Adherence to HIV Treatment Postpartum: The Implications of Transitions Among Women Living with HIV in South Africa

产后坚持艾滋病毒治疗：南非艾滋病毒感染妇女转变的影响

基本信息

批准号：
10223887
负责人：
Jennifer Ann Pellowski
金额：
$ 15.15万
依托单位：
BROWN UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-08-01 至 2023-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10223887
关键词：
AIDS prevention Address Adherence Adult African Area Behavior Behavior Therapy Behavioral Behavioral Research Breast Feeding Caring Clinic Clinical Management Clinical Sciences Country Discipline of obstetrics Educational workshop Epidemiology Equilibrium Evaluation Face Funding Future Goals Gynecology HIV HIV Seropositivity Health behavior Horizontal Disease Transmission Human immunodeficiency virus test Individual Infant Infant Care Infectious Disease Epidemiology Influentials International Intervention Interview K-Series Research Career Programs Lead Life Maternal Health Maternal Mortality Maternal and Child Health Mentors Mentorship Methodology Mothers Motivation Participant Perception Perinatal Epidemiology Perinatal Infection Personal Satisfaction Pharmaceutical Preparations Phase Population Postpartum Period Postpartum Women Pregnancy Pregnant Women Prevention Prevention Research Process Psychologist Public Health Qualitative Methods Randomized Controlled Trials Reading Reproductive Health Research Research Personnel Research Training Resources Risk Role Scientist Self Care Sexual Health Sexual Partners Shapes South Africa South African Special Population Structure Techniques Testing Training United States Vertical Disease Transmission Virus Woman antenatal antiretroviral therapy base behavioral adherence biobehavior career child bearing cohort design experience follow up assessment follow-up improved innovation mortality motherhood postpartum care preference prevent preventive intervention psychosocial public health relevance recruit social social disadvantage social stigma theories therapy adherence therapy development transmission process treatment adherence treatment research uptake

项目摘要

PROJECT SUMMARY Prevention of mother-to-child transmission (PMTCT) efforts have reduced the rates of vertical transmission to 2.7%, however, optimal antiretroviral therapy (ART) adherence remains a difficult goal to reach, particularly postpartum. The contribution of the proposed research is expected to be two-fold: 1) to gain an understanding of how influential contextual, interpersonal, clinic, and individual level factors change during key moments of transition during pregnancy and postpartum and influence ART adherence and 2) to develop bio-behavioral interventions to assist mothers in maintaining their adherence to ART postpartum. Candidate: I am a social psychologist with a background in ART adherence socially disadvantaged groups in the United States. I am applying for a five-year K01 Career Development Award to obtain training, mentorship, and research experience to become an expert in maternal health among women living with HIV in resource limited settings and an independent investigator capable of obtaining R01 funding. Mentoring: I have put together an exceptional mentoring team with extensive experience in HIV treatment and prevention research in South Africa that integrates epidemiology, qualitative methods, and clinical science. Drs. Don Operario and Mark Lurie will serve as co-Primary mentors and bring complementary expertise in international HIV behavioral intervention development and infectious disease epidemiology. In addition to my two Primary mentors, my co- mentors provide expertise in specific content areas and methodologies and are based in both the U.S. and South Africa (ZA). My co-mentorship team includes: Dr. Susan Cu-Uvin (U.S.-based, clinical management of HIV, obstetrics and gynecology), Dr. Landon Myer (ZA-based, perinatal epidemiology, postpartum ART adherence), Dr. Abigail Harrison (U.S.-based, longitudinal qualitative methods, sexual and reproductive health), and Dr. Christopher Colvin (ZA-based, qualitative methods, maternal child health). Training: Specific training in perinatal epidemiology, longitudinal qualitative methods, theory-based interventions, cross-cultural intervention development and evaluation will be achieved through intensive mentored training, coursework, workshops and directed readings and primary ZA research. Guided by my excellent mentorship team, these training and research experiences will establish my independent investigator career as an expert in developing HIV treatment and prevention interventions to address maternal health in high impact, low resource settings, that take into account key moments of transition and change that impact health behaviors. Research: The goals of the proposed project are to (1) identify contextual, interpersonal, clinic, and individual level factors that influence women's HIV treatment adherence during key period of transition during pregnancy and postpartum; (2) evaluate a Transition Theory-based bio-behavioral intervention to improve ART adherence postpartum using a small scale randomized controlled trial; (3) assess participants' experiences of the intervention, perceived usefulness, and identify ways to refine the intervention for future evaluation

项目摘要预防母子传播（PMTCT）努力降低了垂直的速度然而，传播到2.7％，最佳抗逆转录病毒疗法（ART）依从性仍然是一个困难的目标到达，尤其是产后。预计拟议的研究的贡献将为两个：1）了解影响力，人际关系，诊所和个人层面因素如何变化的影响怀孕期间和产后过渡的关键时刻，并影响艺术依从性以及2）生物行为干预措施，以帮助母亲维持对艺术产后的遵守。候选人：我是一名社会心理学家国家。我正在申请五年K01职业发展奖，以获得培训，指导和研究经验是在资源有限的艾滋病毒妇女中成为孕产妇健康的专家设置和能够获得R01资金的独立调查员。指导：我把在南方拥有丰富经验在HIV治疗和预防研究方面具有丰富经验的卓越指导团队整合流行病学，定性方法和临床科学的非洲。博士。唐歌剧和马克 Lurie将担任联合主要导师，并带来国际艾滋病毒行为的补充专业知识干预发展和传染病流行病学。除了我的两个主要导师，我的共同导师在特定内容领域和方法中提供专业知识，并在美国和南非（ZA）。我的委托团队包括：苏珊·库文（Susan Cu-uvin）博士（总部位于美国，艾滋病毒，妇产科），兰登·迈尔（Landon Myer）博士（基于ZA，围产期流行病学，产后艺术依从性），阿比盖尔·哈里森（Abigail Harrison）博士（总部位于美国的纵向定性方法，性和生殖健康）和克里斯托弗·科尔文（Christopher Colvin）博士（基于ZA的定性方法，母性儿童健康）。培训：具体围产期流行病学，纵向定性方法，基于理论的干预措施，跨文化的培训干预开发和评估将通过密集的指导培训，课程，讲习班和定向阅读和主要ZA研究。在我出色的指导团队的指导下，这些培训和研究经验将建立我的独立研究者职业，作为开发专家艾滋病毒治疗和预防干预措施，以应对高影响力，低资源环境中的孕产妇健康，这考虑了过渡和改变影响健康行为的关键时刻。研究：拟议项目的目标是（1）确定上下文，人际关系，诊所和个人级别的因素在怀孕期间和产后过渡期间关键时期影响妇女的艾滋病毒治疗依从性；（2）评估基于过渡理论的生物行为干预措施，以改善产后艺术依从性使用小规模随机对照试验；（3）评估参与者的干预经历，感知的有用性，并确定方法来完善干预措施以进行未来评估