Understanding individual- and social network-level factors affecting infant HIV testing to design social network interventions to increase testing of HIV-exposed infants

了解影响婴儿艾滋病毒检测的个人和社交网络层面的因素，以设计社交网络干预措施，以增加对艾滋病毒暴露婴儿的检测

• 批准号: 10259284
• 负责人: Alison B Comfort
• 金额: $ 14.51万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-01 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10259284
• 关键词: AIDS prevention; AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; Adult; Affect; Africa South of the Sahara; African; Age; Age-Months; Applied Research; Behavior; Birth History; Cessation of life; Characteristics; Child; Communities; Country; Data; Data Collection; Disclosure; Effectiveness; Ensure; Epidemic; Exposure to; Family; Feasibility Studies; Focus Groups; Foundations; Goals; Grant; HIV; HIV Infections; HIV Seropositivity; Health; Health behavior; Human immunodeficiency virus test; Individual; Infant; Influentials; Infrastructure; Intervention; Interview; Investigation; Knowledge; Link; Longitudinal Studies; Maps; Measures; Medical Records; Mentorship; Methods; Mothers; Nulliparity; Parents; Pathway Analysis; Pathway interactions; Pattern; Positioning Attribute; Prevention; Public Health; Qualitative Research; Recording of previous events; Research; Research Methodology; Research Personnel; Research Priority; Role; Social Network; Social support; Space Models; Surveys; Testing; Training; Uganda; United States National Institutes of Health; Woman; behavior change; care seeking; career; cohort; design; econometrics; experience; implementation framework; implementation science; improved; infant infection; innovation; intimate partner violence; learning network; member; mortality; novel; novel strategies; peer; peer influence; peer learning; prevent; reproductive; social; social engagement; social norm; social stigma; theories; therapy design; therapy development; uptake; working group

PROJECT SUMMARY/ABSTRACT More than one million infants are exposed to HIV each year in high-burden sub-Saharan African countries. Yet only 60% of HIV-exposed infants are tested as recommended by two months of age. The key barriers to infant HIV testing – stigma/non-disclosure, lack of access and poor social support – may be more effectively overcome through interventions that engage women's social networks, the patterns of relationships women have with family, peers, and other community members. Social networks make salient contextual norms and enable peer learning, social support, and social engagement, all of which can affect health behaviors. There remains a scientific gap in applying social network analysis to infant HIV testing. Until this gap is addressed, there will also remain an implementation knowledge gap on how to design interventions that engage social networks to prompt infant HIV testing. The central hypothesis of this proposed grant is that social networks can influence women's decisions to test their infants for HIV. The primary objective of this K01 application is to understand how women's individual- and social network-level characteristics affect infant HIV testing to design and assess the feasibility of a social network intervention to improve infant HIV testing. The approach leverages the infrastructure from an ongoing longitudinal study (R01MH113494, PI: Tsai) with complete social network data from all adults living in 8 villages of Mbarara, Uganda and extends new primary data collection to all HIV-positive, reproductive-age women and their children born during the study period. The grant will achieve the following specific aims: 1) estimate individual- and social-network level correlates of infant testing through social network analysis exploring the roles of peer influence, social norms, social support and social engagement; 2) conduct in-depth qualitative interviews among women and integrate findings with quantitative data to understand how social network mechanisms affect infant testing and develop a conceptual framework of infant testing; 3) design and assess feasibility, acceptability, fidelity, reach and preliminary effectiveness of a social network intervention to prompt infant HIV testing. My long-term goal is to become an independent researcher with expertise in developing social network interventions to enhance HIV treatment and prevention among women and children in sub-Saharan Africa. This K01 proposal will supplement my prior training and experience with additional training and mentorship from a team of senior researchers with expertise in social networks, qualitative and mixed methods, and implementation science applied to the context of HIV. I will obtain integrated training, mentorship, and preliminary data for an R01 proposal to empirically test a novel intervention to overcome the public health problem of low infant HIV testing. The key innovation of this proposed study is that it is one of the first to apply social network theory and analysis to infant HIV testing. This contribution will have significant public health impact by increasing uptake of HIV testing for the nearly one half million exposed/undiagnosed infants in sub-Saharan Africa who are not tested by two months of age.

项目摘要/摘要 在负担沉重的撒哈拉以南非洲国家，每年有100多万婴儿感染艾滋病毒。还没有 只有60%的感染艾滋病毒的婴儿在两个月大时接受了推荐的检测。婴幼儿面临的主要障碍 艾滋病毒检测--污名/不披露、缺乏机会和糟糕的社会支持--可能更有效 通过让女性的社交网络参与的干预措施，女性的关系模式 与家人、同龄人和其他社区成员保持联系。社交网络使显著的背景规范和 促进同伴学习、社会支持和社会参与，所有这些都会影响健康行为。那里 在将社交网络分析应用于婴儿艾滋病毒检测方面，仍然存在科学空白。在这一差距得到弥补之前， 在如何设计让社会参与的干预措施方面，还将存在执行知识差距 促进婴儿艾滋病毒检测的网络。这项拟议拨款的中心假设是，社交网络可以 影响妇女对婴儿进行艾滋病毒检测的决定。此K01应用程序的主要目标是 了解女性的个人和社会网络级别的特征如何影响婴儿艾滋病毒检测设计 并评估社交网络干预改善婴儿艾滋病毒检测的可行性。该方法 利用正在进行的纵向研究(R01MH113494，PI：TSAI)提供的基础设施以及完整的 来自乌干达姆巴拉拉8个村庄所有成年人的网络数据，并将新的主要数据收集扩展到 所有艾滋病毒阳性的育龄妇女及其在研究期间出生的子女。这笔赠款将 实现以下具体目标：1)评估婴儿测试的个人和社会网络水平相关性 通过社会网络分析，探索同伴影响、社会规范、社会支持和社会支持的作用 参与；2)对妇女进行深入的定性访谈，并将结果与量化相结合 了解社交网络机制如何影响婴儿测试并制定概念框架的数据 3)设计和评估可行性、可接受性、保真度、可达性和初步有效性 社会网络干预，促使婴儿进行艾滋病毒检测。我的长期目标是成为一名独立的 具有开发社会网络干预措施以加强艾滋病毒治疗和预防的专业知识的研究人员 在撒哈拉以南非洲的妇女和儿童中。这份K01建议书将补充我之前的培训和 具有额外培训和来自具有社会专业知识的高级研究人员团队的指导的经验 将网络、定性和混合方法以及实施科学应用于艾滋病毒防治工作。这就做 获得R01提案的综合培训、指导和初步数据，以对小说进行经验性测试 采取干预措施，克服婴儿艾滋病毒检测率低的公共卫生问题。它的关键创新之处在于 提出的研究是将社会网络理论和分析应用于婴儿HIV检测的首创之一。这 通过增加近一半的人接受艾滋病毒检测，将对公共卫生产生重大影响 撒哈拉以南非洲有100万受感染/未确诊的婴儿，他们在两个月大的时候没有接受检测。