PrEP Implementation Science with Hard to Reach Populations in India

项目摘要/摘要 Anne E.Fehrenbacher，博士，公共卫生硕士，精神病学系社会流行病学家， 加州大学洛杉矶分校生物行为科学和公众Fogary Glocal研究员 印度卫生研究所。费伦巴赫博士的长期职业目标是成为一名独立的 在艾滋病毒干预方面具有实施科学专业知识的调查员。这个 拟议的K01研究和培训计划将为Fehrenbacher博士提供方法学和实用性 达到这一目标的技能。本研究将评估可接受性、可行性和可持续性 调整世卫组织E-PrEP实施工具，以提高PrEP的摄取率、保留率和依从性。 费伦巴赫博士的研究计划将在EPIS框架的指导下解决三个具体目标 实施科学：1)为政策、结构和组织层面的障碍和促进者建模 采用世卫组织E-PrEP实施工具，支持在印度开展有针对性的干预措施；2) 为了评估患者和提供者对捆绑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、卫生官员和有针对性的干预进行概念规划和瓶颈分析 让员工直观地了解PrEP实施的利益相关者优先事项。第二个目标将通过以下方式实现 与评估捆绑干预属性的患者和提供者进行的联合分析实验 阐明每个属性对成功实施的可能性的相对重要性。第三 AIM将涉及一项试点整群随机对照试验，以评估实施过程和结果 沿着检测、连接、PrEP摄取、保留和坚持的艾滋病毒预防连续体。 费伦巴赫博士的培训目标与这些具体目标中的每一个都相对应，具体如下：1) 获得实施科学方法方面的专业知识；2)获得eHealth设计和适应方面的专业知识 3)获得纵向干预措施的监测和评价方面的专门知识。调查结果 从这一实施中，科学研究将有助于扩大可持续生物行为干预措施的规模，以 减少印度各地受歧视群体之间的艾滋病毒差距。

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.