Feasibility pilot of home-based STI testing and risk self-assessment among adolescent girls in South Africa to trigger PrEP re-start
在南非少女中进行家庭性传播感染检测和风险自我评估以触发 PrEP 重新启动的可行性试点
基本信息
- 批准号:10678858
- 负责人:
- 金额:$ 21.06万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2021
- 资助国家:美国
- 起止时间:2021-09-01 至 2024-08-31
- 项目状态:已结题
- 来源:
- 关键词:AIDS preventionAddressAdherenceAdolescenceAdolescentAgeAge YearsBehavior assessmentBehavioralCOVID-19 pandemicCaringChlamydia trachomatisClinicClinical TrialsComplicationContraceptive AgentsCounselingCountryCoupledDataData CollectionDiagnosticDiagnostic Reagent KitsDiagnostic testsDoseDropoutEnrollmentEpidemicEvidence based programExposure toFaceFamily PlanningFemaleFemale AdolescentsHIVHIV riskHIV-1HealthHealth PersonnelHomeIncidenceIndividualInfertilityInstructionInterventionInterviewLaboratoriesLeftMeasurementMethodsNeisseria gonorrhoeaeOralOutcomeParentsParticipantPelvic Inflammatory DiseasePersonal AutonomyPersonsPoliciesPositioning AttributePrevalencePreventionPrevention programProceduresProviderPublic HealthRandomizedRandomized, Controlled TrialsRecommendationReproductive HealthReproductive Health ServicesResearchResearch PersonnelRiskRisk AssessmentRisk ReductionSTI preventionScheduleScienceSelf AdministrationSelf AssessmentSex BehaviorSexual HealthSexually Transmitted DiseasesSouth AfricaSouth AfricanSymptomsTarget PopulationsTelephoneTestingTextTrainingVisitWitage groupagedclinical careclinical implementationcohortcostempowermentexperiencefollow-upgender disparityhigh riskhome testimplementation scienceinfection riskmalenovelpeerpilot trialpoint of carepre-exposure prophylaxisprimary outcomeprogramsrandomized trialrapid testrecruitself testingstandard of caresyndemictooluptakevirtualwillingnessyoung woman
项目摘要
ABSTRACT
Rationale. Since their initiation in 2016, oral pre-exposure prophylaxis (PrEP) HIV-1 prevention programs in
South Africa (SA) have prioritized access for adolescent girls and young women (AGYW) due to their high HIV
prevalence and incidence rates. Despite this effort, PrEP uptake has been low and persistence has been sub-
optimal. Data are now emerging to characterize PrEP re-start as a further step in the PrEP cascade. Reasons
described for PrEP restart include fluctuations in perceived HIV risk based on dynamic and shifting partnerships
and sexual activity. Parallel to the HIV epidemic is a silent raging epidemic of curable but asymptomatic sexually
transmitted infections (STI) which can increase risk of HIV acquisition. Recent data indicate SA AGYW as having
the highest STI symptom burden nationally with gender disparity highest in the 15-19-year age-group (incidence
of STI among females twice as high as males in Gauteng). We believe that targeting this younger age group to
recognize and address their HIV/ STI risk during adolescence when they are developing personal autonomy,
has potential to inform health seeking behavioral change needed in later years to reduce their exposure to the
HIV/STI syndemics. Approach. We aim to develop a package of Neisseria gonorrhea and Chlamydia
trachomatis STI kits paired with training (in-person and remote virtual methods) for at-home testing to determine
whether AG can self-administer these tests and if this intervention could influence AG re-starting PrEP following
receipt of a positive STI result and in clinic guided HIV self-test. The study will be conducted at the Wits
Reproductive Health and HIV Institute, Johannesburg. For Aim 1, we will conduct in-depth interviews (IDI)
among ~20 AGYW who have used PrEP, 20 parents of AG who have used PrEP and 20 healthcare providers
to qualitatively explore barriers and facilitators to PrEP uptake, experiences with PrEP discontinuation,
perspectives on re-start and willingness to self-assess STI risk using STI rapid tests and behavioral
assessments. For Aim 2, we will recruit 50 AG (ages 16-17), who recently discontinued PrEP and randomize
them in a 1:1 ratio to receive 1) the STI testing package coupled with self-administered behavioral risk
assessments or 2) self-administered behavioral risk assessments only. Follow-up will be monthly for 6 months
through a combination of remote and in-person visits. All participants will receive comprehensive sexual and
reproductive health services and behavioral risk reduction counseling. Primary outcomes will include accrual,
program continuation, use of STI kits for self-test, and measurement of PrEP adherence. For Aim 3, we will
conduct study exit IDI with ~20 AG participating in Aim 2 to assess experiences with STI self-testing, self-
administered behavioral risk assessment and re-starting PrEP. Impact. By achieving these aims, we will optimize
methods and generate preliminary data to support an R01 proposal for a full trial of at-home STI testing and
PrEP re-start among AG. These data will have potential to inform country policy on PrEP re-start among AG
using self-identified STIs as a marker of heightened risk.
摘要
项目成果
期刊论文数量(0)
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会议论文数量(0)
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Renee A. Heffron其他文献
Renee A. Heffron的其他文献
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{{ truncateString('Renee A. Heffron', 18)}}的其他基金
Effectiveness of PrEP product choice on HIV prevention coverage among young women in Kenya seeking reproductive health services
PrEP 产品选择对寻求生殖健康服务的肯尼亚年轻女性艾滋病毒预防覆盖率的有效性
- 批准号:
10761048 - 财政年份:2023
- 资助金额:
$ 21.06万 - 项目类别:
Implementation science research on PrEP delivery and costing within MAT andNSP services for PWUD in Uganda
乌干达残疾人士 MAT 和 NSP 服务中 PrEP 交付和成本计算的实施科学研究
- 批准号:
10744381 - 财政年份:2022
- 资助金额:
$ 21.06万 - 项目类别:
Mentoring and research to prepare oral PrEP delivery platforms for novel HIVprevention products
指导和研究,为新型 HIV 预防产品准备口服 PrEP 递送平台
- 批准号:
10642471 - 财政年份:2022
- 资助金额:
$ 21.06万 - 项目类别:
Implementation science research on PrEP delivery and costing within MAT andNSP services for PWUD in Uganda
乌干达残疾人士 MAT 和 NSP 服务中 PrEP 交付和成本计算的实施科学研究
- 批准号:
10631694 - 财政年份:2022
- 资助金额:
$ 21.06万 - 项目类别:
Mentoring and research to prepare oral PrEP delivery platforms for novel HIVprevention products
指导和研究,为新型 HIV 预防产品准备口服 PrEP 递送平台
- 批准号:
10548809 - 财政年份:2022
- 资助金额:
$ 21.06万 - 项目类别:
Implementation science research on PrEP delivery and costing within MAT andNSP services for PWUD in Uganda
乌干达残疾人士 MAT 和 NSP 服务中 PrEP 交付和成本计算的实施科学研究
- 批准号:
10684112 - 财政年份:2022
- 资助金额:
$ 21.06万 - 项目类别:
Mentoring and research to prepare oral PrEP delivery platforms for novel HIV prevention products
指导和研究,为新型艾滋病毒预防产品准备口服 PrEP 递送平台
- 批准号:
10322040 - 财政年份:2021
- 资助金额:
$ 21.06万 - 项目类别:
Feasibility pilot of home-based STI testing and risk self-assessment among adolescent girls in South Africa to trigger PrEP re-start
在南非少女中进行家庭性传播感染检测和风险自我评估以触发 PrEP 重新启动的可行性试点
- 批准号:
10256147 - 财政年份:2021
- 资助金额:
$ 21.06万 - 项目类别:
Mentoring and research to prepare oral PrEP delivery platforms for novel HIV prevention products
指导和研究,为新型艾滋病毒预防产品准备口服 PrEP 递送平台
- 批准号:
10159602 - 财政年份:2021
- 资助金额:
$ 21.06万 - 项目类别:
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