Population mobility and retention in HIV care among postpartum women in South Africa

南非产后妇女的人口流动性和艾滋病毒护理保留率

• 批准号: 9041682
• 负责人: Kate Clouse
• 金额: $ 14.32万
• 依托单位: VANDERBILT UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-04-01 至 2019-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9041682
• 关键词: Address; Adherence; Adult; Africa; Africa South of the Sahara; Aftercare; Behavioral; Birth; Birth Place; Caring; Cellular Phone; Cessation of life; Characteristics; Child; Clinic; Continuity of Patient Care; Data; Data Collection; Data Linkages; Databases; Development; Development Plans; Drops; Epidemiologist; Face; Fingerprint; Frequencies; Future; Geographic Information Systems; Goals; HIV; HIV Seropositivity; HIV diagnosis; Health; Health Services Accessibility; Healthcare; High Risk Woman; Home environment; Incentives; Individual; Infant; Intervention; Interview; K-Series Research Career Programs; Knowledge; Laboratories; Length of Stay; Life; Link; Location; Maps; Mentored Research Scientist Development Award; Mentors; Mentorship; Mothers; Motivation; Movement; Nature; Outcome; Participant; Patients; Pattern; Persons; Population; Postpartum Period; Postpartum Women; Pregnancy; Pregnant Women; Primary Health Care; Professional Organizations; Province; Qualitative Research; Reading; Recording of previous events; Registries; Reporting; Research; Research Activity; Research Methodology; Research Personnel; Research Proposals; Research Training; Rural; Services; Smart Card; Social Welfare; South Africa; Staging; System; Time; Training; Training Activity; Training Programs; Training Support; Travel; Woman; Work; career development; coping; design; effective intervention; experience; follow-up; health care availability; health care service utilization; high risk; implementation science; improved; meetings; novel; patient population; pregnant; public health relevance; residence; skills; social; social stigma; theories; voucher

 DESCRIPTION (provided by applicant): The proposed 4-year career development award will combine mentorship, training and research activities to enable me to develop the skills necessary to become an independent investigator in the field of HIV implementation science. In the latter years of this K award, I will submit a competitive R01 application to design and conduct an intervention to retain HIV-positive, postpartum women in care. My prior work found that pregnant HIV-positive women in South Africa are at particularly high risk of dropping out of care soon after delivery, but additional research is needed in order to develop targeted, effective interventions to improve continuity of care. Key unresolved questions that my research seeks to address are the lack of information about the characteristics of mobility within this population and the impact of population mobility on retention in postpartum HIV care. The K-related training program is a critical component of my career development plan, and includes mentorship meetings, didactic coursework, directed readings and discussions, seminars, and professional society meetings. As an epidemiologist, I am highly competent in quantitative analysis, but I require additional training in social and behavioral theory, selected qualitative research methods and geographic information systems (GIS) in order to address existing research questions that will inform future interventions. My K-supported research proposal has 3 AIMS: 1) to determine the frequency of "clinic shopping" and identify factors associated with clinic switching using existing databases; 2) to characterize mobility and health care utilization among pregnant and postpartum HIV-positive women; and 3) to determine the effect of mobility on retention in HIV care and adherence to ART. Project activities will take place in Johannesburg, South Africa, using existing HIV clinic data for Aim 1 and primary data collection at Witkoppen Health and Welfare Centre, a primary care clinic, for Aims 2 and 3. RELEVANCE: My work addresses a substantial knowledge gap related to population mobility and retention in HIV care among a specific population (peripartum women) at highest risk of dropping out of HIV care. Addressing these gaps will accelerate the creation of novel interventions to improve continuity of care for women in Africa. My project aims and training objectives align to enable me to develop the skills and experience to become an independent investigator with the guidance of my highly experienced mentorship committee.

 描述（由申请人提供）：拟议的4年职业发展奖将结合联合收割机导师，培训和研究活动，使我能够发展必要的技能，成为一个独立的调查员在艾滋病毒实施科学领域。在这个K奖的最后几年，我将提交一份有竞争力的R 01申请，以设计和实施一项干预措施，以留住艾滋病毒阳性的产后妇女。我之前的工作发现，南非的艾滋病毒阳性孕妇在分娩后不久就退出护理的风险特别高，但需要进行更多的研究，以制定有针对性的，有效的 采取干预措施，改善护理的连续性。我的研究旨在解决的关键未决问题是缺乏有关这一人群的流动性特征以及人口流动性对产后艾滋病毒护理保留的影响的信息。K相关培训计划是我职业发展计划的重要组成部分，包括导师会议，教学课程，指导阅读和讨论，研讨会和专业协会会议。作为一名流行病学家，我在定量分析方面能力很强，但我需要在社会和行为理论，选定的定性研究方法和地理信息系统（GIS）方面进行额外的培训，以解决现有的研究问题，为未来的干预措施提供信息。我的K支持的研究计划有3个目标：1）确定“诊所购物”的频率，并确定与诊所转换使用现有的数据库相关的因素; 2）描述流动性和卫生保健利用孕妇和产后艾滋病毒阳性妇女;和3）确定流动性对艾滋病毒护理的保留和坚持抗逆转录病毒疗法的影响。项目活动将在约翰内斯堡进行，南非，利用现有艾滋病毒诊所数据实现目标1，利用Witkoppen保健和福利中心初级保健诊所收集的初级数据实现目标2和3。相关性：我的工作解决了一个巨大的知识差距，人口流动和艾滋病毒护理中的特定人群（围产期妇女）在退出艾滋病毒护理的风险最高的保留。解决这些差距将加速创造新的干预措施，以改善非洲妇女护理的连续性。我的项目目标和培训目标一致，使我能够发展技能和经验，成为一个独立的调查员与我的经验丰富的指导委员会的指导。