IPrEP: A Combination HIV Prevention Strategy for Young Women at Risk for HIV

IPrEP：针对面临艾滋病毒风险的年轻女性的艾滋病毒综合预防策略

基本信息

批准号：
9355701
负责人：
Kawango Agot
金额：
$ 54.03万
依托单位：
COLUMBIA UNIVERSITY HEALTH SCIENCES
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：
2016-09-22 至 2021-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9355701
关键词：
AIDS prevention Address Adherence Adverse effects Affect Africa South of the Sahara Age-Years Area Attention Attitude Behavior Therapy Behavior assessment Behavioral Biological Client Collaborations Cost Effectiveness Analysis Counseling Country Discipline of Nursing Economics Effectiveness Epidemic Epidemiology Evidence based intervention Face Feasibility Studies Financial compensation Funding Gatekeeping General Population Geography Goals Government HIV HIV Infections HIV prevention trial HIV risk Health Personnel Heterosexuals Human immunodeficiency virus test Incidence Individual Infection Injecting drug user Internet Intervention Intervention Studies Interview Kenya Knowledge Life Light Link Measures Men&apos s Role Methods Motivation Nurses Nursing Education Nursing Faculty Nursing Staff Nursing Students Oral Perception Pharmaceutical Preparations Play Population Populations at Risk Prevalence Prevention Prevention approach Prevention program Prevention strategy Preventive Intervention Public Health Qualitative Research Randomized Controlled Trials Recruitment Activity Research Research Design Research Infrastructure Research Priority Research Project Grants Resistance development Resources Risk Risk Behaviors Risk Reduction Series Sexual Partners Social Network Study models Universities Vulnerable Populations Woman Work brief intervention cohort community organizations compare effectiveness cost effectiveness design efficacy study evidence base experience female sex worker high risk implementation research implementation science innovation male men men who have sex with men neglect peer support pre-exposure prophylaxis preference prevention service programs public health relevance risk perception scale up sex social stem transmission process uptake willingness young woman

项目摘要

DESCRIPTION (provided by applicant): Key populations within the generalized HIV epidemic in sub-Saharan Africa (SSA) have received insufficient attention including female sex workers (FSWs), a group with HIV prevalence substantially higher than the general population and a major contributor to the HIV epidemic in Kenya. Young FSWs (18-24 years old), a vulnerable population, are at highest risk among FSWs and require tailored biomedical, behavioral and structural interventions to counter the epidemiological and contextual complexities they face. We propose the IPrEP Research Project which includes: 1) formative research, inclusive of qualitative research among young FSWs, male clients (MCs) to elucidate life challenges, motivations and perceptions of HIV risks; risk behaviors; knowledge, attitudes about HIV and HIV prevention, including PrEP; preferences for adherence support; and sex partner relations. Interviews with health care providers (HCPs) will assess knowledge regarding HIV prevention and PrEP and attitudes towards FSWs; 2) an enhanced oral pre-exposure prophylaxis (PrEP) study among young FSWs to determine the uptake, adherence, feasibility and acceptability of combination strategy of PrEP, a biomedical intervention, with behavioral and structural adherence interventions (peer support versus reminders and resource transfer) and risk-reduction counseling intervention; 3) feasibility study for recruitment and retention of MCs with assessment of acceptability of risk-reduction counseling intervention; 4) cost-effectiveness analysis in collaboration with University of Nairobi (UoN) of the combination PrEP strategies to inform implementation and scale-up and 5) capacity building in implementation research for nurse faculty and students at UoN building on PEPFAR Nursing Education Partnership Initiative (NEPI) experience and infrastructure. The proposed research is distinguished by several innovations, including focus on young FSW, a population a high risk in a geographic HIV hotspot in Kenya, as well as on MCs and HCPs who play key roles in access by FSWs to prevention services and to prevention methods. The research includes implementation of theoretically- driven combination prevention strategies inclusive of biomedical, behavioral and structural interventions and an intervention aimed to decrease sexual risk compensation and risk behaviors; the assessment of HCPs' knowledge and attitudes regarding HIV prevention, including PrEP, and FSWs; cost-effectiveness analysis to inform implementation and scale-up within PEPFAR-supported programs, as well as a commitment to building capacity to design, implement and analyze findings from implementation studies working with nursing partner. The ultimate goal of our research is to identify how PrEP can be effectively implemented for this young population at substantial risk for HIV decreasing their risk of HIV acquisition, consequently diminishing the overall number of new HIV infections in Kenya and similar settings. Findings from this research will also inform PEPFAR as it aims to stem the spread of HIV through the effective use of evidence-based interventions.

描述（由适用提供）：撒哈拉以南非洲（SSA）中普遍的艾滋病毒流行中的关键人群（包括女性性工作者（FSWS））的关注不足，女性性工作者（FSWS），艾滋病毒患病率大大高于一般人群，并且是肯尼亚HIV流行病的主要贡献者。年轻的FSW（18-24岁）是一个脆弱的人群，在FSW中处于最高风险，需要量身定制的生物医学，行为和结构干预措施，以应对他们所面临的流行病学和上下文复杂性。我们提出了IPREP研究项目，其中包括：1）形成性研究，包括年轻FSW，男性客户（MCS）的定性研究，以阐明对HIV风险的生活挑战，动机和看法；风险行为；知识，关注艾滋病毒和艾滋病毒预防，包括准备；遵守支持的偏好；和性伴侣关系。对医疗保健提供者（HCP）的访谈将评估有关预防HIV和PREP并参加FSW的知识； 2）在年轻FSW中进行了增强的口服预防前预防（PREP）研究，以确定PREP的摄取，遵守，可行性和可接受性，并通过行为和结构性遵守干预措施（同行支持与提醒和资源转移）以及风险降低的干预措施以及行为和结构性的遵守干预措施，以及生物医学干预措施以及行为和结构性的依从性干预； 3）评估降低风险降低干预的可接受性的可行性研究； 4）与内罗毕大学（UON）合作的成本效益分析，以为实施和规模提供限制的组合准备策略，以及5）PEPFAR护理教育教育伙伴关系计划（NEPI）的经验和基础设施的UON Building实施研究的能力建设。拟议的研究以几项创新为特色，包括关注年轻FSW，肯尼亚地理艾滋病毒热点的高风险，以及在FSW访问预防服务和预防方法中发挥关键作用的MCS和HCP。该研究包括实施理论驱动的组合预防策略，包括生物医学，行为和结构干预措施，以及旨在减少性风险补偿和风险行为的干预措施；评估HCP的知识和有关预防HIV的知识，包括PREP和FSW；成本效益分析，以告知PEPFAR支持计划中的实施和扩大规模，并致力于建立与护士合作伙伴一起设计，实施和分析研究结果的能力。我们研究的最终目的是确定如何有效地为年轻人人群实施PREP，该人群具有艾滋病毒的重大风险降低其艾滋病毒收购风险，从而减少了肯尼亚新的HIV感染的总数和类似情况。这项研究的结果还将告知PEPFAR，因为它旨在通过有效利用基于证据的干预措施来阻止艾滋病毒的传播。