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Integrating HIV Prevention into Clinical Care for PLWHA in South Africa

将艾滋病毒预防纳入南非艾滋病毒感染者的临床护理

基本信息

批准号：
7544929
负责人：
JEFFREY D FISHER
金额：
$ 152.19万
依托单位：
UNIVERSITY OF CONNECTICUT STORRS
依托单位国家：
美国
项目类别：
财政年份：
2007
资助国家：
美国
起止时间：
2007-01-11 至 2011-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7544929
关键词：
AIDS prevention AIDS/HIV problem Abate Adherence Affect African Age Anti-Retroviral Agents Behavior Behavioral Caring Case Study Centers for Disease Control and Prevention (U.S.)Clinic Control Groups Counseling Country Data Development Disease Disease Progression Drug usage Effectiveness Environment Epidemic Evaluation Funding Goals Government HIV Health Health Personnel Healthcare Human Human Resources Human immunodeficiency virus test Incentives Incidence Individual Injection of therapeutic agent International International Agencies Intervention Intervention Studies Investigation Learning Life Link Mediating Modeling Monitor Motivation Natural History Outcome Study Outcomes Research Participant Patients Persons Pharmaceutical Preparations Population Prevalence Prevention Prevention approach Preventive Preventive Intervention Primary Health Care Private Sector Professional counselor Protocols documentation Public Health Randomized Controlled Trials Recommendation Reporting Research Research Design Research Personnel Research Support Risk Risk Behaviors Risk Reduction Services Sex Behavior Site Societies Source South Africa Specific qualifier value Stigmata Suggestion System Techniques Testing Time Treatment Protocols United States National Institutes of Health Virus Work antiretroviral therapy base behavior change brief intervention clinical care cohort design effective intervention group intervention improved inner city intervention effect motivational enhancement therapy pathogen patient oriented prevent prevention service programs sex risk skills social stigma standard of care stem surveillance data transmission process uptake

项目摘要

DESCRIPTION (provided by applicant): Project Summary: The South African HIV epidemic continues to cause catastrophic human suffering across all sectors of society. With the rollout of antiretroviral therapy, however, far more South Africans are being tested for HIV and far more are entering HIV clinical care. The proposed research involves development, implementation, and evaluation of a culturally-appropriate HIV prevention intervention, situated in the South African HIV clinical care context, and aimed at assisting South African PLWHA to reduce HIV transmission risk behavior. This intervention approach is based on the behavior change framework from the Options Project; an acceptable, feasible, and effective HIV prevention intervention, implemented in US HIV care settings, which significantly reduced HIV+ individuals' HIV transmission risk behavior. The overall objective of the proposed research is to create a culturally-appropriate, effective, and efficient intervention strategy that may be widely disseminated within the South African clinical care context, to aid in stemming the South African HIV epidemic. The proposed research design involves a cluster randomized controlled trial of the effectiveness of a counselor-driven HIV prevention intervention, delivered in the South African clinical care context, compared to a standard-of-care control, in reducing HIV transmission risk behavior and incident STI rates among South African PLWHA. Specific aims of the proposed investigation are to conduct formative research with South African PLWHA and South African HIV care personnel, to identify unique obstacles to HIV preventive behavior for South African PLWHA, and to identify ways of overcoming these obstacles, in a feasible and culturally-acceptable, clinical care-based intervention; to design, pilot test, refine, implement, and evaluate an intervention, to be delivered in the South African HIV care setting, to assist South African PLWHA to reduce HIV transmission risk behaviors and incident STI; and to utilize the standard of care control as a cohort for a longitudinal natural history study of HIV transmission risk behavior, STI incidence, and how health improvements associated with ARV treatment may be related to changes in HIV risk behavior among South African PLWHA. Relevance. The proposed research aims to develop an effective and readily disseminated intervention to improve individual and public health by preventing transmission of HIV to uninfected individuals, and acquisition of STI by HIV+ persons, in the context of the South African HIV epidemic.

描述（由申请人提供）：项目摘要：南非的艾滋病毒流行病继续在社会各部门造成灾难性的人类痛苦。然而，随着抗逆转录病毒疗法的推出，越来越多的南非人正在接受艾滋病毒检测，越来越多的人正在接受艾滋病毒临床治疗。拟议的研究涉及发展、实施和评估一种文化上适当的艾滋病毒预防干预措施，该干预措施位于南非艾滋病毒临床护理背景下，旨在帮助南非艾滋病毒感染者卫生组织减少艾滋病毒传播风险行为。这种干预方法是基于选项项目中的行为改变框架；一种可接受的、可行的、有效的艾滋病预防干预措施，在美国艾滋病护理机构实施，显著降低了HIV+个体的艾滋病传播风险行为。拟议研究的总体目标是创建一种文化上适当、有效和高效的干预策略，可以在南非临床护理范围内广泛传播，以帮助遏制南非的艾滋病毒流行。拟议的研究设计涉及一项聚类随机对照试验，对在南非临床护理背景下提供的咨询师驱动的艾滋病毒预防干预措施的有效性进行了比较，与标准护理对照相比，降低了南非艾滋病感染者的艾滋病毒传播风险行为和性传播感染发生率。拟议调查的具体目的是与南非艾滋病毒感染者和南非艾滋病毒护理人员进行形成性研究，确定南非艾滋病毒感染者预防行为的独特障碍，并确定克服这些障碍的方法，以可行和文化上可接受的临床护理为基础的干预；设计、试点测试、完善、实施和评估将在南非艾滋病毒护理环境中提供的干预措施，以协助南非艾滋病毒携带者卫生组织减少艾滋病毒传播风险行为和性传播感染事件；并利用护理控制标准作为队列，对艾滋病毒传播风险行为、性传播感染发生率进行纵向自然历史研究，以及与抗逆转录病毒治疗相关的健康改善如何与南非艾滋病毒感染者中艾滋病毒风险行为的变化相关。的相关性。拟议的研究旨在制定一项有效和易于传播的干预措施，在南非艾滋病毒流行的背景下，通过防止艾滋病毒传染给未感染的个人和艾滋病毒阳性者感染性传播感染，改善个人和公众健康。