Using Implementation Science to Increase PrEP Uptake among African American Women in the South

利用实施科学提高南方非裔美国妇女对 PrEP 的接受率

• 批准号: 10199997
• 负责人: Tiara C. Willie
• 金额: $ 13.51万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-06-22 至 2025-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10199997
• 关键词: AIDS prevention; Address; Adherence; Adoption; Affect; African American; Age; Award; Caring; Clinic; Clinical; Community Healthcare; Counseling; Data; Development; Doctor of Philosophy; Educational workshop; Effectiveness; Epidemic; Epidemiologist; Evaluation; Face; Focus Groups; Funding; Future; Goals; Grant; HIV; HIV Infections; HIV Seropositivity; HIV diagnosis; HIV risk; High Risk Woman; Incidence; Infection; Interruption; Interview; Knowledge; Manuscripts; Mentored Research Scientist Development Award; Mentorship; Mississippi; Neighborhood Health Center; Outcome; Patients; Prevalence; Prevention Research; Prevention program; Prevention strategy; Primary Health Care; Principal Investigator; Reach, Effectiveness, Adoption, Implementation, and Maintenance; Readiness; Recommendation; Research; Risk; Safety; Services; South African; Testing; Time; Time Series Analysis; Training; United States Health Resources and Services Administration; Unsafe Sex; Waiting Lists; Woman; Work; Writing; acceptability and feasibility; care seeking; career; combat; condoms; design; experience; implementation framework; implementation science; implementation study; informant; innovation; interest; intimate partner violence; novel; pre-exposure prophylaxis; prevent; preventive intervention; programs; racial disparity; reproductive; research study; scale up; screening; service delivery; sex; skills; symposium; therapy development; uptake; violence exposure; violence prevention

Project Summary/Abstract HIV and intimate partner violence (IPV) are intersecting, mutually-reinforcing epidemics that significantly affect African American women, particularly women in the U.S. South. African American women face some of the highest rates of both HIV and IPV among U.S. women, and these burdens are most pronounced in the South. IPV-exposed African American women may experience forced, condomless sex, which increases the risk of HIV acquisition. Pre-exposure prophylaxis (PrEP) is the most innovative HIV prevention strategy, however it remains underutilized by African American women and residents of the South. In order to reduce African American women’s HIV acquisition risk in the South, effective HIV prevention interventions need to concurrently address relationship safety and HIV acquisition risks. The proposed training plan in this Mentored Research Scientist Development Award (K01) application will provide the knowledge and skills that the principal investigator, Tiara C. Willie, PhD, MA needs to launch an independent and productive research career. Further, the proposed research would contribute significantly to PrEP implementation in real-world settings and facilitate PrEP access to African American women in the South. The proposed research aims to address this call via the development, testing, and evaluation of a PrEP Implementation Toolkit for staff in community healthcare clinics in the South. The Toolkit will be evaluated using the Reach, Effectiveness- Adoption, Implementation, Maintenance (RE-AIM). The Toolkit will facilitate PrEP uptake among eligible African American women in the South, especially IPV-exposed women. This K01 project includes formative work (i.e., reach stage), like key informant interviews with staff at partnering clinics (N=10), and six focus groups with African American women. The qualitative data will inform the development of the PrEP Implementation Toolkit. The Toolkit will be employed in two clinics using a nonrandomized waitlist control design. Monthly aggregated clinic data will be collected 8-months before and after Toolkit implementation in each clinic. Toolkit effectiveness will be assessed using interrupted time series analyses and outcomes are changes in PrEP uptake, coverage and retention among African American women. Four focus groups with staff will be conducted to assess adoption, acceptability, and feasibility. 20 qualitative interviews with staff will be conducted to assess fidelity. This project will yield preliminary evidence of a PrEP implementation program for African American women with a focus on IPV. It will also inform future large-scale studies using stepped- wedge designs. The training acquired by Dr. Willie via this timely and novel project, courses, workshops, conferences, manuscript and grant-writing, and mentorship will target 3 training objectives to gain expertise in: (1) HIV prevention research among African American women, (2) intervention development and evaluation, and (3) implementation science in clinics.

项目总结/摘要 艾滋病毒和亲密伴侣暴力是相互交叉、相互强化的流行病， 非洲裔美国女性，尤其是美国南部的女性。非洲裔美国妇女面临着一些 在美国妇女中，艾滋病毒和IPV的感染率最高，这些负担在南方最为明显。 暴露于IPV的非洲裔美国妇女可能会经历强迫，无避孕套的性行为，这增加了 艾滋病毒感染。暴露前预防（PrEP）是最具创新性的艾滋病毒预防策略，但它 非洲裔美国妇女和南方居民仍然没有充分利用。为了减少非洲 美国南方女性艾滋病感染风险大，有效的艾滋病预防干预措施需要 同时解决关系安全和艾滋病毒感染风险。本培训计划中的建议 研究科学家发展奖（K 01）申请将提供知识和技能， 首席研究员Tiara C.威利，博士，马需要启动一个独立的和富有成效的研究 事业此外，拟议的研究将大大有助于在现实世界中实施PrEP 环境，并促进南部非洲裔美国妇女获得PrEP。拟议的研究旨在 通过开发，测试和评估PrEP实施工具包，为工作人员解决这一问题， 南方的社区卫生服务中心。工具包将使用覆盖面、有效性和可持续性指标进行评估。 采用、实施、维护（RE-AIM）。该工具包将促进符合条件的人 南方的非洲裔美国妇女，特别是暴露于IPV的妇女。此K 01项目包括 工作（即，达到阶段），如与合作诊所工作人员的关键线人访谈（N=10），以及六个重点 与非裔美国妇女的团体。定性数据将为PrEP的制定提供信息 执行工具包。该工具包将在两个诊所使用非随机候补名单对照 设计将在工具包实施前后8个月收集每月汇总诊所数据， 每个诊所将使用中断时间序列分析评估工具包的有效性， 在非裔美国妇女中PrEP吸收，覆盖和保留的变化。四个焦点小组与工作人员 将进行评估采用，可接受性和可行性。将与工作人员进行20次定性访谈， 以评估忠诚度。该项目将产生PrEP实施计划的初步证据， 非洲裔美国妇女，重点是IPV。它还将为未来的大规模研究提供信息， 楔形设计。威利博士通过这个及时而新颖的项目、课程、研讨会获得的培训， 会议、撰写论文和赠款以及指导将针对3个培训目标，以获得以下方面的专业知识： (1)非洲裔美国妇女艾滋病毒预防研究，（2）干预措施的制定和评价， （3）临床实施科学。