HIV prevention and care for couples in South Africa

南非夫妇的艾滋病毒预防和护理

• 批准号: 10390420
• 负责人: LYNAE A DARBES
• 金额: $ 53.95万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-07-03 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10390420
• 关键词: AIDS prevention; Address; Adherence; Adult; Attention; Behavioral; Caring; Characteristics; Clinic; Continuity of Patient Care; Control Groups; Counseling; Country; Couples; Educational Curriculum; Epidemic; Female; Goals; HIV; HIV Seropositivity; Heterosexuals; High Prevalence; Human immunodeficiency virus test; Individual; Infection; Intervention; Learning; Life Expectancy; Link; Literature; Mediating; Outcome; Phase; Prevalence; Prevention; Problem Solving; Professional counselor; Qualitative Methods; Randomized; Randomized Controlled Trials; Recording of previous events; Research; Risk; Rural; Rwanda; Sampling; Sexual Partners; Site; South Africa; Techniques; Testing; Training; Viral; Woman; Work; Zambia; antenatal; efficacy evaluation; efficacy testing; female couples; improved; innovation; intervention effect; male; male couples; men; motivational enhancement therapy; novel; preventive intervention; recruit; sexual risk behavior; transmission process; treatment arm; trial design; uptake

PROJECT SUMMARY/ABSTRACT South Africa remains one of the countries mostly heavily impacted by the HIV epidemic, with an overall estimated adult HIV prevalence of 18% to 30% among female antenatal clinic attendees. There is now substantial evidence that more than 80% of new infections occur within primary male-female partnerships. The high rates of new infections among primary partnerships are attributed to a combination of low levels of HIV testing and a high prevalence of outside sex partners. Recent work by Darbes (MPI), in KwaZulu-Natal (KZN) – the site of the proposed new research – found that among a sample of 330 heterosexual couples, 49% of men and 41% of women had no previous HIV testing history. In 20% of couples, neither partner had ever tested for HIV, despite living in a region with one of the highest adult HIV prevalence globally. Beyond the low levels of HIV testing, recent work also demonstrates significant deficits across the continuum of care in South Africa: recent work by Haber in KZN shows that only 45% of HIV-positive individuals are linked to care, 35% initiate ART, and 33% reach viral suppression. There is increasing evidence of efficacy for couples' focused HIV prevention interventions. Couples HIV Testing and Counseling (CHTC) is a proven strategy to reduce the risk of HIV transmission between partners. However, CHTC focuses only on the first stage of the cascade of HIV care – testing – are there are no interventions that allow couples to pass through the cascade of care together. Using a randomized controlled trial design with 272 couples, we aim to address this gap in HIV prevention and care literature by comparing a package of dyadic focused HIV testing and counseling interventions, against an attention matched control. The proposed RCT will test the efficacy of the dyadic intervention for achieving gains in viral suppression and engagement in HIV care. Heterosexual couples represent a significant yet over- looked risk group in South Africa, and innovative solutions are urgently needed to improve progression across the continuum of HIV care.

项目概要/摘要 南非仍然是受艾滋病毒流行影响最严重的国家之一，总体上 据估计，在女性产前诊所就诊者中，成人艾滋病毒感染率为 18% 至 30%。现在有 大量证据表明，超过 80% 的新感染发生在主要的男女伴侣中。 主要伴侣之间的高新感染率归因于低水平的综合作用 艾滋病毒检测和外部性伴侣的流行率很高。 Darbes (MPI) 最近在夸祖鲁-纳塔尔省的工作 (KZN)——拟议的新研究网站——发现，在 330 对异性恋夫妇的样本中，49% 的男性和 41% 的女性以前没有艾滋病毒检测史。 20% 的夫妻中，双方都没有经历过 尽管生活在全球成人艾滋病毒感染率最高的地区之一，但仍接受了艾滋病毒检测。超越低点 艾滋病毒检测水平，最近的工作还表明，南部地区的连续护理存在显着缺陷 非洲：哈伯 (Haber) 在 KZN 的最新研究表明，只有 45% 的艾滋病毒呈阳性者与护理有关，35% 开始 ART，33% 达到病毒抑制。越来越多的证据表明夫妻关注艾滋病毒的有效性 预防干预措施。夫妻艾滋病毒检测和咨询 (CHTC) 是一种行之有效的降低风险的策略 性伙伴之间的艾滋病毒传播。然而，恒天集团仅关注艾滋病毒级联的第一阶段 护理 - 测试 - 是否没有任何干预措施可以让夫妻一起经历级联护理。 我们通过对 272 对夫妇进行随机对照试验设计，旨在弥补艾滋病毒预防和治疗方面的这一差距。 通过比较一揽子以二元为重点的艾滋病毒检测和咨询干预措施，与 注意力匹配控制。拟议的随机对照试验将测试二元干预对于实现目标的有效性 在病毒抑制和参与艾滋病毒护理方面取得进展。异性恋伴侣代表了一个重要但过度的群体 南非的风险群体，迫切需要创新的解决方案来改善进展 艾滋病毒护理的连续性。