A nurse-led intervention to extend the HIV treatment cascade for cardiovascular disease prevention (EXTRA-CVD)

摘要 在艾滋病毒/艾滋病治疗级联模式中，参与护理的艾滋病毒感染者（PLHIV） 可能坚持HIV抗逆转录病毒治疗（ART）并实现持久的病毒抑制。为了实现 病毒抑制，需要近乎完美的ART依从性。即使艾滋病毒携带者负责药物治疗 在艾滋病毒治疗指南中，艾滋病毒护理提供者在鼓励和监测艾滋病毒感染方面发挥着重要作用。 坚持抗逆转录病毒疗法。在实现病毒抑制后，艾滋病毒感染者和提供者有一个重要的机会， 预防其他非艾滋病合并症。在非艾滋病的定义条件，艾滋病毒感染者处于较高的风险 动脉粥样硬化性心血管疾病（ASCVD）的发病率高于普通人群。因此，对于这些人来说， 高危人群保持最佳的药物依从性，以减少晚期 动脉粥样硬化和随后的心脏事件。然而，对药物依从性知之甚少， 治疗ASCVD危险因素，如高血压和高脂血症，用于已达到病毒感染的PLHIV患者 镇压 在这个为期3年的多样性补充，候选人建议使用定性方法来探索内在的， 促进最佳高血压和高脂血症药物依从性的外在动机因素 在已实现持久病毒抑制并确定艾滋病毒医疗保健提供者态度的艾滋病毒感染者中， 实践规范以及其他影响监测和鼓励坚持高血压的因素 和高脂血症药物治疗已达到病毒抑制的PLHIV感染者。候选人还提议， 使用定量方法评估参与者对高血压和高脂血症的药物依从性 入组母研究。

Abstract In the HIV/AIDS treatment cascade model, people living with HIV (PLHIV) who are engaged in care are more likely to adhere to HIV Anti-Retroviral Therapy (ART) and achieve durable viral suppression. In order to achieve viral suppression, near perfect adherence to ART is required. Even though PLHIV are responsible for medication adherence, in HIV treatment guidelines, HIV care providers play an important role in encouraging and monitoring ART adherence. After achieving viral suppression, PLHIV and providers have an important opportunity to focus on preventing other non-AIDS comorbidities. Among non-AIDS defining conditions, PLHIV are at a higher risk for atherosclerotic cardiovascular disease (ASCVD) than the general population. It is therefore critical for these high-risk individuals to maintain optimal adherence to medications to reduce the likelihood of advanced atherosclerosis and subsequent cardiac events. However, little is known about medication adherence for treatment of ASCVD risk factors such as hypertension and hyperlipidemia for PLHIV who have achieved viral suppression. In this 3-year diversity supplement, the candidate proposes to use qualitative methods to explore intrinsic and extrinsic motivational factors that facilitate optimal hypertension and hyperlipidemia medication adherence among PLHIV who have achieved durable viral suppression and identify HIV healthcare provider attitudes and practice norms among other factors that impact intentions to monitor and encourage adherence to hypertension and hyperlipidemia medications in PLHIV who have achieved viral suppression. The candidate also proposes to use quantitative methods to assess medication adherence for hypertension and hyperlipidemia for participants enrolled in the parent study.