Applying a multidimensional measure of human mobility to understand drivers of HIV incidence in Rakai, Uganda

应用多维人口流动性衡量指标来了解乌干达拉凯艾滋病毒发病率的驱动因素

• 批准号: 10761906
• 负责人: Aleya R Khalifa
• 金额: $ 4.6万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10761906
• 关键词: Adult; Africa South of the Sahara; African; Age; Area; Avidity; Biological Assay; Biological Markers; Caliber; Case/Control Studies; Categories; Climate; Cohort Studies; Communicable Diseases; Communities; Country; Data; Data Analyses; Dedications; Dimensions; Economics; Epidemic; Epidemiologic Methods; Exhibits; Face; Frequencies; Future; Gender; Goals; HIV; HIV Infections; HIV Seronegativity; HIV risk; Health; Health Services Accessibility; Home; Household; Human; Human immunodeficiency virus test; Incidence; Individual; Institution; Intervention; Investigation; Knowledge; Learning; Link; Location; Longitudinal Studies; Longitudinal Surveys; Longitudinal cohort; Measures; Mentorship; Methods; Motivation; Movement; National Institute of Mental Health; Odds Ratio; Outcome; Parents; Participant; Partner Notification; Pathway Analysis; Pattern; Persons; Politics; Population; Population Research; Population Study; Prevalence; Prevention; Questionnaires; Religion; Research; Research Personnel; Resources; Risk; Sampling; Selection Bias; Service delivery model; Services; Sexual Partners; Subgroup; Survey Methodology; Surveys; Testing; Training; Travel; Treatment outcome; Uganda; Universities; Unsafe Sex; Viral Load result; Virus; Visit; Work; aged; barrier to care; career; cohort; community transmission; experience; follow-up; improved; longitudinal analysis; mHealth; migration; poor health outcome; population based; population health; population movement; pre-exposure prophylaxis; prevention service; programs; research data dissemination; response; self testing; service delivery; skills; social; social epidemiology; spatial epidemiology; transmission process; treatment adherence; wasting

PROJECT SUMMARY/ABSTRACT Background. As sub-Saharan African (SSA) countries embark on the last mile toward HIV elimination, HIV programs must prioritize hard-to-reach mobile populations at the greatest risk of HIV acquisition and onward transmission. Some differentiated service delivery models may work for mobile people, but targeting services to such a broad category of individuals could waste limited resources. Since it is unclear which forms of mobility most significantly increase the risk of HIV infection, this study aims to systematically characterize mobility and relate it to HIV incidence at both the individual and sexual network levels. Aims. In line with NIMH Human Mobility and HIV program objectives to determine incidence rates and examine HIV outcomes among mobile populations, this study will 1) characterize mobility and its association with HIV testing and viral load suppression, 2) estimate HIV incidence by mobile group, and 3) determine the effect of mobility on the risk of HIV acquisition in sexual networks. Elucidating these gaps will inform future targeting and tailoring of interventions to improve the health of mobile populations. Approach. Since no consistent measure for mobility exists across HIV studies in SSA, this research will use detailed mobility metrics from the Rakai Community Cohort Study (RCCS), a population-based longitudinal study in south-central Uganda where there is substantial human movement, to develop a multidimensional measure that considers the frequency, duration, motivation, and spatial dimensions to people’s movement. This measure will uncover subclasses of mobility that can be linked to HIV incidence and other prevention and treatment outcomes. RCCS data from 19,300 adults aged 15-49 will be supplemented with data from Hard-to-Reach (HTR), an embedded study within the RCCS that captures HIV outcomes and mobility patterns among 2,000 individuals who have been lost to follow-up (LTFU) in the RCCS. This presents a unique opportunity to assess the missing data biases introduced by population mobility in open, dynamic cohorts. Each Specific Aim will use the full extent of the available data, including longitudinal HIV biomarkers and detailed contact investigations conducted among HIV incident cases and their HIV-negative matched controls. Training. Ms. Khalifa’s training plan leverages her quantitative abilities and HIV research experience to advance her skills and launch her into a career as an independent investigator focused on mobility and health. Her training goals are to develop in-depth knowledge of mobility and migration, gain experience with longitudinal survey methods, learn advanced epidemiologic techniques for missing data and network analyses, and build capacity for effective research dissemination. Under the guidance of her Primary Sponsor, Ms. Khalifa will receive tailored mentorship from a team of experienced HIV researchers who work with the parent studies, conduct mobility-focused research, and have tremendous expertise in the requisite quantitative methods. Training will take place at Columbia University, a high-caliber institution with specialized research programs in population health, infectious disease, and spatial and social epidemiology.

项目摘要/摘要 背景资料。随着撒哈拉以南非洲(SSA)国家踏上消除艾滋病毒的最后一英里，艾滋病毒 计划必须优先考虑感染艾滋病毒风险最大的难以接触到的流动人口以及以后的人群 变速箱。一些差异化的服务交付模式可能适用于移动用户，但将服务定位于 如此广泛的个人类别可能会浪费有限的资源。由于目前还不清楚哪些形式的移动性 最显著地增加艾滋病毒感染的风险，这项研究旨在系统地描述机动性和 将其与个人和性网络层面的艾滋病毒发病率联系起来。目标。符合NIMH人类 移动性和艾滋病毒规划目标，以确定在流动人口中的发病率和检查艾滋病毒结果 这项研究将1)描述流动性及其与艾滋病毒检测和病毒载量抑制的关系， 2)按流动人群估计艾滋病毒发病率，以及3)确定流动对艾滋病毒感染风险的影响 在性爱网络中。阐明这些差距将有助于未来制定目标和调整干预措施，以改善 流动人口的健康。接近。由于在所有艾滋病毒研究中没有一致的流动性衡量标准 在SSA中，这项研究将使用Rakai社区队列研究(RCCS)中的详细移动性指标， 在乌干达中南部有大量人口流动的人口纵向研究，以 开发考虑频率、持续时间、动机和空间维度的多维测量 为人们的运动。这项措施将揭示可与艾滋病毒发病率和 其他预防和治疗成果。来自19,300名15-49岁成年人的RCCS数据将得到补充 来自Hard-to-to-Reach(HTR)的数据，这是一项嵌入RCCS的研究，捕获了艾滋病毒的结果和流动性 2,000名在农村信用社失去随访(LTFU)的个人的模式。这呈现了一种独特的 有机会评估开放、动态队列中的人口流动所带来的缺失数据偏差。每个人 具体目标将充分利用现有数据，包括纵向艾滋病毒生物标志物和详细的 对HIV病例及其HIV阴性配对对照进行接触调查。训练。 哈利法女士的培训计划利用她的量化能力和艾滋病毒研究经验来提升她的技能 并让她成为一名专注于机动性和健康的独立调查员。她的训练目标 是发展关于流动和移徙的深入知识，获得纵向调查方法的经验， 学习用于缺失数据和网络分析的先进流行病学技术，并建设有效的能力 研究成果传播。在她的主要赞助人的指导下，哈利法女士将得到量身定做的指导 来自一组经验丰富的艾滋病毒研究人员，他们与父母研究一起，进行以行动为重点的研究 研究，并在必要的定量方法方面拥有丰富的专业知识。培训将在以下时间进行 哥伦比亚大学是一所高水平的机构，拥有人口健康、传染性疾病的专门研究项目 疾病，以及空间和社会流行病学。