A new approach to controlling chlamydia transmission in young people

控制年轻人衣原体传播的新方法

• 批准号: 9487276
• 负责人: Patricia J Kissinger
• 金额: $ 58.7万
• 依托单位: TULANE UNIVERSITY OF LOUISIANA
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-08-15 至 2021-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9487276
• 关键词: Affect; African American; Aftercare; Area; Awareness; Behavioral; Centers for Disease Control and Prevention (U.S.); Charge; Chlamydia; Chlamydia trachomatis; Clinic; Communities; Community Networks; Community Pharmacy; Cost-Benefit Analysis; Ectopic Pregnancy; Education; Educational Materials; Effectiveness; Fostering; Future; Geography; Goals; HIV; Hair; Healthcare; High Prevalence; Incentives; Infection; Infertility; Intervention; Legal; Literature; Logistics; Modeling; Participant; Pelvic Inflammatory Disease; Persons; Phase; Prevention; Prevention program; Public Health; Recommendation; Reporting; Reproductive Health; Research; Risk; Sampling; Sexual Partners; Sexually Transmitted Diseases; Social Network; Target Populations; Testing; Text; Time; Time and Motion Studies; Translating; Translational Research; Transportation; Trust; Urine; Woman; Work; aged; base; community intervention; community organizations; cost; cost effective; cost effectiveness; effectiveness measure; epidemiological model; evidence base; experience; financial incentive; health disparity; improved; indexing; male; man; medical examination; men; novel strategies; peer; peer networks; population based; post intervention; practical application; program costs; programs; reproductive morbidity; routine screening; screening; screening program; sexually active; social stigma; transmission process; uptake; young man

Abstract Chlamydia trachomatis (Ct) is the most commonly reported sexually transmitted infection in the U.S., is a major cause of infertility, pelvic inflammatory disease and ectopic pregnancy among women and has been associated with increased HIV acquisition. Because women experience the most severe sequelae, the focus of Ct prevention in the U.S. has been on screening sexually active women < 25 years old. Though men are reservoirs of the infection, the Centers for Disease Control and Prevention have not recommended targeting men due to lack of evidence for this approach. This research will fill this gap. African American (AA) women are 7.5 times more likely to be infected with Ct than whites, thus AA are the focus of this research. We hypothesize that screening AA men is essential to curbing the high rates of Ct among young AA women and that a bundled approach will by synergistic. Our community-based pilot program, called “Check it,” is a pilot- tested male screening program which targeted AA men aged 15-25. At the core of this intervention is male Ct screening, but it is also bundled with other evidence-based and best practices for Ct control including: venue- based sampling (VBS), social network peer referral, modest monetary incentives (MMI), screening of target men, rescreening of target men found to be Ct positive with text reminders (Text-RS) , expedited treatment for index men (EIT) and for the partners (EPT), and Wed-based education (Web-Ed). The goal of this study is to examine the effectiveness of a pilot-tested, bundled Ct prevention program focusing on screening young AA men for the prevention of Ct among young AA women: Aim 1. To determine the impact of Check it on women's Ct rates – This aim has a formative phase and an intervention phase. In the formative phase, the pilot Check it is developed and manualized. In the intervention, Check it is implemented and evaluated. We hypothesize that, post-intervention, Ct rates among AA women in the intervention community will be significantly lower compared to rates in the control communities, and that Check it will result in high rates of index/partner treatment and rescreening. Aim 2. To model the potential impact and optimal coverage needed - Using inputs from this study and the literature, a deterministic population-based epidemiological model will be used to model the number of cases averted by Check it and to determine the potential impact at different intensities of the intervention. Aim 3. To determine the cost effectiveness of Check it - Time motion studies will be conducted and used as inputs for the cost-benefit/effectiveness analysis of the Check it Program in order to distinguish study from program costs. If Check it is found to be effective as hypothesized, we will conduct future translational research to disseminate the program. This research has the potential for practical application by improving reproductive health and high impact by removing disparities in the control of Ct among AA men. .

摘要 沙眼衣原体（Ct）是美国最常见的性传播感染，是一个重大 不孕症，盆腔炎和宫外孕的原因，并已 与艾滋病毒感染增加有关。因为女性经历最严重的后遗症， 在美国，Ct预防的重点是筛查25岁以下的性活跃女性。虽然男人是 疾病控制和预防中心不建议针对感染的水库， 由于缺乏这种方法的证据。这项研究将填补这一空白。非裔美国人（AA） 比白人感染Ct的可能性高7.5倍，因此AA是本研究的重点。我们 假设筛查AA男性对于抑制年轻AA女性中Ct的高发病率至关重要， 捆绑的方法将产生协同作用。我们以社区为基础的试点项目，叫做“检查它”，是一个试点- 测试了针对15-25岁AA男性的男性筛查计划。这种干预的核心是男性Ct 筛查，但它也与其他基于证据的最佳实践捆绑在一起，用于Ct控制，包括： 基于抽样（VBS），社会网络同行推荐，适度货币激励（MMI），目标筛选 男性，通过文本提醒（Text-RS）对发现Ct阳性的目标男性进行重新筛选，加速治疗 指数男性（EIT）和伴侣（EPT），以及基于Wed的教育（Web-Ed）。本研究的目的是 检查试点测试的有效性，捆绑Ct预防计划，重点是筛查 年轻AA男性预防年轻AA女性Ct：目标1。为了确定 检查妇女的Ct率-这一目标有一个形成阶段和干预阶段。在形成 阶段，试点检查它是制定和手动。在干预中，检查是否实施， 评估。我们假设，干预后，干预社区中AA妇女的Ct率 与对照社区的比率相比，将显着降低，并且检查它将导致高 索引/伴侣治疗和重新筛选的比率。目标2.为了模拟潜在的影响和最佳的 所需的覆盖范围-使用本研究和文献的输入， 流行病学模型将用于模拟通过检查避免的病例数，并确定 不同干预强度下的潜在影响。目标3.确定成本效益， 检查-将进行时间运动研究，并将其用作成本效益/有效性分析的输入 检查它的程序，以区分研究从程序的成本。如果选中，则发现它有效， 假设，我们将进行未来的翻译研究，以传播该计划。这项研究有 通过改善生殖健康和通过消除性别差异产生重大影响， AA患者Ct的控制。 .