PrEP Implementation Science with Hard to Reach Populations in India

项目总结/摘要 安妮·E费奇巴赫尔博士，公共卫生硕士是精神病学系的社会流行病学家， 加州大学洛杉矶分校的生物行为科学和公共科学院的Fogary GloCal研究员 印度卫生研究所。费奇巴赫博士的长期职业目标是成为一名独立的 具有执行科学方面专门知识调查员，对受歧视人群进行艾滋病毒干预。的 拟议的K 01研究和培训计划将为Feedbacher博士提供方法论和实践 技能来实现这一目标。本研究将评估可接受性，可行性和可持续性， 调整世卫组织电子PrEP实施工具，以增加PrEP的吸收、保留和遵守。 Feedbacher博士的研究计划将解决由EPIS框架指导的三个具体目标， 实施科学：1）在政策，结构和组织层面上建模障碍和促进因素 采用世卫组织E-PrEP实施工具，以支持在印度有针对性的干预措施中推广PrEP; 2） 为了评估患者和提供者对捆绑的干预组件的偏好以通知适应， 世卫组织E-PrEP实施工具的本地化和定制;以及3）评估可接受性， 经调整的世卫组织E-PrEP实施工具的可行性和可持续性。第一个目标将得到解决 通过与政策制定者、卫生官员进行概念制图和瓶颈分析， 工作人员将PrEP实施的利益相关者优先事项可视化。第二个目标将使用 与患者和提供者进行联合分析实验，评估捆绑干预属性 阐明每个属性对成功实施可能性的相对重要性。第三 aim将包括一个试点集群随机对照试验，以评估实施过程和结果 沿着艾滋病毒预防连续体进行检测、连接、PrEP吸收、保留和坚持。 Feedbacher博士的培训目标与这些具体目标相对应，如下所示：1） 获得实施科学方法的专业知识; 2）获得设计和适应电子健康的专业知识 3）获得监测和评价纵向干预措施的专门知识。这些发现 从这项实施科学研究将有助于扩大可持续的生物行为干预， 减少印度各地受歧视群体在艾滋病毒方面的差距。

PROJECT SUMMARY/ABSTRACT Anne E. Fehrenbacher, PhD, MPH is a social epidemiologist in the Department of Psychiatry and Biobehavioral Sciences at the University of California, Los Angeles and a Fogary GloCal Fellow at the Public Health Research Institute of India. Dr. Fehrenbacher’s long-term career goal is to become an independent investigator with expertise in implementation science for HIV interventions with stigmatized populations. The proposed K01 research and training plan will provide Dr. Fehrenbacher with the methodological and practical skills to meet this goal. The present study will evaluate the acceptability, feasibility, and sustainability of an adapted WHO E-PrEP Implementation Tool to increase PrEP uptake, retention, and adherence. Dr. Fehrenbacher’s research plan will address three specific aims guided by the EPIS Framework of Implementation Science: 1) to model barriers and facilitators at the policy, structural, and organizational levels for adopting the WHO E-PrEP Implementation Tool to support PrEP rollout in targeted interventions in India; 2) to assess patient and provider preferences for bundled intervention components to inform the adaptation, localization, and tailoring of the WHO E-PrEP Implementation Tool; and 3) to evaluate the acceptability, feasibility, and sustainability of the adapted WHO E-PrEP Implementation Tool. The first aim will be addressed through concept mapping and bottleneck analysis with policymakers, health officials, and targeted intervention staff to visualize stakeholder priorities for PrEP implementation. The second aim will be addressed using conjoint analysis experiments conducted with patients and providers assessing bundled intervention attributes to elucidate the relative importance of each attribute on the likelihood of successful implementation. The third aim will involve a pilot cluster randomized controlled trial to evaluate implementation processes and outcomes along the HIV prevention continuum for testing, linkage, PrEP uptake, retention, and adherence. Dr. Fehrenbacher’s training objectives correspond with each of these specific aims, as follows: 1) to gain expertise in implementation science methods; 2) to gain expertise in the design and adaptation of eHealth interventions; and 3) to gain expertise in monitoring and evaluation of longitudinal interventions. The findings from this implementation science study will aid in the scale-up of sustainable biobehavioral interventions to reduce HIV disparities among stigmatized groups across India.