Optimizing Mechanisms for Identifying Older Children with Undiagnosed HIV-1

优化识别未确诊 HIV-1 年龄较大儿童的机制

• 批准号: 8466190
• 负责人: Anjuli Dawn Wagner
• 金额: $ 3.96万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-12-16 至 2015-12-15
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8466190
• 关键词: Adolescent; Adult; Africa; Africa South of the Sahara; Caring; Child; Childhood; Clinic; Collaborations; Confidentiality; Consent; Counseling; Data; Data Collection; Diagnosis; Disclosure; Disease; Early Diagnosis; Early identification; Early treatment; Emotional; Enrollment; Epidemiology; Focus Groups; Funding; HIV; HIV-1; Health Personnel; Healthcare Systems; Home environment; Human immunodeficiency virus test; Individual; Infant; Infection; Interview; Kenya; Life; Link; Measures; Medical; Methods; Modeling; Morbidity - disease rate; Mothers; Parents; Phase; Policies; Prevention; Privacy; Provider; Public Health; Questionnaires; Recruitment Activity; Research; Resources; Risk; Screening procedure; Services; Stigmata; Structure; Testing; Time; Translating; Underserved Population; United States National Institutes of Health; Universities; antiretroviral therapy; base; cost; cost effective; cost effectiveness; follow-up; implementation science; mortality; pediatric human immunodeficiency virus; preference; programs; response; scale up; sexual debut; social; social stigma; tool; transmission process; treatment center; treatment program; uptake

DESCRIPTION (provided by applicant): This multi-disciplinary, implementation science project is nested within a larger NIH-funded study, the HIV-1 Counseling and Testing for Children at Home (CATCH) Study, which will examine uptake of, and response to, treatment in HIV-infected children identified via their parents. My sub-study will take place during the screening and enrollment phase for CATCH; we aim to develop and optimize operational mechanisms to identify undiagnosed, asymptomatic HIV-1 infected children in Kenya and bring them into HIV care. To find these undiagnosed children, we propose to access their HIV-1 infected parents through various access points at HIV testing and treatment centers and offer them either home-based or clinic-based testing for their children of unknown HIV status. Our intent is compare clinic- versus home-based testing-in terms of yield, acceptability, feasibility, and cost. In order to holistically understand the challenges and facilitators to identifying undiagnosed children through home-based or clinic-base testing, we will collect three types of data: traditional quantitative epidemiological and program data, qualitative data from parents and care providers, and cost and impact data. Through the combination of these three methods, we hope to translate the benefit of medical advances in the form of HIV testing and treatment to a currently underserved population of undiagnosed children through targeting implementation challenges. PUBLIC HEALTH RELEVANCE: In sub-Saharan Africa, there is an urgent need to evaluate and optimize programs to identify undiagnosed HIV-1 infected children. Earlier identification and treatment of HIV-infected children has the potential to decrease morbidity and mortality associated with late presentation and also to decrease transmission of HIV upon sexual debut. This project will integrate qualitative and quantitative data collection methods at individual and facility-level to evaluate the uptake, feasibility, acceptability and cost-effectiveness of home-based and clinic-based HIV testing for children born to HIV-infected adults.

描述（由申请人提供）：这个多学科的实施科学项目是嵌套在一个更大的NIH资助的研究，HIV-1咨询和测试的儿童在家里（CATCH）研究，这将检查吸收，并响应，通过他们的父母确定的艾滋病毒感染儿童的治疗。我的子研究将在CATCH的筛查和招募阶段进行;我们的目标是开发和优化操作机制，以识别肯尼亚未确诊的无症状HIV-1感染儿童，并将他们纳入HIV护理。为了找到这些未确诊的儿童，我们建议通过艾滋病毒检测和治疗中心的各种接入点访问他们感染HIV-1的父母，并为他们未知HIV状况的儿童提供家庭或诊所检测。我们的目的是比较诊所与家庭为基础的测试，在产量，可接受性，可行性和成本。为了全面了解通过家庭或诊所检测识别未确诊儿童的挑战和促进因素，我们将收集三种类型的数据：传统的定量流行病学和项目数据，来自父母和护理提供者的定性数据，以及成本和影响数据。通过结合这三种方法，我们希望通过有针对性地应对执行方面的挑战，将艾滋病毒检测和治疗形式的医疗进步的好处，转化为目前得不到充分服务的未确诊儿童群体。 公共卫生相关性：在撒哈拉以南非洲，迫切需要评估和优化方案，以确定未确诊的HIV-1感染儿童。及早发现和治疗感染艾滋病毒的儿童，有可能降低与晚发病有关的发病率和死亡率，并减少初次性行为时艾滋病毒的传播。该项目将在个人和设施一级整合定性和定量数据收集方法，以评估对感染艾滋病毒的成年人所生子女进行家庭和诊所艾滋病毒检测的接受情况、可行性、可接受性和成本效益。