-based DOT-HAART versus the control group; 2) compare social capital among community members in DOT-HAART versus control communities; and 3) assess the cost-effectiveness of community-based DOT-HAART. Innovative aspects of this proposal include 1) a targeted intervention for the most vulnerable subgroup of individuals starting HAART (i.e. those living in extreme poverty); 2) a community- based DOT-HAART intervention designed specifically to achieve long-term efficacy; 3) cost- effectiveness analysis; and 4) assessment of the intervention effect on community-level social capital. These study components will inform how best to design and implement DOT-HAART strategies in Peru and other resource-poor settings. By offering a practical, efficacious and cost-effective model of DOT-HAART for resource-poor settings, the findings of this study could improve global efforts to achieve excellent long-term clinical outcomes among individuals on HAART.

描述（由申请人提供）：我们提出了一个集群随机试验，以评估社区为基础的DOT-HAART对艾滋病毒阳性的个人和社区成员在利马，秘鲁的影响。我们将招募生活在极端贫困中的个体，他们因病毒学失败而开始一线HAART或挽救治疗。那些居住在干预集群将接受12个月的DOT-HAART。我们的目标是：1）评估在开始HAART治疗后18个月和24个月，接受社区DOT-HAART治疗的患者与对照组相比，HIV病毒载量受到抑制的比例; 2）比较DOT-HAART社区成员与对照社区的社会资本; 3）评估社区DOT-HAART的成本效益。这项建议的创新方面包括：（1）对开始HAART治疗的最脆弱人群（即生活在赤贫中的人）进行有针对性的干预;（2）专门为实现长期疗效而设计的基于社区的DOT-HAART干预;（3）成本效益分析;（4）评估干预对社区一级社会资本的影响。这些研究内容将为如何在秘鲁和其他资源贫乏的地区最好地设计和执行DOT-HAART战略提供信息。通过为资源匮乏的环境提供一个实用，有效和具有成本效益的DOT-HAART模型，这项研究的结果可以改善全球努力，在HAART患者中实现良好的长期临床结局。

项目成果

Burden of depression among impoverished HIV-positive women in Peru.

秘鲁贫困艾滋病毒阳性妇女的抑郁症负担。

• DOI: 10.1097/qai.0b013e31817dc3e9
• 发表时间: 2008
• 期刊: Journal of acquired immune deficiency syndromes (1999)
• 作者: Wu,DianaYing;Munoz,Maribel;Espiritu,Betty;Zeladita,Jhon;Sanchez,Eduardo;Callacna,Miriam;Rojas,Christian;Arevalo,Jorge;Caldas,Adolfo;Shin,Sonya
• 通讯作者: Shin,Sonya

Validation of 2 Spanish-Language Scales to Assess HIV-Related Stigma in Communities.

• DOI: 10.1177/2325957414547738
• 发表时间: 2015-11
• 期刊: Journal of the International Association of Providers of AIDS Care
• 作者: Franke MF;Nelson AK;Muñoz M;Cruz JS;Atwood S;Lecca L;Shin SS
• 通讯作者: Shin SS

Community-based DOT-HAART accompaniment in an urban resource-poor setting.

• DOI: 10.1007/s10461-009-9559-5
• 发表时间: 2010-06
• 期刊: AIDS and behavior
• 影响因子: 4.4
• 作者: Muñoz M;Finnegan K;Zeladita J;Caldas A;Sanchez E;Callacna M;Rojas C;Arevalo J;Sebastian JL;Bonilla C;Bayona J;Shin S
• 通讯作者: Shin S

Matching social support to individual needs: a community-based intervention to improve HIV treatment adherence in a resource-poor setting.

• DOI: 10.1007/s10461-010-9697-9
• 发表时间: 2011-10
• 期刊: AIDS and behavior
• 影响因子: 4.4
• 作者: Muñoz M;Bayona J;Sanchez E;Arevalo J;Sebastian JL;Arteaga F;Guerra D;Zeladita J;Espiritu B;Wong M;Caldas A;Shin S
• 通讯作者: Shin S

From HIV diagnosis to initiation of treatment: Social transformation among people starting antiretroviral therapy in Peru.

• DOI: 10.1177/1473325015597996
• 发表时间: 2017-01-01
• 期刊: Qualitative social work : QSW : research and practice
• 作者: Waters C;Wong M;Nelson AK;SantaCruz J;Beeson A;Pfeiffer J;Muñoz M;Castro A;Shin S
• 通讯作者: Shin S