Simplifying HIV Treatment and Monitoring (STREAM2): Point-of-Care Urine Tenofovir Adherence and Viral Load Testing to Improve HIV Outcomes in South Africa

简化艾滋病毒治疗和监测 (STREAM2):护理点尿液替诺福韦依从性和病毒载量检测,以改善南非的艾滋病毒治疗结果

基本信息

  • 批准号:
    10665728
  • 负责人:
  • 金额:
    $ 34.8万
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
    2019
  • 资助国家:
    美国
  • 起止时间:
    2019-07-23 至 2025-06-30
  • 项目状态:
    未结题

项目摘要

ABSTRACT For millions of people living with HIV (PLHIV) receiving antiretroviral therapy (ART), adequate ART adherence and routine HIV viral load (VL) monitoring are critical to ensure viral suppression and good health outcomes. Initiation and management of life-long ART in low- and middle-income countries (LMICs) is challenging for both PLHIV and providers in part due to the reliance on self-reported adherence and delays with lab-based VL testing, which are part of the usual care. Drs. Drain and Garrett (co-principal investigators) recently completed a pilot study in South Africa demonstrating that point-of-care (POC) VL monitoring for PLHIV receiving efavirenz-based ART increased VL suppression and retention in care by 14% (95% CI 6-21%) over a 12-month period compared to standard lab testing. However, the applicability of these findings to the context of newer, more robust dolutegravir-based ART regimens being introduced in several LMICs, including South Africa, is not known. To complement POC VL monitoring, we have recently completed the development and initial evaluation of a novel POC urine tenofovir assay, in collaboration with Abbott Diagnostics, which can monitor ART adherence in clinic- based settings in real-time. Building on our pilot study results, our objective in this application is to determine the clinical efficacy and cost effectiveness of implementing an integrated HIV care model using POC tenofovir adherence testing and POC VL monitoring in maintaining durable VL suppression among PLHIV receiving tenofovir-based ART in South Africa. Our central hypotheses are that POC tenofovir adherence testing and POC VL monitoring will improve VL suppression rates and retention in care, while being a feasible, acceptable, and cost-effective strategy for ART management. We will objectively test our central hypotheses with three specific aims: (1) to determine if an integrated model for HIV monitoring using a POC tenofovir adherence assay and a POC VL test will improve VL suppression and retention in care; (2) to monitor implementation and assess patient and provider perspectives of real-time POC tenofovir adherence testing and POC VL monitoring in South Africa; and (3) to estimate the costs and cost-effectiveness of implementing POC tenofovir adherence testing with POC VL monitoring, compared to no objective adherence testing and lab-based VL monitoring. To complete these aims, we will randomize 534 participants (1:1) at ART initiation into regular POC tenofovir adherence testing with POC VL monitoring (Arm 1) or standard-of-care with no objective tenofovir adherence testing and lab-based VL monitoring (Arm 2). Participants will be followed to compare a primary composite outcome of VL suppression and retention in care between the study arms at 18 months after ART initiation. This randomized controlled implementation trial will provide crucial data on the clinical efficacy, acceptability, and cost-effectiveness of an integrated model of POC adherence and VL testing to inform global policy on improving HIV care in LMICs.
摘要

项目成果

期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)

数据更新时间:{{ journalArticles.updateTime }}

{{ item.title }}
{{ item.translation_title }}
  • DOI:
    {{ item.doi }}
  • 发表时间:
    {{ item.publish_year }}
  • 期刊:
  • 影响因子:
    {{ item.factor }}
  • 作者:
    {{ item.authors }}
  • 通讯作者:
    {{ item.author }}

数据更新时间:{{ journalArticles.updateTime }}

{{ item.title }}
  • 作者:
    {{ item.author }}

数据更新时间:{{ monograph.updateTime }}

{{ item.title }}
  • 作者:
    {{ item.author }}

数据更新时间:{{ sciAawards.updateTime }}

{{ item.title }}
  • 作者:
    {{ item.author }}

数据更新时间:{{ conferencePapers.updateTime }}

{{ item.title }}
  • 作者:
    {{ item.author }}

数据更新时间:{{ patent.updateTime }}

Paul K Drain其他文献

Micronutrients in HIV-positive persons receiving highly active antiretroviral therapy
  • DOI:
    10.1093/ajcn/85.2.333
  • 发表时间:
    2007-02-01
  • 期刊:
  • 影响因子:
  • 作者:
    Paul K Drain;Roland Kupka;Ferdinand Mugusi;Wafaie W Fawzi
  • 通讯作者:
    Wafaie W Fawzi
A systematic review of hepatic tuberculosis with considerations in human immunodeficiency virus co-infection
  • DOI:
    10.1186/s12879-015-0944-6
  • 发表时间:
    2015-05-06
  • 期刊:
  • 影响因子:
    3.000
  • 作者:
    Andrew J Hickey;Lilishia Gounder;Mahomed-Yunus S Moosa;Paul K Drain
  • 通讯作者:
    Paul K Drain

Paul K Drain的其他文献

{{ item.title }}
{{ item.translation_title }}
  • DOI:
    {{ item.doi }}
  • 发表时间:
    {{ item.publish_year }}
  • 期刊:
  • 影响因子:
    {{ item.factor }}
  • 作者:
    {{ item.authors }}
  • 通讯作者:
    {{ item.author }}

{{ truncateString('Paul K Drain', 18)}}的其他基金

A novel REverSe Transcriptase Chain Termination (RESTRICT) assay for near-patient, objective monitoring of long-term PrEP adherence
一种新型 REverSe 转录酶链终止 (RESTRICT) 测定,可用于患者附近长期 PrEP 依从性的客观监测
  • 批准号:
    10300073
  • 财政年份:
    2020
  • 资助金额:
    $ 34.8万
  • 项目类别:
A novel REverSe Transcriptase Chain Termination (RESTRICT) assay for near-patient, objective monitoring of long-term PrEP adherence
一种新型 REverSe 转录酶链终止 (RESTRICT) 测定,可用于患者附近长期 PrEP 依从性的客观监测
  • 批准号:
    10159767
  • 财政年份:
    2020
  • 资助金额:
    $ 34.8万
  • 项目类别:
A novel REverSe Transcriptase Chain Termination (RESTRICT) assay for near-patient, objective monitoring of long-term PrEP adherence
一种新型 REverSe 转录酶链终止 (RESTRICT) 测定,可用于患者附近长期 PrEP 依从性的客观监测
  • 批准号:
    10513809
  • 财政年份:
    2020
  • 资助金额:
    $ 34.8万
  • 项目类别:
Simplifying HIV Treatment and Monitoring (STREAM2): Point-of-Care Urine Tenofovir Adherence and Viral Load Testing to Improve HIV Outcomes in South Africa
简化艾滋病毒治疗和监测 (STREAM2):护理点尿液替诺福韦依从性和病毒载量检测,以改善南非的艾滋病毒治疗结果
  • 批准号:
    10203799
  • 财政年份:
    2019
  • 资助金额:
    $ 34.8万
  • 项目类别:
Drug Resistance Genotypic and Phenotypic Correlates of Efavirenz and Dolutegravir based Treatment Outcomes across Non-B HIV-1 subtypes
非 B HIV-1 亚型依非韦伦和多替拉韦治疗结果的耐药性基因型和表型相关性
  • 批准号:
    9973184
  • 财政年份:
    2019
  • 资助金额:
    $ 34.8万
  • 项目类别:
Drug Resistance Genotypic and Phenotypic Correlates of Efavirenz and Dolutegravir based Treatment Outcomes across Non-B HIV-1 subtypes
非 B HIV-1 亚型依非韦伦和多替拉韦治疗结果的耐药性基因型和表型相关性
  • 批准号:
    10202449
  • 财政年份:
    2019
  • 资助金额:
    $ 34.8万
  • 项目类别:
Drug Resistance Genotypic and Phenotypic Correlates of Efavirenz and Dolutegravir based Treatment Outcomes across Non-B HIV-1 subtypes
非 B HIV-1 亚型依非韦伦和多替拉韦治疗结果的耐药性基因型和表型相关性
  • 批准号:
    10662274
  • 财政年份:
    2019
  • 资助金额:
    $ 34.8万
  • 项目类别:
Simplifying HIV Treatment and Monitoring (STREAM2): Point-of-Care Urine Tenofovir Adherence and Viral Load Testing to Improve HIV Outcomes in South Africa
简化艾滋病毒治疗和监测 (STREAM2):护理点尿液替诺福韦依从性和病毒载量检测,以改善南非的艾滋病毒治疗结果
  • 批准号:
    10448268
  • 财政年份:
    2019
  • 资助金额:
    $ 34.8万
  • 项目类别:
Drug Resistance Genotypic and Phenotypic Correlates of Efavirenz and Dolutegravir based Treatment Outcomes across Non-B HIV-1 subtypes
非 B HIV-1 亚型依非韦伦和多替拉韦治疗结果的耐药性基因型和表型相关性
  • 批准号:
    10443774
  • 财政年份:
    2019
  • 资助金额:
    $ 34.8万
  • 项目类别:
Simplifying HIV Treatment and Monitoring (STREAM2): Point-of-Care Urine Tenofovir Adherence and Viral Load Testing to Improve HIV Outcomes in South Africa
简化艾滋病毒治疗和监测 (STREAM2):护理点尿液替诺福韦依从性和病毒载量检测,以改善南非的艾滋病毒治疗结果
  • 批准号:
    9982217
  • 财政年份:
    2019
  • 资助金额:
    $ 34.8万
  • 项目类别:

相似海外基金

Digital cognitive-behavior therapy for anxiety and depressive disorders: Building an impactful research project from international partnerships and knowledge exchange in primary care
针对焦虑和抑郁症的数字认知行为疗法:通过初级保健领域的国际合作和知识交流建立一个有影响力的研究项目
  • 批准号:
    480808
  • 财政年份:
    2023
  • 资助金额:
    $ 34.8万
  • 项目类别:
    Miscellaneous Programs
Function of cost bias and effect of cognitive behavior therapy on social anxiety in children and adolescents
成本偏差的作用及认知行为治疗对儿童青少年社交焦虑的影响
  • 批准号:
    23K02970
  • 财政年份:
    2023
  • 资助金额:
    $ 34.8万
  • 项目类别:
    Grant-in-Aid for Scientific Research (C)
Combined Dialectical Behavior Therapy and Digital Cognitive Behavioral Therapy for Insomnia for Adolescents at High Risk for Suicide: A Pilot RCT
辩证行为疗法和数字认知行为疗法相结合治疗自杀高危青少年的失眠:一项试点随机对照试验
  • 批准号:
    10643478
  • 财政年份:
    2023
  • 资助金额:
    $ 34.8万
  • 项目类别:
A Randomized Clinical Trial Comparing Transdiagnostic Behavior Therapy to Disorder-Specific Psychotherapy in the Recovery of Veterans with Social Anxiety Disorder and Comorbid PTSD Symptomatology
一项随机临床试验,比较跨诊断行为疗法与特定障碍心理疗法在患有社交焦虑症和共病 PTSD 症状的退伍军人康复中的作用
  • 批准号:
    10746930
  • 财政年份:
    2023
  • 资助金额:
    $ 34.8万
  • 项目类别:
Reducing suicide risk among aging caregivers of persons with AD/ADRD: Adapting, implementing, and evaluating Dialectical Behavior Therapy skills training interventions.
降低 AD/ADRD 患者老年护理人员的自杀风险:调整、实施和评估辩证行为治疗技能培训干预措施。
  • 批准号:
    10730708
  • 财政年份:
    2023
  • 资助金额:
    $ 34.8万
  • 项目类别:
A Randomized control trial of behavior therapy of tics in Japan. Exploring the behavior model of tics.
日本抽动行为治疗的随机对照试验。
  • 批准号:
    22K13840
  • 财政年份:
    2022
  • 资助金额:
    $ 34.8万
  • 项目类别:
    Grant-in-Aid for Early-Career Scientists
The Role of Behavior Therapy Combined with Buprenorphine for the Treatment of Opioid Use Disorder
行为疗法联合丁丙诺啡治疗阿片类药物使用障碍的作用
  • 批准号:
    10440820
  • 财政年份:
    2022
  • 资助金额:
    $ 34.8万
  • 项目类别:
Efficacy of digital cognitive behavior therapy for insomnia for the prevention of perinatal depression
数字认知行为疗法治疗失眠预防围产期抑郁症的疗效
  • 批准号:
    10429841
  • 财政年份:
    2022
  • 资助金额:
    $ 34.8万
  • 项目类别:
Efficacy of digital cognitive behavior therapy for insomnia for the prevention of perinatal depression
数字认知行为疗法治疗失眠预防围产期抑郁症的疗效
  • 批准号:
    10656415
  • 财政年份:
    2022
  • 资助金额:
    $ 34.8万
  • 项目类别:
Efficacy of digital cognitive behavior therapy for insomnia for the prevention of perinatal depression - supplement
数字认知行为疗法治疗失眠预防围产期抑郁症的疗效 - 补充
  • 批准号:
    10794868
  • 财政年份:
    2022
  • 资助金额:
    $ 34.8万
  • 项目类别:
{{ showInfoDetail.title }}

作者:{{ showInfoDetail.author }}

知道了