HAART Adherence Interventions in Africa: an RCT

描述(由申请人提供)： 候选人：Michael H.Chung博士是华盛顿大学过敏症和传染病系的高级研究员。他毕业于芝加哥大学普利兹克医学院和哈佛大学公共卫生学院，自2002年以来一直在肯尼亚内罗毕进行艾滋病毒-1随机临床试验。他的近期目标是完成几项国际艾滋病毒-1实地研究，并加强他在流行病学和生物统计学方面的知识。他的长期职业目标是在资源匮乏的环境和空间流行病学方面成为抗逆转录病毒坚持治疗方面的专家。 环境：华盛顿大学在艾滋病毒/艾滋病研究资金方面排名美国大学第三位，其众多艾滋病毒/艾滋病资源中包括艾滋病研究中心、艾滋病临床试验单位和国际艾滋病研究和培训计划。在内罗毕，华盛顿大学自1985年以来一直参与艾滋病毒-1的合作研究，自1992年以来一直在进行随机临床试验。在这种理想的研究环境中，钟博士将通过接受专家指导、参加相关领域的课程以及领导肯尼亚艾滋病毒-1研究的实施来发展他的研究生涯。 研究：随着非洲大规模免费HAART治疗计划的到来，良好地坚持抗逆转录病毒药物将对保护健康和防止耐药HIV-1变种的传播至关重要。 在这种资源匮乏的环境中，依从性知识是有限的，没有任何随机临床试验支持。因此，这项研究建议在肯尼亚内罗毕进行一项四臂因素随机临床试验，以确定认知和行为干预对HAART依从性的影响。在这项试验中，研究还建议检查对依从性干预的态度，并确定依从性的社会人口学和空间相关性。这项研究假设，教育咨询和药物警报设备可以显著提高依从性，依从性差可能与社会经济地位低、流动性增加和与临床的距离有关。

DESCRIPTION (provided by applicant): Candidate: Dr. Michael H. Chung is a Senior Fellow in the Division of Allergy and Infectious Diseases at the University of Washington. A graduate of the University of Chicago Pritzker School of Medicine and the Harvard School of Public Health, he has been conducting HIV-1 randomized clinical trials in Nairobi, Kenya since 2002. His immediate goal is to complete several international HIV-1 field studies and to strengthen his knowledge of epidemiology and biostatistics. His long-term career goal is to become an expert in antiretroviral adherence in resource-poor settings and spatial epidemiology. Environment: Ranking third among U.S. universities in HIV/AIDS research funding, the University of Washington counts the Center for AIDS Research, the AIDS Clinical Trials Unit, and the International AIDS Research and Training Program among its many HIV/AIDS resources. In Nairobi, the University of Washington has been involved in collaborative HIV-1 research since 1985 and has been conducting randomized clinical trials continuously since 1992. In this ideal research environment, Dr. Chung will develop his research career by receiving expert mentorship, taking courses in relevant fields, and leading the implementation of HIV-1 studies in Kenya. Research: With the advent of large-scale free HAART treatment programs in Africa, good adherence to antiretrovirals will be essential to preserve health and prevent the spread of resistant HIV-1 variants. Adherence knowledge in this resource-poor setting is limited and not supported by any randomized clinical trials. Consequently, this study proposes a 4-armed factorial randomized clinical trial in Nairobi, Kenya to determine the effect of cognitive and behavioral interventions on HAART adherence. Within this trial, the study also proposes to examine attitudes towards adherence interventions and identify sociodemographic and spatial correlates of adherence. The study hypothesizes that educational counseling and medication alarm devices may significantly improve adherence, and that poor adherence may be associated with low socioeconomic standing, increased mobility, and distance from clinic.