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

项目总结 背景：在撒哈拉以南非洲，男性在艾滋病毒护理的每一步都落后于女性 导致艾滋病毒在妇女中的传播，并促成其传播。披露艾滋病毒是预防的关键一步， 然而，几乎没有基于证据的资源来支持在亚洲区艾滋病毒感染者(MWH)中披露艾滋病毒 撒哈拉非洲。候选人：我的长期目标是成为一名独立的、由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 资源受限设置。指导：Jessica Haberer博士(临床试验实施)和Lynn Matthews (干预发展方法；共同初级导师)都是成功的NIH资助的研究人员 两人都曾指导过多名NIH职业发展奖获得者。Winnie Muyindke博士(艾滋病毒临床护理 参与和成果)、安德鲁·穆朱吉拉(男性参与艾滋病毒和性传播感染护理和研究)、克里斯蒂娜 Psaros(行为科学理论)，Seth Kalichman(艾滋病毒披露和协助伴侣通知)，以及 Bathany Hedt-Gauthier(高级临床试验分析和生物统计学)将提供更多重点 良师益友确保成功。研究：这项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：有性传播感染症状的人 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，但没有病毒抑制。在目标1中，我 将确定独特的艾滋病毒披露需求和偏好，以通过深入的 符合资格标准的多达30兆瓦的定性面试。在目标2中，我将利用来自AIM的调查结果 1调整带有艾滋病毒披露组成部分的干预措施，以制定新的艾滋病毒披露 干预的重点是MWH。将通过焦点小组讨论反复改进干预措施 多达20名参与者、他们的性伴侣和一个社区顾问委员会。在目标3中，我将招募70兆瓦的 符合参加随机对照试验的资格标准，以针对 注意匹配对照组。将鼓励参与者带有性伴侣来学习 招生、艾滋病毒检测和咨询。最多15兆瓦时和他们的性伴侣将被邀请 定性访谈。我将用混合方法来衡量可接受性和可行性的初步结果。 培训：为了达到我的目标并获得研究独立性，我需要在以下方面进行额外的培训：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 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，来自卓越指导团队的支持，强大的机构承诺，以及创新的 研究计划，我很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调查员 在资源有限的情况下进行预防和治疗。

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.