A mobile phone short message service intervention to increase retention in HIV care among HIV-positive men who have sex with men in Peru (WelTel Peru)

一项手机短信服务干预措施，旨在提高秘鲁男男性行为艾滋病毒阳性男性对艾滋病毒护理的保留率 (WelTel Peru)

• 批准号: 10053854
• 负责人: LUIS ALBERTO MENACHO ALVIRIO
• 金额: $ 15万
• 依托单位: UNIVERSIDAD PERUANA CAYETANO HEREDIA
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-17 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10053854
• 关键词: AIDS prevention; Adherence; Affect; Appointment; Area; Award; Awareness; Car Phone; Caring; Cellular Phone; Clinic; Clinical Virology; Cohort Studies; Communication; Computer software; Continuity of Patient Care; Country; Data; Diagnosis; Effectiveness of Interventions; Enrollment; Epidemic; Epidemiologic Methods; Evaluation; Fostering; Funding; Funding Mechanisms; Gays; General Population; Goals; Government; Grant; HIV; HIV Infections; HIV Seropositivity; HIV prevention trial; Health; Health Personnel; Health Policy; Hospital Referrals; Hospitals; Human immunodeficiency virus test; Incidence; Infection; Institution; International; Intervention; Intuition; K-Series Research Career Programs; Knowledge; Latin America; Link; Manuscripts; Mentors; Mentorship; Methods; Monitor; Morbidity - disease rate; Online Systems; Outcome; Participant; Patient Self-Report; Patients; Peru; Peruvian; Population Group; Prevalence; Privatization; Provider; Qualitative Research; Quality of Care; Randomized; Randomized Controlled Trials; Reporting; Research; Research Personnel; Research Proposals; Research Training; Resources; Risk; Role; Sexually Transmitted Diseases; Site; Statistical Methods; System; Technology; Telephone; Testing; Text Messaging; Time; Training; Training Support; Treatment Efficacy; Viral; Visit; World Health Organization; Writing; antiretroviral therapy; arm; base; career; cost effective; design; effective intervention; experience; global health; implementation science; improved; interest; mHealth; men; men who have sex with men; mobile computing; mortality; mortality risk; multi-site trial; multidisciplinary; novel; recruit; responsible research conduct; service intervention; skills; standard care; standard of care; tool; transmission process; treatment arm; viral resistance; young men who have sex with men

Summary Retention in HIV care is associated with longer survival, viral suppression, and lower HIV transmission. HIV disproportionally affects men who have sex with men (MSM). In Peru, the HIV epidemic is concentrated among them (prevalence 12.2%), while only 0.4% of the general population is HIV+. Worryingly, MSM with HIV are less likely to stay engaged in care! than other population groups. Studies with MSM have reported efficacy of text-message (SMS) reminders for retesting of HIV and other sexually transmitted infections. However, more trials are needed with them in order to assess the use of SMS for increasing retention in HIV care in resource- limited settings, such as in Latin America. Two-way text messaging can provide an increased level of real-time support to patients. WelTel was the first randomized controlled trial using an interactive two-way text messaging approach that reported a significant increase in self-reported adherence and viral suppression. The hypothesis for this study is that an upgraded version of WelTel to deliver an interactive two-way SMS-based intervention will increase retention in care among HIV+ MSM in Peru. This career development award seeks: 1) to develop an SMS-based intervention to be delivered through the WelTel system to increase retention in HIV care among HIV-positive MSM at a government-based hospital in Peru; and 2) to determine the efficacy of the intervention for increasing retention in HIV care when compared with standard-of-care. I will recruit 208 HIV+ MSM and randomize them (1:1) to an intervention (receives the SMS-based intervention) and control (standard of care) group. I will follow them up throughout the duration of the twelve months course. The main outcome will be retention in HIV care within one year after enrollment. Results will be used to design a multi- site trial to assess the effectiveness of the intervention in improving retention in HIV care among HIV+ Peruvian MSM that will be submitted for R01 funding. A multi-disciplinary mentoring team will support me with expertise in areas related to my career plan: HIV prevention trials (Dr. Duerr), mobile health (Dr. Blas and Dr. Lester), HIV research (Dr. Gonzales), implementation science (Dr. Zunt), qualitative research (Dr. Galea), quantitative methods (Dr. Carcamo), and evaluation of interventions (Dr. Garcia). With them, I have designed a training plan to fill the gaps in knowledge and skills I need to succeed in my goals. I will obtain additional formal training in qualitative research and implementation science, and! statistical and epidemiological methods. I will also acquire skills in grant/manuscript writing and I will pursue continuous training in responsible conduct of research. This mentored research training support will enable me to achieve my goal of becoming a leading global health researcher at Universidad Peruana Cayetano Heredia, actively collaborating with top international institutions and fostering health policies with rigorous evidence.

总结 继续接受艾滋病毒护理与更长的生存期、病毒抑制和更低的艾滋病毒传播有关。艾滋病毒 男男性行为者（MSM）。在秘鲁，艾滋病毒流行病集中在 艾滋病毒感染率为12.2%，而总人口中只有0.4%为艾滋病毒阳性。令人担忧的是，携带艾滋病毒的MSM 不太可能继续从事护理工作！比其他人群。对MSM的研究报告了 短信提醒重新检测艾滋病毒和其他性传播感染。但更多 需要对他们进行试验，以评估SMS的使用是否增加了艾滋病毒护理的资源保留， 有限的设置，如在拉丁美洲。双向文本消息可以提供更高级别的实时性， 支持患者。WelTel是第一个使用交互式双向文本的随机对照试验 消息传递方法，报告自我报告的依从性和病毒抑制显著增加。的 这项研究的假设是，一个升级版的WelTel提供一个互动的双向短信为基础的 干预措施将增加秘鲁艾滋病毒阳性男男性行为者继续接受护理。该职业发展奖寻求： 1)开发基于SMS的干预措施，通过WelTel系统提供，以提高 秘鲁一家政府医院对艾滋病毒阳性男男性行为者的艾滋病毒护理; 2）确定 与标准护理相比，增加艾滋病毒护理保留的干预措施。我会招募208人 HIV+ MSM，并将他们（1：1）随机分配到干预组（接受基于SMS的干预）和对照组 （标准护理）组。我将在十二个月的课程期间跟踪他们。主要 结果将是在入组后一年内继续接受艾滋病毒护理。结果将用于设计多- 现场试验，以评估干预措施在改善艾滋病毒+患者艾滋病毒护理保留率方面的有效性 秘鲁男男性接触者，将提交R 01资金。一个多学科的指导团队将支持我， 我在与我的职业规划相关的领域拥有专业知识：艾滋病毒预防试验（Duerr博士）、移动的健康（Blas博士和Blas博士）。 Lester博士）、艾滋病毒研究（冈萨雷斯博士）、执行科学（Zunt博士）、定性研究（Galea博士）， 定量方法（Carcamo博士）和干预措施评价（Garcia博士）。我设计了一个 培训计划，以填补知识和技能的差距，我需要成功地在我的目标。我将获得额外的正式 在定性研究和实施科学的培训，和！统计和流行病学方法。我会 我还获得了赠款/手稿写作的技能，我将继续接受负责任的行为培训， research.这种指导性的研究培训支持将使我能够实现我成为一个领先的目标 秘鲁卡耶塔诺·埃雷迪亚大学的全球健康研究员，积极与国际顶级 机构和促进具有严格证据的卫生政策。