Intensive Combination Approach to Rollback the Epidemic (iCARE) in Nigerian Adolescents

尼日利亚青少年抗击疫情的强化组合方法 (iCARE)

• 批准号: 10046115
• 负责人: Robert Garofalo
• 金额: $ 37.64万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-01-17 至 2020-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10046115
• 关键词: AIDS/HIV problem; Adolescent; Adult; Africa South of the Sahara; Age; Awareness; Blood; Caring; Centers for Disease Control and Prevention (U.S.); Clinic; Collaborations; Communities; Continuity of Patient Care; Development; Epidemic; Evidence based intervention; Feedback; Focus Groups; Gender; Goals; Government; HIV; HIV Infections; HIV Seroprevalence; Hair; Health; Hot Spot; Human immunodeficiency virus test; Incidence; Infrastructure; Institution; Intervention; Link; Literature; Measurement; Measures; Mediator of activation protein; Medical Records; Nigeria; Nigerian; Outcome; Outcome Measure; Pharmacy facility; Phase; Policies; Population; Poverty; Prevalence; Public Health; Randomized; Records; Research; Research Training; Site; Subgroup; Testing; Text Messaging; Time; United States National Institutes of Health; Universities; Viral; Viral Load result; Youth; aged; antiretroviral therapy; base; burden of illness; care outcomes; design; evidence base; experience; improved; innovation; intervention effect; mHealth; medication compliance; men who have sex with men; multidisciplinary; neglect; pediatric human immunodeficiency virus infection; peer; pilot trial; primary outcome; programs; response; same-sex partnership; social media; social stigma; therapy adherence; therapy development; transmission process; working group; young man; young men who have sex with men

Nigeria has the 2nd highest number of people living with HIV (PLWH) and the most pediatric HIV infections globally, however, it has been neglected as a focus of public health efforts. Progress towards UNAIDS 90-90- 90 goals in Nigeria has been slow with all goals < 35%. Youth and men who have sex with men (MSM), are the weakest link in Nigeria's response to the HIV epidemic. Interventions reaching youth (including hard-to-reach MSM) and improving HIV care outcomes across the HIV care continuum should involve combination interventions as these have additive benefits compared to single interventions. In this study, we propose to build on infrastructure developed through a very successful U.S-Nigeria HIV-centered academic partnership in collaboration with partner institutions in Ibadan, Lagos and Jos, Nigeria. We will test two combination interventions among youths aged 15 to 24 years across the HIV care continuum. In the UG3 phase, we will (Aim 1) develop manualized interventions for: (a) HIV testing and linkage; and (b) HIV care outcomes among youth age 15-24 years in Ibadan using a combination approach that includes theoretically-grounded peer navigation and mHealth components. Once developed we will (Aim 2) test each combination intervention in pilot trials in Ibadan for feasibility, acceptability and initial efficacy using a pre-post design. The two interventions include: 2a) social media engagement + peer navigation to improve HIV testing and linkage to care among young MSM. The pilot test for this intervention will be considered successful if there is an increase of ≥ 30% in the number of young men completing HIV tests and an increase in the HIV incidence rate by OR=2.0 over a 48-week period compared to baseline. In addition, we will pilot test: 2b) a short message service (SMS; via adaptation of an evidence-based intervention, TXTXT) + peer navigation intervention to improve HIV care outcomes (e.g. care retention, ART adherence and viral suppression) among 40 young PLWH. This pilot intervention will be considered successful if there is ≥ 30% increase in proportion with viral load < 1000 copies/mL over a 48-week period, reflecting an effect size of OR=1.5 compared to baseline. We will also assess feasibility for measurement of medication adherence (via ART concentration in hair) and retention in care (via medical records abstraction). In the UH3 phase we will (Aim 3) demonstrate the scalability and efficacy of the two combination interventions in different HIV seroprevalence settings in Nigeria by: 3a) conducting a randomized stepped wedge trial (5 steps, 6 sites) in Ibadan, Lagos and Jos; and 3b) testing ART adherence and retention in care as mediators AND age, gender, and mode of transmission as potential moderators of the HIV care intervention effect. We hypothesize that, using the same primary outcome measures as in the UG3, the effect size of each combination intervention across and within settings, will be ≥ the effects observed in the UG3. Our goal is to develop efficacious and scalable combination intervention strategies that will accelerate UNAIDS 90/90/90 goals among Nigerian youths, including MSM.

尼日利亚是艾滋病毒感染者人数第二高的国家，也是儿童艾滋病毒感染人数最多的国家

项目成果

Successful Implementation Strategies in iCARE Nigeria-A Pilot Intervention with Text Message Reminders and Peer Navigation for Youth Living with HIV.

• DOI: 10.3390/tropicalmed8110498
• 发表时间: 2023-11-16
• 期刊: Tropical medicine and infectious disease
• 影响因子: 2.9
• 作者: Ahonkhai AA;Kuti KM;Hirschhorn LR;Kuhns LM;Garofalo R;Johnson AK;Adetunji A;Berzins B;Okonkwor O;Awolude O;Omigbodun O;Taiwo BO
• 通讯作者: Taiwo BO

Accelerating adolescent HIV research in low-income and middle-income countries: evidence from a research consortium.

在低收入和中等收入国家中加速青少年艾滋病毒研究：研究财团的证据。

• DOI: 10.1097/qad.0000000000003049
• 发表时间: 2021-12-01
• 期刊: AIDS (London, England)
• 作者: Tucker JD;Iwelunmor J;Abrams E;Donenberg G;Wilson EC;Blachman-Demner D;Laimon L;Taiwo BO;Kuhns LM;John-Stewart GC;Kohler P;Subramanian S;Ayieko J;Gbaja-Biamila T;Oladele D;Obiezu-Umeh C;Chima KP;Jalil EM;Falcao J;Ezechi OC;Kapogiannis BG
• 通讯作者: Kapogiannis BG

Effect of Text Messaging Plus Peer Navigation on Viral Suppression Among Youth With HIV in the iCARE Nigeria Pilot Study.

• DOI: 10.1097/qai.0000000000002694
• 发表时间: 2021-08-01
• 期刊: Journal of acquired immune deficiency syndromes (1999)
• 作者: Taiwo BO;Kuti KM;Kuhns LM;Omigbodun O;Awolude O;Adetunji A;Berzins B;Janulis P;Johnson AK;Okonkwor O;Oladeji BD;Muldoon A;Adewumi OM;Amoo P;Atunde H;Kapogiannis B;Garofalo R
• 通讯作者: Garofalo R

Adaptation of evidence-based approaches to promote HIV testing and treatment engagement among high-risk Nigerian youth.

• DOI: 10.1371/journal.pone.0258190
• 发表时间: 2021
• 期刊: PloS one
• 影响因子: 3.7
• 作者: Kuhns LM;Johnson AK;Adetunji A;Kuti KM;Garofalo R;Omigbodun O;Awolude OA;Oladeji BD;Berzins B;Okonkwor O;Amoo OP;Olomola O;Taiwo B
• 通讯作者: Taiwo B