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
基本信息
- 批准号:10761048
- 负责人:
- 金额:$ 69.33万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2023
- 资助国家:美国
- 起止时间:2023-09-14 至 2028-07-31
- 项目状态:未结题
- 来源:
- 关键词:AIDS preventionAdherenceAdvocateAgeAtopobium vaginaeBehavioral SciencesBloodCaringClientClinicClinicalClinical TrialsCluster randomized trialCollaborationsConsolidated Framework for Implementation ResearchContraceptive AgentsCounselingCountryDapivirineDependenceDiphosphatesDropsEducational MaterialsEffectivenessEligibility DeterminationEpidemicExposure toFamily PlanningFemale AdolescentsFocus GroupsFrequenciesGuidelinesHIVHealthcareHuman immunodeficiency virus testIncidenceIndividualInjectableInjectionsInterventionInterviewIntramuscular InjectionsKenyaLengthMeasuresMethodsOralPathway interactionsPatientsPersonsPharmaceutical PreparationsPopulationPreventionProcessProtocols documentationProviderQualitative ResearchRandomizedRandomized, Controlled TrialsRecommendationReproductive HealthReproductive Health ServicesResearchResearch MethodologyResidual stateRiskSafetyServicesSex BehaviorSexual HealthSocial supportSouthern AfricaSystemTenofovirTimeTrainingVaginal RingWomanWorkantenatalclinical epidemiologycommunity based researchcommunity consultationdesignexperienceimplementation scienceimprovedinterestmemberpillpre-exposure prophylaxisproduct developmentprogramsscale upsecondary outcomesupply chainunintended pregnancyuptakeyoung woman
项目摘要
ABSTRACT
Daily oral PrEP has been scaled up in Kenya for numerous populations, including young women with substantial
risk for HIV. For many young women who start oral PrEP, numerous studies have demonstrated that
discontinuation rates are high and they unlikely benefit from long-term HIV protection. Newer PrEP products that
are longer acting, including dapivirine-eluting vaginal rings and intramuscular injections of cabotegravir, offer 1-
2 months of protection and less dependence on the user to remember to take a daily pill. Following WHO
guidelines, these products are being integrated into clinical guidelines in Kenya and other countries. For daily
oral PrEP, a key strategy for efficient scale up was integration into existing programs, such as those for
reproductive health care (e.g., family planning, antenatal, postabortal care) and we have been studying ways to
optimize integration of PrEP into these settings. Through implementation science research protocols, we have
been working with public clinic staff to introduct PrEP, train providers to delivery PrEP, develop linkages between
clinics and national supply chain mechanisms for PrEP, and support providers and programs to overcome
challenges. Despite documented high levels of interest in PrEP yielding high frequency of PrEP initiation – 13-
35% of eligible women ages 15-30 years in our family planning and post-abortal clinic partners – we have
continued to see high levels of program drop out, non-adherence, and only moderate ability to track whether
PrEP is re-started in alignment with fluctuating sexual behavior and potential exposure to HIV. These barriers to
PrEP continuation are driven by young women’s needs for PrEP products that afford discretion, convenience,
and safety.
It is yet unknown whether the availability of multiple HIV PrEP products in a PrEP program will yield a degree of
choice, support longer term use of PrEP, and ultimately, greater HIV prevention coverage. Through a multi-step
process invoking formative work and a stepped-wedge cluster randomized trial, the research team proposes to
determine whether the availability of a suite of PrEP options yields greater HIV protection coverage over a 3-
and 6- month period relative to periods when only daily oral PrEP is available. The proposed study aims to: 1)
develop a pathway to add injectable cabotegravir and dapivirine ring into existing PrEP services offered through
in reproductive health clinics in Kenya leveraging qualitative and community-based research methods, 2)
determine whether integration of injectable cabotegravir and dapivirine ring into existing PrEP programs
improves PrEP uptake and persistence among young women accessing reproductive health services via a
stepped-wedge cluster randomized trial in 12 facilities, and 3) interrogate potential weak points in the PrEP
choice intervention including: a) provider hesitancy and client experiences, b) quality of choice-based HIV
prevention counseling.
摘要
每日口服PrEP在肯尼亚已扩大到许多人群,包括患有大量
艾滋病毒的风险。对于许多开始口服PrEP的年轻女性来说,许多研究表明,
停药率很高,他们不太可能受益于长期的艾滋病毒保护。较新的PrEP产品,
包括dapivirine洗脱阴道环和cabotegravir肌内注射,
2个月的保护和更少的依赖用户记得每天服用药丸。以下谁
这些产品正在被纳入肯尼亚和其他国家的临床指南。日常
口服PrEP,有效扩大规模的一个关键策略是整合到现有的计划中,例如
生殖保健(例如,计划生育、产前和产后护理),我们一直在研究如何
优化PrEP与这些环境的整合。通过实施科学研究协议,我们
一直与公共诊所工作人员合作,介绍PrEP,培训提供者提供PrEP,
诊所和国家供应链机制的PrEP,并支持供应商和计划,以克服
挑战尽管记录了对PrEP的高度兴趣,但PrEP启动的频率很高- 13-
35%的15-30岁符合条件的妇女在我们的计划生育和堕胎后诊所合作伙伴-我们有
继续看到高水平的计划辍学,不遵守,只有中等能力,以跟踪是否
PrEP重新开始与波动的性行为和潜在的艾滋病毒暴露保持一致。这些障碍,
PrEP的延续是由年轻女性对PrEP产品的需求驱动的,这些产品提供了自由裁量权,便利性,
和安全性
目前尚不清楚在PrEP计划中提供多种HIV PrEP产品是否会产生一定程度的预防效果。
选择,支持长期使用PrEP,最终扩大艾滋病毒预防覆盖面。通过多步骤
过程调用形成性工作和阶梯楔形集群随机试验,研究小组建议,
确定一套PrEP方案的可用性是否会在3- 10年内产生更大的艾滋病毒保护覆盖率,
和6个月的时间段相对于只有每日口服PrEP可用的时间段。拟议的研究旨在:1)
开发一种途径,将可注射的cabotegravir和dapivirine环添加到现有的PrEP服务中,
在肯尼亚的生殖健康诊所利用定性和基于社区的研究方法,2)
确定是否将注射用cabotegravir和dapivirine环整合到现有的PrEP计划中
通过以下方式提高获得生殖健康服务的年轻妇女对PrEP的接受率和持久性:
在12个设施中进行的阶梯楔形群随机试验,以及3)询问PrEP中的潜在弱点
选择性干预包括:a)提供者的犹豫和客户的经验,B)基于选择的艾滋病毒的质量
预防咨询。
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 }}
Renee A. Heffron其他文献
Renee A. Heffron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('Renee A. Heffron', 18)}}的其他基金
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:
$ 69.33万 - 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:
$ 69.33万 - 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:
$ 69.33万 - 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:
$ 69.33万 - 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:
$ 69.33万 - 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:
$ 69.33万 - 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:
10678858 - 财政年份:2021
- 资助金额:
$ 69.33万 - 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:
$ 69.33万 - 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:
10478163 - 财政年份:2021
- 资助金额:
$ 69.33万 - 项目类别:
相似海外基金
An innovative, AI-driven prehabilitation platform that increases adherence, enhances post-treatment outcomes by at least 50%, and provides cost savings of 95%.
%20创新、%20AI驱动%20康复%20平台%20%20增加%20依从性、%20增强%20治疗后%20结果%20by%20at%20至少%2050%、%20和%20提供%20成本%20节省%20of%2095%
- 批准号:
10057526 - 财政年份:2023
- 资助金额:
$ 69.33万 - 项目类别:
Grant for R&D
Improving Repositioning Adherence in Home Care: Supporting Pressure Injury Care and Prevention
提高家庭护理中的重新定位依从性:支持压力损伤护理和预防
- 批准号:
490105 - 财政年份:2023
- 资助金额:
$ 69.33万 - 项目类别:
Operating Grants
I-Corps: Medication Adherence System
I-Corps:药物依从性系统
- 批准号:
2325465 - 财政年份:2023
- 资助金额:
$ 69.33万 - 项目类别:
Standard Grant
Unintrusive Pediatric Logging Orthotic Adherence Device: UPLOAD
非侵入式儿科记录矫形器粘附装置:上传
- 批准号:
10821172 - 财政年份:2023
- 资助金额:
$ 69.33万 - 项目类别:
Nuestro Sueno: Cultural Adaptation of a Couples Intervention to Improve PAP Adherence and Sleep Health Among Latino Couples with Implications for Alzheimer’s Disease Risk
Nuestro Sueno:夫妻干预措施的文化适应,以改善拉丁裔夫妇的 PAP 依从性和睡眠健康,对阿尔茨海默病风险产生影响
- 批准号:
10766947 - 财政年份:2023
- 资助金额:
$ 69.33万 - 项目类别:
CO-LEADER: Intervention to Improve Patient-Provider Communication and Medication Adherence among Patients with Systemic Lupus Erythematosus
共同领导者:改善系统性红斑狼疮患者的医患沟通和药物依从性的干预措施
- 批准号:
10772887 - 财政年份:2023
- 资助金额:
$ 69.33万 - 项目类别:
Pharmacy-led Transitions of Care Intervention to Address System-Level Barriers and Improve Medication Adherence in Socioeconomically Disadvantaged Populations
药房主导的护理干预转型,以解决系统层面的障碍并提高社会经济弱势群体的药物依从性
- 批准号:
10594350 - 财政年份:2023
- 资助金额:
$ 69.33万 - 项目类别:
Antiretroviral therapy adherence and exploratory proteomics in virally suppressed people with HIV and stroke
病毒抑制的艾滋病毒和中风患者的抗逆转录病毒治疗依从性和探索性蛋白质组学
- 批准号:
10748465 - 财政年份:2023
- 资助金额:
$ 69.33万 - 项目类别:
Improving medication adherence and disease control for patients with multimorbidity: the role of price transparency tools
提高多病患者的药物依从性和疾病控制:价格透明度工具的作用
- 批准号:
10591441 - 财政年份:2023
- 资助金额:
$ 69.33万 - 项目类别:
Development and implementation of peer-facilitated decision-making and referral support to increase uptake and adherence to HIV pre-exposure prophylaxis in African Caribbean and Black communities in Ontario
制定和实施同行协助决策和转介支持,以提高非洲加勒比地区和安大略省黑人社区对艾滋病毒暴露前预防的接受和依从性
- 批准号:
491109 - 财政年份:2023
- 资助金额:
$ 69.33万 - 项目类别:
Fellowship Programs