Development and assessment of an HIV disclosure intervention for men in Uganda

乌干达男性艾滋病毒披露干预措施的制定和评估

• 批准号: 10676867
• 负责人: Pooja Rao Chitneni
• 金额: $ 19.34万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-04 至 2027-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10676867
• 关键词: AIDS prevention; Adherence; Africa South of the Sahara; Attention; Behavior; Behavior Therapy; Behavioral Sciences; Biometry; Caring; Clinical; Clinical Investigator; Cognitive Therapy; Communication; Communities; Control Groups; Counseling; Data; Dedications; Development; Diagnosis; Disclosure; Education; Elements; Eligibility Determination; Enrollment; Ensure; Epidemic; Epidemiology; Event; Family; Focus Groups; Funding; Future; Gender; Goals; HIV; HIV risk; Health; Healthcare; Human immunodeficiency virus test; Institution; Intervention; Intervention Trial; Interview; Manuals; Masculine; Measures; Mentors; Mentorship; Methods; Modeling; Obesity; Outcome; Participant; Partner Notification; Patient Self-Report; Persons; Physiological; Positioning Attribute; Prevention; Problem Solving; Process; Qualitative Methods; Randomized; Randomized, Controlled Trials; Reaction; Reporting; Research; Research Personnel; Resource-limited setting; Resources; Risk; Risk Reduction; Role playing therapy; Rural; STI prevention; Sampling; Scientist; Sexual Partners; Sexually Transmitted Diseases; Social support; Southern Africa; Symptoms; Training; Treatment Efficacy; Uganda; United States National Institutes of Health; Viral; Viral Load result; Woman; Work; acceptability and feasibility; antiretroviral therapy; behavioral clinical trial; career development; clinical care; clinical trial analysis; clinical trial implementation; cohort; efficacy evaluation; evidence base; experience; improved; innovation; male; male health; meetings; men; novel; pilot test; preference; primary outcome; recruit; sexual risk taking; skills; social stigma; success; theories; therapy adherence; therapy development; tool; transmission process; treatment as prevention; uptake

PROJECT SUMMARY Background: In sub-Saharan Africa, men consistently lag behind women along each step of the HIV care cascade and contribute to HIV transmission among women. Disclosure of HIV is a key step in prevention, however, few evidence-based resources exist to support HIV disclosure among men with HIV (MWH) in sub- Saharan Africa. Candidate: My long-term goal is to become an independent, NIH-funded clinical researcher dedicated to interventions to support HIV and sexually transmitted infection (STI) prevention and treatment in resource limited settings. Mentoring: Drs. Jessica Haberer (clinical trial implementation) and Lynn Matthews (methods for intervention development; co-primary mentors) are both successful NIH-funded investigators who have both mentored multiple NIH career development awardees. Drs. Winnie Muyindike (HIV clinical care engagement and outcomes), Andrew Mujugira (male engagement in HIV and STI care and research), Christina Psaros (behavioral science theory), Seth Kalichman (HIV disclosure and assisted partner notification), and Bethany Hedt-Gauthier (advanced clinical trial analysis and biostatistics) will provide additional focused mentorship to ensure success. Research: The goal of this proposal is to develop and test an HIV disclosure intervention focused on MWH meeting the following eligibility criteria: with STI symptoms who are either not accessing antiretroviral therapy or are accessing antiretroviral therapy but without viral suppression. In Aim 1, I will identify the unique HIV disclosure needs and preferences to support HIV disclosure through in-depth qualitative interviews with up to 30 MWH meeting eligibility criteria. In Aim 2, I will utilize the findings from Aim 1 to adapt interventions with HIV disclosure components in order to develop a novel HIV disclosure intervention focused on MWH. The intervention will be iteratively refined through focus group discussions with up to 20 participants, their sexual partners, and a community advisory board. In Aim 3, I will recruit 70 MWH meeting eligibility criteria for participation in a randomized controlled trial to pilot test the intervention against an attention-matched control group. Participants will be encouraged to bring their sexual partners for study enrollment and HIV testing and counseling. Up to 15 MWH and their sexual partners will be invited for qualitative interviews. I will measure the primary outcomes of acceptability and feasibility by mixed methods. Training: To achieve my aims and gain research independence, I require additional training in: 1) behavioral science theory for behavioral intervention development and assessment 2) methods for behavioral intervention development, and 3) advanced behavioral clinical trial analysis. Based on my previous research experience and success, support from an exceptional mentoring team, strong institutional commitment, and an innovative research plan, I am well-positioned to become an independent clinical investigator focused on HIV and STI prevention and treatment in resource limited settings.

项目摘要 背景：在撒哈拉以南非洲，男性在艾滋病毒护理的每一步都沿着在女性之后 并助长了艾滋病毒在妇女中的传播。披露艾滋病毒是预防的关键步骤， 然而，很少有证据为基础的资源存在，以支持艾滋病毒感染者（MWH）的艾滋病毒披露， 撒哈拉非洲。候选人：我的长期目标是成为一名独立的，NIH资助的临床研究人员 致力于支持艾滋病毒和性传播感染（STI）预防和治疗的干预措施， 资源有限的设置。指导：Jessica Haberer博士（临床试验实施）和林恩马修斯 （干预开发方法;共同主要导师）都是成功的NIH资助的研究人员， 都指导了多个NIH职业发展奖获得者。温妮·穆因迪克博士（艾滋病毒临床护理 Andrew Mujugira（男性参与艾滋病毒和性传播感染护理和研究），Christina Psaros（行为科学理论），Seth Kalichman（艾滋病毒披露和协助伴侣通知），以及 Bethany Hedt-Gauthier（高级临床试验分析和生物统计学）将提供额外的重点 指导以确保成功。研究：该提案的目标是开发和测试艾滋病毒披露 干预的重点是符合以下资格标准的MWH：有STI症状， 正在接受抗逆转录病毒治疗或正在接受抗逆转录病毒治疗但没有抑制病毒。在目标1中， 将确定独特的艾滋病毒披露需求和偏好，以支持艾滋病毒披露，通过深入 与多达30 MWH符合资格标准的定性访谈。在目标2中，我将利用Aim的发现 1.调整干预措施，包括艾滋病毒披露内容，以制定新的艾滋病毒披露办法 干预的重点是MWH。干预措施将通过焦点小组讨论反复完善， 最多20名参与者，他们的性伴侣和社区咨询委员会。在目标3中，我将招募70 MWH 符合参与随机对照试验的资格标准，以针对 注意力匹配的对照组。我们鼓励参加者带同他们的性伴侣参加研究 登记和艾滋病毒检测和咨询。最多15兆瓦时及其性伴侣将被邀请参加 定性访谈。我将通过混合方法衡量可接受性和可行性的主要结果。 培训：为了实现我的目标并获得研究独立性，我需要以下方面的额外培训：1）行为 行为干预发展和评估的科学理论2）行为干预的方法 发展，和3）先进的行为临床试验分析。根据我以前的研究经验 和成功，从一个特殊的指导团队，强大的机构承诺，和创新的支持， 根据我的研究计划，我有能力成为一名专注于艾滋病毒和性传播感染的独立临床研究人员 在资源有限的情况下进行预防和治疗。