Ukubandakanya abesilisisa: HIV self-testing for Partners of HIV-uninfected Postpartum Women to facilitate PrEP and ART uptake to promote HIV treatment and prevention

Ukubandakanya abesilisisa：为未感染艾滋病毒的产后妇女的伴侣进行艾滋病毒自我检测，以促进 PrEP 和 ART 的采用，从而促进艾滋病毒治疗和预防

• 批准号: 10762152
• 负责人: Lynn T Matthews
• 金额: $ 62.3万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-08 至 2026-09-07
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10762152
• 关键词: AIDS prevention; Acute; Address; Africa South of the Sahara; Awareness; Behavior; Behavioral Model; Behavioral Research; Breast Feeding; Caring; Child; Client satisfaction; Clinic; Counseling; Coupled; Couples; Data; Diagnosis; Diagnostic Reagent Kits; Effectiveness; Enrollment; Family; Feedback; Female; Female of child bearing age; Focus Groups; Fright; Funding; Gender; HIV; HIV Infections; HIV diagnosis; Health; Health protection; Human immunodeficiency virus test; Incidence; Individual; Infant; Information Centers; Information Distribution; Intervention; Interview; Lead; Learning; Link; Masculine; Measures; Modification; Mothers; Oral; Outcome; Perception; Postpartum Period; Postpartum Women; Pregnancy; Prevalence; Prevention; Prevention strategy; Privacy; Province; Questionnaires; Randomized; Reporting; Reproductive Health; Research; Retinal blind spot; Risk; Schedule; Sexual Partners; South Africa; Standardization; Structure; System; Tenofovir; Test Result; Testing; Time; United States National Institutes of Health; Viral; Woman; Work; acceptability and feasibility; antiretroviral therapy; arm; catalyst; follow-up; high risk; infection rate; intervention mapping; male; men; novel; offspring; perinatal HIV; perinatal period; perinatal women; pilot trial; post intervention; post pregnancy; pre-exposure prophylaxis; preference; pregnant; prevent; primary outcome; self testing; social stigma; standard of care; success; transmission process; treatment arm; uptake

PROJECT SUMMARY Perinatal women in South Africa (SA) have one of the highest HIV infection rates in the world, and are almost exclusively infected via sexual contact from male partners. The postpartum period is an increased time of risk for HIV. If women become HIV infected at the end of pregnancy or during the postpartum period, HIV may be transmitted to the infant via breastfeeding. Women and men in partnerships in SA do not always know each other’s HIV statuses. This can make HIV prevention difficult, particularly in SA, where men are less likely to be tested for HIV than women. HIV-uninfected women have the option of using pre-exposure prophylaxis (PrEP) to help them remain HIV-uninfected; men with HIV (MWH) who know their status, and who take treatment effectively, are unlikely to transmit HIV to their female partners. Men are now able to test themselves for HIV using HIV self-test (HIVST) kits; use of these kits has the potential to circumvent barriers to traditional, clinic- based HIV testing, such as concerns about stigma or privacy, or competing demands, like busy work schedules. Our earlier work suggests that men are willing to engage in behaviors to protect their female partners from HIV during attempts to conceive in order to protect their offspring, including HIV testing. Providing HIV-uninfected women with HIVST kits for male partner distribution and HIV prevention counseling during the early postpartum period may help women remain HIV-uninfected during this time of increased risk, and may also identify MWH and help those men engage in HIV care. Thus, this study has the following objectives: (1) to refine the content of a combination intervention to promote HIVST for Partners and PrEP uptake for HIV-uninfected Postpartum Women (“H4P”) via focus group discussion feedback from women and men in SA who have had a child in the past year (N = up to 10 women and 10 men); (2) to conduct a randomized pilot trial of the H4P intervention for postpartum HIV-uninfected women (N = 60 and their male partners) in KwaZulu-Natal, SA, who report a partner of unknown serostatus. All women will receive HIVST kits and standardized health information for distribution to male partners; those randomized to the H4P intervention arm will also receive PrEP uptake counseling, and male partners will receive reproductive health-centered information about why HIV testing is important. Feasibility and acceptability will be assessed. (3a) To evaluate preliminary effectiveness by calculating, across intervention/control arms at three months post-intervention, the proportion of women initiating PrEP among those whose partners test positive, do not test, or do not share a test result, and the proportion of men with a positive test who link to HIV care. (3b) To conduct individual qualitative interviews with a subset of enrolled women and their partners (N = up to 10-15 women and men) in the intervention arm to explore opportunities to optimize the intervention.

项目摘要 南非（SA）的围产期妇女是世界上艾滋病毒感染率最高的国家之一， 仅通过男性伴侣的性接触感染。产后期是一个风险增加的时期 艾滋病病毒如果妇女在妊娠末期或产后感染艾滋病毒， 通过母乳喂养传染给婴儿。南非合伙企业中的男女并不总是相互了解 其他人的艾滋病状况。这可能使艾滋病毒的预防变得困难，特别是在南非，那里的男子不太可能感染艾滋病毒。 比女性更容易感染艾滋病毒。未感染艾滋病毒的妇女可以选择使用暴露前预防（PrEP） 帮助他们保持未感染艾滋病毒;了解自己状况并接受治疗的艾滋病毒感染者（MWH） 实际上，不太可能将艾滋病毒传染给其女性伴侣。男性现在能够检测自己是否感染艾滋病毒 使用艾滋病毒自我检测（HIVST）试剂盒;使用这些试剂盒有可能绕过传统的，临床的， 基于艾滋病毒检测，如对耻辱或隐私的关注，或竞争的需求，如忙碌的工作， 时间表。我们早期的研究表明，男性愿意采取保护女性的行为， 为了保护他们的后代，包括艾滋病毒检测， 向未感染艾滋病毒的妇女提供艾滋病毒/艾滋病防治工具包，供男性伴侣分发和提供艾滋病毒预防咨询 在产后早期，可能有助于妇女在这段风险增加的时期保持艾滋病毒未感染， 还可以识别MWH并帮助这些男性参与艾滋病毒护理。因此，这项研究有以下几点 目标：（1）完善联合干预措施的内容，以促进合作伙伴的艾滋病毒/艾滋病防治和PrEP 通过重点小组讨论，从妇女和 在过去一年中有过一个孩子的SA男性（N =最多10名女性和10名男性）;（2）进行一项 对产后未感染HIV的妇女进行H4 P干预的随机试点试验（N = 60，其男性 在南非的夸祖鲁-纳塔尔，报告了一名血清状态未知的伴侣。所有妇女都将获得艾滋病毒/艾滋病治疗包 和标准化的健康信息分发给男性伴侣;那些随机接受H4 P干预的人 手臂还将接受PrEP摄取咨询，男性伴侣将接受以生殖健康为中心的 了解为什么艾滋病毒检测很重要。将评估可行性和可接受性。(3a)评价 通过计算干预后三个月干预/对照组的初步有效性， 启动PrEP的女性在其伴侣检测呈阳性、不检测或不共享PrEP的女性中的比例 艾滋病毒检测结果，以及与艾滋病毒护理有关的阳性检测男子的比例。(3b)进行个人 对登记的妇女及其伴侣（N =最多10-15名妇女和男子）进行定性访谈， 干预部门探索优化干预的机会。