Next generation partner notification and intervention services

下一代合作伙伴通知和干预服务

• 批准号: 8729741
• 负责人: John Schneider
• 金额: $ 23.7万
• 依托单位: UNIVERSITY OF CHICAGO
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-08-15 至 2017-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8729741
• 关键词: 18 year old; AIDS prevention; Address; Adherence; Adoption; Anal Sex; Area; Attention; Behavioral; Birth; Caring; Centers for Disease Control and Prevention (U.S.); Characteristics; Chicago; Client; Clinic; Clinical; Clinical Services; Clinical Trials; Clinical assessments; Contact Tracing; Data; Development; Disease; Distal; Dose; Female; Funding; Geographic Locations; HIV; HIV risk; Imagery; Incentives; Individual; Injection of therapeutic agent; Intervention; Link; Location; Low Income Population; Manufacturer Name; Metric; Motivation; Participant; Partner Notification; Persons; Pharmaceutical Preparations; Play; Population; Positioning Attribute; Prevalence; Prevention program; Prophylactic treatment; Protocols documentation; Provider; Public Health; Randomized; Randomized Controlled Trials; Recruitment Activity; Risk; Risk Behaviors; Role; Safety; Sampling; Services; Sexual Partners; Site; Specialist; Staging; Telephone; Testing; Text; Thinking; Time; Training; Underinsured; United States Public Health Service; Woman; clinical care; cohort; design; flexibility; high risk; improved; next generation; preference; programs; public health relevance; safety net; service intervention; sex; treatment as usual

DESCRIPTION (provided by applicant): This developmental application (R34) requests funds to refine and pilot test a flexible Partner notification services Pre-exposure Prophylaxis (PS-PrEP) intervention that will engage existing department of public health (DPH) partner notification services in linkage to clinical PrEP care for at risk HIV seronegative persons from diverse backgrounds. These funds are requested because there remains a stark efficacy implementation divide following randomized controlled trials which have demonstrated partial PrEP efficacy. Following these trials, DPHs have yet to integrate PrEP into existing HIV prevention programs resulting in few people on PrEP and those who might benefit most (highest risk populations) are not receiving it. To address these gaps, we aim to integrate PrEP into existing DPH activities, and in particular, DPH partner notification services. DPH partner notification services implemented by Disease Intervention Specialists (DIS) are widespread in high HIV prevalence areas domestically and have great potential. Partner notification services (engaging the risk partners of newly infected HIV persons), is recommended by the CDC for HIV prevention and is frequently conducted by public health departments. In data from South Chicago over 50% of these risk contacts are HIV infected. This high HIV prevalence outpaces that of traditional risk groups in the same geographic area and suggests that we shift our thinking of who an appropriate candidate for PrEP linkage is from individual risk (anal sex, injecting drugs), to network risk (people connected to HIV infected persons). PS-PrEP tests the integration of PrEP into routine DPH services by training DIS staff to provide brief tailored PrEP linkage planning/motivation, mini-booster sessions via text/phone, and to directly link clients int PrEP care. PS-PrEP will set the stage for a large trial by examining two key components of early PrEP care: 1) efficacy of PS-PrEP in linking high-risk seronegative clients to PrEP care as part of partner notification services; and 2) how personal characteristics (e.g. risk behavior) and downstream PrEP cascade metrics (e.g. retention and adherence to PrEP) of study participants identified through partner notification services compare to other individuals initiating PrEP withi the same clinical context and time frame. We aim to: 1) Refine the PS-PrEP intervention protocol, materials and assessments by shifting more of the intervention to focus on direct PrEP linkage and by developing a network visualization component where participants complete an interactive sociogram of individuals in their own risk network; 2) Pilot test the feasibility (reac, adoption, safety and implementation) and initial efficacy (higher linkage to care) of the PS-PrEP intervention versus treatment as usual at 3 months post randomization among a sample of contacts >18 years old recruited from partner notification services; and 3) Compare sociodemographic, HIV risk and two distal PrEP cascade metrics (retention and adherence) of PS-PrEP intervention participants linked to PrEP care with other individuals initiating PrEP within the same clinical context and time frame (12 months).

描述（由申请人提供）：本开发申请（R34）要求提供资金，以完善和试点测试灵活的合作伙伴通知服务暴露前预防（PS-PrEP）干预措施，该干预措施将使现有的公共卫生部（DPH）合作伙伴通知服务与临床PrEP护理联系起来，为来自不同背景的高危艾滋病毒血清阴性者提供服务。之所以要求提供这些资金，是因为在已证明部分PrEP有效性的随机对照试验之后，仍然存在明显的有效性实施鸿沟。在这些试验之后，DPH尚未将PrEP纳入现有的艾滋病毒预防计划，导致PrEP的使用者很少，而那些可能受益最多的人（最高风险人群）没有接受它。为了解决这些差距，我们的目标是将PrEP纳入现有的DPH活动，特别是DPH合作伙伴通知服务。由疾病干预专家实施的DPH伙伴通知服务在国内艾滋病毒高流行地区很普遍，具有很大的潜力。合作伙伴通知服务（接触新感染艾滋病毒者的风险合作伙伴）是CDC为预防艾滋病毒而建议的，经常由公共卫生部门进行。在南芝加哥的数据中，超过50%的风险接触者是艾滋病毒感染者。这种高艾滋病毒流行率超过了同一地理区域的传统风险群体，并表明我们将我们对PrEP联系的适当候选人的想法从个人风险（肛交，注射毒品）转变为网络风险（与艾滋病毒感染者有关的人）。 PS-PrEP通过培训DIS工作人员来测试PrEP与常规DPH服务的整合，以通过文本/电话提供简短的定制PrEP联系计划/动机，迷你助推器会议，并直接将客户与PrEP护理联系起来。PS-PrEP将通过检查早期PrEP护理的两个关键组成部分为大型试验奠定基础：1）PS-PrEP在将高风险血清阴性客户与PrEP护理联系起来作为伴侣通知服务的一部分方面的功效;以及2）个人特征（例如风险行为）和 通过合作伙伴通知服务识别的研究参与者的下游PrEP级联指标（例如，保留和遵守PrEP）与在相同临床背景和时间范围内启动PrEP的其他个体进行比较。我们的目标是：1）通过将更多的干预措施转移到直接的PrEP联系上，并通过开发网络可视化组件，使参与者在自己的风险网络中完成个人的交互式社交图，来完善PS-PrEP干预方案，材料和评估;（2）可行性试验（reac，adoption，安全性和实施）和初始疗效在随机化后3个月，在接触者样本中，PS-PrEP干预与常规治疗相比（与护理的联系更高）>从伴侣通知服务招募的18岁;和3）将与PrEP护理相关的PS-PrEP干预参与者的社会人口统计学，HIV风险和两个远端PrEP级联指标（保留和依从性）与在相同临床背景和时间框架（12个月）内启动PrEP的其他个人进行比较。