Intervention for Sustained Testing and Retention (iSTAR) Among HIV-infected Patients
HIV 感染者持续检测和保留干预 (iSTAR)
基本信息
- 批准号:9337549
- 负责人:
- 金额:$ 25.5万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2016
- 资助国家:美国
- 起止时间:2016-09-02 至 2018-03-31
- 项目状态:已结题
- 来源:
- 关键词:15 year oldAccountingAcquired Immunodeficiency SyndromeAddressAfrica South of the SaharaAttitudeB-LymphocytesBehaviorCaliforniaCaringCase ManagementChicagoChildChildhoodChurchClergyClimateClinicClinicalCluster randomized trialCollaborationsCommunitiesContinuity of Patient CareControl GroupsCountryDevelopmentDiagnosisEducational InterventionEffectivenessEffectiveness of InterventionsEvaluationFemale of child bearing ageFundingFunding AgencyGenerationsGenotypeGoalsHIVHIV InfectionsHIV diagnosisHealthHepatitis BHuman immunodeficiency virus testIndividualInfantInfectionInstitutionInterventionLaboratoriesLeadershipLifeLinkMaintenanceMediationMethodsMother-to-child HIV transmissionNevadaNigeriaOutcomeParticipantPathway AnalysisPatientsPerceptionPhasePolicy MakerPregnancyPregnant WomenPreparationPreventionPrevention programRandomizedResourcesRiskSickle CellSiteSocial NetworkStagingTestingTrainingTreatment CostUniversitiesViralViral Load resultWomanantiretroviral therapybasecare deliverycohesioncollegecomparative effectivenessdesigneducation accesseffectiveness trialfollow-upimplementation sciencemotivational enhancement therapyprimary outcomeprogramsretention ratesecondary outcomeskillssocial stigmatrial design
项目摘要
DESCRIPTION (provided by applicant): Globally, Nigeria has the 2nd largest number of: a) people living with HIV, b) new HIV infections, and c) pregnant women living with HIV. In 2013 only 17.1% of women of childbearing age 15-49 years received an HIV test (preceding 12-months) and only 27% of the estimated 190,000 HIV-infected pregnant women in Nigeria who delivered babies received antiretroviral therapy for prevention of mother-to-child HIV transmission (PMTCT), compared to 68% of pregnant women receiving ART overall in sub-Saharan Africa (SSA). Nigeria accounts for 25% of new childhood HIV infections among the 21 priority countries (estimated 51,000 new infections). Roughly 49% of HIV-infected pregnant women in SSA are lost to follow up between registration in antenatal care and delivery, and 45% of infants are lost after HIV testing. Nigeria has high loss to follow-up (15%-56%) among HIV-infected women and children. In 2014, we demonstrated that the Healthy Beginning Initiative (HBI), a congregation-based intervention delivered by church-based health teams, was more effective in increasing HIV testing among pregnant women compared to a clinic-based approach. HBI uses church organized baby showers to engage and identify women early in pregnancy, combines educational intervention with integrated, on-site laboratory testing designed to reduce stigma associated with HIV-only testing. Baby receptions facilitate post-delivery follow-up and linkage to care. HBI addresses several barriers to HIV testing: perception of low risk to infection (education), access to testing and treatment, and cost and stigma (on-site, free, integrated testing). At least one faith-based institution is in each community, presenting a unique opportunity to evaluate the effectiveness of iSTAR, an integrated community and clinic based intervention that is designed to test, link, engage and sustain HIV-infected women in care. We propose a cluster randomized comparative effectiveness trial of iSTAR versus a clinic-based approach (CG). We will assess linkage, engagement, retention and viral suppression among 400 HIV-infected women. Based on the EPIS framework, we will use social network intervention methods to facilitate implementation and also assess implementation leadership and context. Fifty churches in south-south Nigeria will be randomly assigned (1:1) to iSTAR or CG. The iSTAR intervention provides: confidential, onsite integrated laboratory testing during baby showers; a network of church-based health advisors; clinic based teams trained in motivational interviewing; quality improvement skills to engage and support HIV-infected women; and integrated case management to reduce loss to follow-up. Primary outcomes are difference in linkage and engagement rates between iSTAR and CG. Secondary outcomes are difference in retention and viral suppression rate. This proposal is a collaboration among University of Nigeria (PEPFAR-funded partner in Nigeria [training and local project oversight]; University of Southern California (network analysis); UC San Diego (implementation science); UIC Chicago (assessment of sustainment); Nevada State College (statistical analyses and mediation/moderation analysis), and University of Nevada, Las Vegas (overall oversight of program implementation and evaluation).
描述(由申请人提供):在全球范围内,尼日利亚的以下人数排名第二:a) 艾滋病毒感染者,b) 新发艾滋病毒感染者,以及 c) 艾滋病毒孕妇感染者。 2013 年,只有 17.1% 的 15-49 岁育龄妇女接受了艾滋病毒检测(12 个月前),尼日利亚估计有 190,000 名艾滋病毒感染孕妇分娩后,只有 27% 接受了抗逆转录病毒治疗以预防艾滋病毒母婴传播 (PMTCT),而撒哈拉以南非洲地区接受抗逆转录病毒治疗的孕妇总数为 68% (SSA)。在 21 个重点国家中,尼日利亚占新增儿童艾滋病毒感染人数的 25%(估计新增感染人数为 51,000 人)。 SSA 中大约 49% 的感染 HIV 的孕妇在产前护理登记和分娩之间失访,45% 的婴儿在 HIV 检测后失访。尼日利亚感染艾滋病毒的妇女和儿童的失访率很高(15%-56%)。 2014 年,我们证明,健康起点计划 (HBI) 是一种由教会卫生团队提供的以会众为基础的干预措施,与基于诊所的方法相比,在增加孕妇艾滋病毒检测方面更有效。 HBI 利用教会组织的婴儿送礼会来吸引和识别怀孕早期的女性,将教育干预与综合的现场实验室检测相结合,旨在减少与仅艾滋病毒检测相关的耻辱。婴儿接待有助于产后跟进和护理联系。 HBI 解决了 HIV 检测的几个障碍:感染风险低的认知(教育)、获得检测和治疗的机会以及成本和耻辱(现场、免费、综合检测)。每个社区至少有一个基于信仰的机构,为评估 iSTAR 的有效性提供了独特的机会,iSTAR 是一种基于社区和诊所的综合干预措施,旨在测试、联系、吸引和维持接受护理的艾滋病毒感染妇女。我们提出了一项 iSTAR 与基于临床的方法 (CG) 的整群随机比较有效性试验。我们将评估 400 名 HIV 感染女性的联系、参与、保留和病毒抑制。基于EPIS框架,我们将使用社交网络干预方法来促进实施,并评估实施领导力和背景。尼日利亚南南部的 50 个教堂将被随机分配(1:1)到 iSTAR 或 CG。 iSTAR 干预措施提供: 迎婴派对期间的保密现场综合实验室测试;以教会为基础的健康顾问网络;接受过动机访谈培训的诊所团队;吸引和支持艾滋病毒感染妇女的质量改进技能;综合案例管理以减少后续损失。主要结果是 iSTAR 和 CG 之间的联系和参与率的差异。次要结果是保留率和病毒抑制率的差异。该提案是尼日利亚大学(PEPFAR 资助的尼日利亚合作伙伴[培训和当地项目监督]、南加州大学(网络分析)、加州大学圣地亚哥分校(实施科学)、UIC 芝加哥分校(维持评估)、内华达州立学院(统计分析和调解/调节分析)和内华达大学拉斯维加斯分校(项目实施和评估的总体监督)之间的合作。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Echezona Edozie Ezeanolue其他文献
Echezona Edozie Ezeanolue的其他文献
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{{ truncateString('Echezona Edozie Ezeanolue', 18)}}的其他基金
Adolescent Coordinated Transition (ACT) to Improve Health Outcomes among Nigerian HIV Youth
青少年协调过渡 (ACT) 旨在改善尼日利亚艾滋病毒青少年的健康状况
- 批准号:
9206425 - 财政年份:2016
- 资助金额:
$ 25.5万 - 项目类别:
Point-of-Delivery Prenatal Test Results through mHealth to Improve Birth Outcome
通过移动医疗提供分娩点产前检测结果以改善出生结果
- 批准号:
9020158 - 财政年份:2015
- 资助金额:
$ 25.5万 - 项目类别:
Point-of-Delivery Prenatal Test Results through mHealth to Improve Birth Outcome
通过移动医疗提供分娩点产前检测结果以改善出生结果
- 批准号:
9149340 - 财政年份:2015
- 资助金额:
$ 25.5万 - 项目类别:
Comparative Effectiveness of Congregation and Clinic Based Approaches to PMTCT
基于会众和临床的 PMTCT 方法的比较效果
- 批准号:
8551683 - 财政年份:2012
- 资助金额:
$ 25.5万 - 项目类别:
Comparative Effectiveness of Congregation and Clinic Based Approaches to PMTCT
基于会众和临床的 PMTCT 方法的比较效果
- 批准号:
8433153 - 财政年份:2012
- 资助金额:
$ 25.5万 - 项目类别:
Comparative Effectiveness of Congregation and Clinic Based Approaches to PMTCT
基于会众和临床的 PMTCT 方法的比较效果
- 批准号:
8879485 - 财政年份:2012
- 资助金额:
$ 25.5万 - 项目类别:
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