Creating a Global fRAmework of Data collection Used for Adolescent HIV Transition Evaluation (GRADUATE)

创建用于青少年艾滋病毒过渡评估的全球数据收集框架（研究生）

• 批准号: 9321396
• 负责人: Mary-Ann Davies
• 金额: $ 11.98万
• 依托单位: FOUNDATION FOR AIDS RESEARCH
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-08-01 至 2019-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9321396
• 关键词: Address; Adolescence; Adolescent; Adolescent and Young Adult; Adult; Africa South of the Sahara; Age; Asia; Behavioral; Caring; Categories; Childhood; Clinic; Clinical; Computer software; Consensus; Country; Data; Data Collection; Databases; Development; Diagnostic radiologic examination; Ensure; Epidemic; Epidemiologic Monitoring; Evaluation; Failure; Family; HIV; Healthcare; Income; Individual; Infant; Infection; Information Systems; Internist; Intervention; Laboratories; Long-Term Survivors; Malawi; Measurement; Methods; Outcome; Patients; Perinatal Infection; Policy Maker; Preparation; Process; Provider; Questionnaires; Reporting; Research; Research Infrastructure; Research Personnel; Risk Behaviors; Risk Factors; South Africa; Southern Africa; Surveillance Program; System; Testing; Thailand; antiretroviral therapy; care systems; clinical care; cohort; data access; data management; epidemiology study; experience; innovation; low and middle-income countries; novel; outcome prediction; pediatrician; programs; routine care; sex; socioeconomics; success; surveillance data; tool; uptake; young adult; young man; young woman

PROJECT SUMMARY There are more than four million adolescents and young adults living with HIV in the world today. However, there are no mechanisms within current global surveillance data systems to distinguish how many of these young people were infected as infants or acquired HIV through risk behaviors in adolescence/young adulthood, and what proportion has subsequently transitioned from pediatric to adult HIV care. In order to address this serious gap, there is a critical need to harmonize HIV clinical and program data across the adolescent-to-adult HIV care transition period in a way that would be implementable in low- and middle-income country (LMIC) settings. The proposed research initiative, Creating a Global fRAmework of Data collection Used for Adolescent HIV Transition Evaluation (GRADUATE), seeks to establish a data collection and management platform that can guide clinical programs as to the demographic, socio-economic, clinical, and laboratory data they should be documenting in order to describe how adolescents are moving through the transition period within clinical care systems. GRADUATE would be created in the context of LMICs, where it could be used to conduct epidemiologic research and surveillance to understand how transition impacts program retention and antiretroviral therapy success or failure among young people. GRADUATE would promote a level of data granularity allowing disaggregation of data by age, sex, and infection exposure group that could dramatically change our understanding of how young women experience transitions in HIV care compared to young men, and of long-term survivors of perinatal infection compared to those infected at older ages. The new data management framework and research initiative would include 1) the identification of key variables and data definitions that capture the process of transition as well as the clinical and socio-economic predictors and outcomes across the transition period, 2) creation of data tables and online tools to facilitate data collection at the clinic level and for research purposes, and 3) pilot testing of the data-capture methods in Asia and sub-Saharan Africa at the patient level in individual clinics, within regional research cohort databases, and through a large provincial HIV program management and surveillance program. We hypothesize that a number of core indicators of the transition process can be derived from routine cohort data or can readily be captured through minimal additional data collection. We also hypothesize that transition success will vary across different settings and by sex, and that it will be possible to identify risk factors for poor transition outcomes that may be amenable to specific interventions. The proposed initiative will create the first broadly implementable and open access data platform to support measurement of adolescent HIV care transition outcomes.

项目总结 当今世界有400多万青少年和青壮年携带艾滋病毒。然而， 在当前的全球监控数据系统中，没有任何机制来区分其中有多少 年轻人在婴儿期感染艾滋病毒或在青春期/青年时期通过危险行为感染艾滋病毒， 以及随后从儿童艾滋病毒护理过渡到成人艾滋病毒护理的比例。为了解决这个问题 严重的差距，迫切需要协调青少年到成年人之间的艾滋病毒临床和规划数据 艾滋病毒护理过渡期，可在中低收入国家(LMIC)实施 设置。拟议的研究倡议，创建用于以下目的的全球数据收集框架 青少年艾滋病毒过渡评价(研究生)，寻求建立一个数据收集和 管理平台，可以指导临床项目的人口统计、社会经济、 他们应该记录临床和实验室数据，以描述青少年是如何 正在经历临床护理系统内的过渡期。毕业生将在 LMICs的背景，可用于进行流行病学研究和监测，以了解 过渡如何影响年轻人的计划保留和抗逆转录病毒治疗的成功或失败。 毕业生将提升数据粒度级别，允许按年龄、性别和 感染暴露组可能会极大地改变我们对年轻女性经历的理解 与年轻男子相比，艾滋病毒护理的过渡，与围产期感染的长期幸存者相比 那些在年龄较大时感染的人。新的数据管理框架和研究举措将包括1) 确定捕捉过渡过程的关键变量和数据定义，以及 过渡时期的临床和社会经济预测因素和结果；2)创建数据表 和在线工具，以促进在临床一级和用于研究目的的数据收集，以及3)试点测试 亚洲和撒哈拉以南非洲地区个别诊所病人层面的数据捕获方法 区域研究队列数据库，并通过大型省级艾滋病毒方案管理和监测 程序。我们假定，过渡进程的一些核心指标可以从 常规队列数据，或通过最少的额外数据收集即可轻松捕获。我们还假设 这种过渡的成功将因不同的环境和性别而有所不同，而且将有可能识别风险 导致过渡结果不佳的因素，这些因素可能会受到具体干预的影响。拟议的倡议将 创建第一个可广泛实施的开放访问数据平台，以支持青少年测量 艾滋病毒护理过渡成果。