Improving HIV Prevention Services among Socioeconomically Disadvantaged Cis-gender Women

改善社会经济弱势顺性别女性的艾滋病毒预防服务

• 批准号: 10772735
• 负责人: Jenell S Coleman
• 金额: $ 21.62万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-05 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10772735
• 关键词: AIDS prevention; Acute; Address; Administrative Supplement; African American; Belief; Black race; Breast Feeding; Caring; Child; City Planning; Clinic; Clinical; Counseling; Data; Decision Making; Development; Diagnosis; Discipline of obstetrics; Enrollment; Ensure; Epidemic; Ethnic Origin; Ethnic Population; Family; Feedback; Gender; Guidelines; Gynecology; HIV; HIV Infections; HIV Seropositivity; HIV risk; Hispanic; Home; Human immunodeficiency virus test; Infant; Interview; Knowledge; Latino; Live Birth; Methods; Newly Diagnosed; Outcome; Parents; Patients; Perinatal; Perinatal transmission; Personal Satisfaction; Persons; Population; Postpartum Period; Pregnancy; Pregnant Women; Prenatal care; Prevention; Provider; Recommendation; Recording of previous events; Research; Risk; Schedule; Sexual Partners; Surveys; Testing; Time; United States; Vagina; Visit; Woman; antiretroviral therapy; barrier to testing; cis-female; effectiveness/implementation trial; evidence base; health of the mother; high risk; implementation research; improved; infection rate; male; obstetric care; perinatal HIV; pre-exposure prophylaxis; pregnant; prevent; prevention service; racial disparity; racial population; seroconversion; social culture; socioeconomic disadvantage; testing uptake; transmission process; uptake; virtual

Eliminating perinatal HIV in the U.S. is within reach. The overall rate of perinatal HIV infections in 2020 was 1:100,000, but there were disparities by race and ethnicity. For example, the rate of infections among Black/African American infants was 3.8:100,000, which is four and nearly 13 times the rates among Hispanic/Latino and White persons, respectively. To reduce the number of babies born with HIV, we must ensure pregnant women and their partners have access to HIV testing and PrEP. Opt-out HIV testing of the pregnant person is an effective evidenced-based strategy to prevent perinatal HIV transmission; however, this approach does not identify or address those at risk of HIV seroconversion during pregnancy. Ending the HIV epidemic may not be successfully achieved inn certain populations without the intentional engagement of the male partner during the pregnancy period. Male partner engagement benefits a wide range of outcomes related to maternal, child, and family wellbeing. U.S. guidelines recommend that partners of pregnant women undergo HIV testing when their status is unknown. However, this recommendation has not been implemented due to a lack of successful implementation research. Whereas the parent hybrid effectiveness-implementation trial (R01MH132146) addresses barriers to HIV testing and PrEP uptake among a non-pregnant population, this administrative supplement focuses on socioeconomically disadvantaged pregnant persons and their male partners. We aim to conduct a pilot mixed methods study to engage male partners in HIV prevention services during prenatal care. We hypothesize that the uptake of HIV prevention services (i.e., counseling, HIV testing, and PrEP) will increase with the engagement of the male partner (in-person or virtually) and the assessment of their HIV risk. This project will assess the perceived risk of HIV infection among the pregnant person and their male sexual partner with a validated survey. Next, we will offer male partners home-based HIV testing. Last, we will identify facilitators and barriers to testing uptake using in-depth interviews.

在美国消除围产期艾滋病毒是遥不可及的。年围产期艾滋病毒总感染率 2020年是1：10万，但不同种族和民族之间存在差异。例如， 黑人/非裔美国婴儿的感染率是3.8：100,000，是4又近13倍 西班牙裔/拉丁裔和白人的这一比例。为了减少婴儿的数量 出生时携带艾滋病毒，我们必须确保孕妇及其伴侣有机会进行艾滋病毒检测和 准备好了。对孕妇进行选择退出艾滋病毒检测是一种有效的循证预防策略 围产期艾滋病毒传播；然而，这种方法不能识别或解决艾滋病毒高危人群 怀孕期间的血清转换。结束艾滋病毒流行可能不会成功实现 在怀孕期间没有男性伴侣故意订婚的某些人群 句号。男性伴侣敬业度有益于与母亲、儿童和 家庭幸福。美国指南建议孕妇的伴侣接受艾滋病毒检测 当他们的状态未知的时候。然而，这项建议尚未实施，原因是 缺乏成功的实施研究。鉴于父代混合有效性--实施 试验(R01MH132146)解决了非孕妇艾滋病毒检测和PrEP吸收的障碍 人口，这项行政补充侧重于社会经济上处于不利地位的孕妇 个人及其男性伴侣。我们的目标是进行一项试验性的混合方法研究，以吸引男性 产前护理期间艾滋病毒预防服务的合作伙伴。我们假设感染艾滋病毒的人 预防服务(即咨询、艾滋病毒检测和预防接种计划)将随着 男性伴侣(面对面或虚拟)及其艾滋病毒风险评估。该项目将评估 患有艾滋病的孕妇及其男性性伴侣感染艾滋病毒的风险认知 经过验证的调查。接下来，我们将为男性伴侣提供家庭艾滋病毒检测。最后，我们将确定 使用深度访谈测试理解的促进者和障碍。

项目成果

An effectiveness-implementation trial protocol to evaluate PrEP initiation among U.S. cisgender women using eHealth tools vs. standard care.

• DOI: 10.3389/frph.2023.1196392
• 发表时间: 2023
• 期刊: FRONTIERS IN REPRODUCTIVE HEALTH
• 作者: Izadi, Lillee H;Mmeje, Okeoma;Drabo, Emmanuel F;Perin, Jamie;Martin, Stephen;Coleman, Jenell S
• 通讯作者: Coleman, Jenell S