Developing and Testing a Multi-level Package of Interventions for an Integrated Care Delivery Model of HIV Prevention and Treatment in Zambia: Targeting Adolescent Boys and Young Men

制定和测试赞比亚艾滋病毒预防和治疗综合护理服务模式的多层次干预措施：以青春期男孩和年轻男性为目标

• 批准号: 10355670
• 负责人: SUJHA SUBRAMANIAN
• 金额: $ 3.21万
• 依托单位: RESEARCH TRIANGLE INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-05-01 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10355670
• 关键词: AIDS prevention; Administrative Supplement; Adolescence; Adolescent; Adolescent and Young Adult; Affect; Africa South of the Sahara; Age; Caring; Clinic; Cluster randomized trial; Complement; Continuity of Patient Care; Data; Data Collection; Diagnosis; Dimensions; Economics; Education; Effectiveness of Interventions; Enrollment; Ensure; Face; Female Adolescents; Future; Gender Role; Goals; HIV; Health system; High Prevalence; Human immunodeficiency virus test; Incidence; Individual; Intervention; Knowledge; Learning Module; Male Adolescents; Mental Health; Outcome; Parents; Pharmaceutical Preparations; Prevalence; Prevention Research; Randomized; Risk; Self Efficacy; Service delivery model; Services; Social support; System; Testing; Time; Training; Treatment outcome; Variant; Viral Load result; Zambia; age group; aged; base; boys; cohort; community intervention; community setting; cost; cost effectiveness; design; efficacy outcomes; emerging adult; experience; gender difference; gender equality; girls; health care delivery; implementation cost; implementation measures; implementation outcomes; improved; improved outcome; male; multi-component intervention; parent grant; peer; policy implication; preventive intervention; programs; scale up; social; social stigma; standard of care; substance use; trend; young adult; young man; young woman

PROJECT SUMMARY/ABSTRACT Zambia has one of the highest incidences of HIV in the world. Adolescent girls and young women (AGYW) are a particularly affected group because of their social and economic vulnerability. There is growing recognition of the importance of including adolescent boys and young men (ABYM) in HIV prevention research. During adolescence and early adulthood, boys have significantly lower HIV prevalence than AGYW. However, adolescent boys experience large increases in HIV prevalence in the years that follow, which thereby indicates that adolescence may be a critical time when boys should be engaged in HIV prevention. With this administrative supplement, we propose to add a cohort of ABYM to explore the efficacy of tailored multilevel interventions on HIV outcomes. The overall goal of the supplement is to assess gender differences related to both efficacy and implementation outcomes of the multicomponent interventions. We will develop tailored education materials targeted at ABYM to complement the SHIELD (Support for HIV Integrated Education, Linkages to care, and Destigmatization) education modules developed for AGYW. We will conduct similar interventions for ABYM as planned for AGYW in the community setting and support linkages to the Integrated Wellness Care (IWC) clinics already established for the parent study. We will select 300 ABYM from the previously enrolled cohort for inclusion in the study. As stated in the parent grant, we will compare (1) the SHIELD community intervention only, (2) SHIELD and clinic-based interventions, and (3) the standard of care. We will pursue the following specific aims in this administrative supplement: Aim 1 is to include ABYM in assessing efficacy at 6 and 12 months of the multilevel interventions at the individual (HIV knowledge, self-efficacy), interpersonal (social support, stigma reduction), and health system (clinic-based multiple services) levels on HIV testing, retention in care, and viral load suppression using a cluster randomized design and Aim 2 is to assess implementation outcomes and cost-effectiveness of the interventions targeted at ABYM to support scale-up and sustainability. Including a cohort of ABYM will enhance the study by supplementing the data gathered from the cohort of AGYW to understand the impact of gender equality and norms on outcomes along the HIV continuum of care. The findings from the supplement and parent grant will allow us to design a comprehensive program for adolescents that can be implemented in the community setting along with sustainable linkages to the existing health care delivery system.

项目摘要/摘要 赞比亚是世界上艾滋病毒最高事件之一。青少年女孩和年轻女性（AGYW） 由于其社会和经济脆弱性，是一个特别受影响的群体。有增长 认识到包括青春期男孩和年轻男子（Aby）在艾滋病毒预防中的重要性 研究。在青春期和成年初期，男孩的HIV患病率明显低于 Agyw。但是，在接下来的几年中，青春期男孩的艾滋病毒患病率很大， 因此，这表明青春期可能是男孩应参与艾滋病毒的关键时期 预防。 通过这种行政补充，我们建议添加一系列ABY，以探索量身定制的功效 关于艾滋病毒结果的多层次干预措施。补充剂的总体目标是评估性别差异 与多组分干预措施的疗效和实施结果有关。我们将发展 针对ABY的量身定制的教育材料以补充盾牌（支持HIV综合的支持 教育，与护理的联系以及为AGYW开发的教育模块。我们将 在社区环境中为AGYW计划对ABY进行类似的干预措施，并支持联系 到已经为父母研究建立的综合健康护理（IWC）诊所。我们将选择300 先前入学的队列中包含在研究中的Aby。如父母赠款所述，我们将 比较（1）仅盾牌社区干预措施，（2）盾牌和基于诊所的干预措施，以及（3） 护理标准。我们将在此行政补充中追求以下具体目标：目标1是 包括ABY在6个月和12个月的多级干预措施时评估疗效（HIV） 知识，自我效能），人际关系（社会支持，减少污名）和卫生系统（基于诊所 多种服务）使用集群进行艾滋病毒测试，保留护理和病毒负荷抑制的水平 随机设计和目标2是评估实施结果和成本效益 针对ABY的干预措施以支持扩大和可持续性。 包括一系列Aby的队列将通过补充从同类中收集的数据来增强研究 了解性别平等和规范对艾滋病毒连续性结果的影响 关心。补品和父母赠款的发现将使我们能够设计一个全面的计划 对于可以在社区环境中实施的青少年以及与 现有的医疗保健提供系统。