Adherence to HIV Treatment Postpartum: The Implications of Transitions Among Women Living with HIV in South Africa

产后坚持艾滋病毒治疗：南非艾滋病毒感染妇女转变的影响

• 批准号: 10582926
• 负责人: Jennifer Ann Pellowski
• 金额: $ 7.12万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-01 至 2022-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10582926
• 关键词: Address; Adherence; Administrative Supplement; COVID-19; COVID-19 pandemic effects; Clinic; Data; Evaluation; Funding; Future; Goals; Grant; HIV; Individual; Infant; Influentials; Intervention; K-Series Research Career Programs; Maternal Health; Mentorship; Mothers; Participant; Perinatal Infection; Personal Satisfaction; Postdoctoral Fellow; Postpartum Period; Pregnancy; Prevention; Psychologist; Public Health; Randomized Controlled Trials; Research; Research Personnel; Resource-limited setting; Risk; South Africa; Training; United States; Vertical Disease Transmission; Woman; antiretroviral therapy; base; biobehavior; experience; improved; social; social disadvantage; success; theories; therapy adherence; treatment adherence

PROJECT ABSTRACT Prevention of mother-to-child transmission (PMTCT) efforts have reduced the rates of vertical transmission to 2.7%, however, optimal antiretroviral therapy (ART) adherence remains a difficult goal to reach, particularly postpartum. The contribution of the proposed research is expected to be two-fold: 1) to gain an understanding of how influential contextual, interpersonal, clinic, and individual level factors change during key moments of transition during pregnancy and postpartum and influence ART adherence and 2) to develop bio-behavioral interventions to assist mothers in maintaining their adherence to ART postpartum. Candidate: I am a social psychologist with a background in ART adherence among socially disadvantaged groups in the United States. This five-year K01 Career Development Award has been used to obtain training, mentorship, and research experience to become an expert in maternal health among women living with HIV in resource limited settings and an independent investigator capable of obtaining R01 funding. Research: The goals of the proposed project are to (1) identify contextual, interpersonal, clinic, and individual level factors that influence women’s HIV treatment adherence during key periods of transition during pregnancy and postpartum; (2) evaluate a Transition Theory-based bio-behavioral intervention to improve ART adherence postpartum using a small scale randomized controlled trial; (3) assess participants’ experiences of the intervention, perceived usefulness, and identify ways to refine the intervention for future evaluation. Administrative Supplement: The purpose of this administrative supplement is to provide additional support to offset the impacts of the COVID-19 pandemic on the research originally proposed. Considerable progress has been made on the training and research associated with this grant, however, due to COVID-19 related delays and restrictions, the completion of Aim 3 is currently in jeopardy of not being completed. The Aim 3 data are critical to my training and future likelihood of success as an independent investigator.

项目摘要 预防母婴传播(母婴传播)的努力将垂直传播率降至 2.7%，然而，最佳抗逆转录病毒疗法(ART)的坚持仍然是一个很难达到的目标，尤其是 产后。拟议的研究预计将有两方面的贡献：1)了解 有影响力的环境因素、人际因素、临床因素和个人因素在 妊娠和产后的转变和对ART依从性的影响以及2)发展生物行为 干预措施，帮助母亲在产后保持对抗逆转录病毒药物的坚持。应聘者：我是个社会主义者 心理学家，有在美国社会弱势群体中坚持艺术的背景。 这项为期五年的K01职业发展奖用于获得培训、指导和研究 在资源有限的情况下成为艾滋病毒携带者中的产妇保健专家的经验 以及一名能够获得R01资金的独立调查员。研究：建议的目标 该项目旨在(1)确定影响妇女健康的环境、人际、临床和个人层面的因素 妊娠和产后关键过渡时期的艾滋病毒治疗依从性；(2)评估 基于过渡理论的生物行为干预提高产后艺术依从性的小规模研究 随机对照试验；(3)评估参与者的干预体验、感知有用性和 找出改进干预措施的方法，以便将来进行评估。《行政副刊》：其目的 行政补充是提供额外支持，以抵消新冠肺炎大流行对 这项研究最初提出。在培训和研究方面取得了相当大的进展 然而，与这笔赠款相关的是，由于与新冠肺炎有关的延误和限制，目标3的完成 目前正处于无法完成的危险之中。Aim 3的数据对我的训练和未来的可能性至关重要 作为一名独立调查员的成功。

项目成果

Womandla Health: development and rationale of a behavioral intervention to support HIV treatment adherence among postpartum women in South Africa.

• DOI: 10.1186/s12905-023-02817-y
• 发表时间: 2023-12-06
• 期刊: BMC WOMENS HEALTH
• 影响因子: 2.5
• 作者: Pellowski, Jennifer A.;Jensen, Destry;Tsawe, Nokwazi;Colvin, Christopher;Cu-Uvin, Susan;Operario, Don;Lurie, Mark;Harrison, Abigail;Myer, Landon;Knight, Lucia
• 通讯作者: Knight, Lucia

Intimate partner violence and growth outcomes through infancy: A longitudinal investigation of multiple mediators in a South African birth cohort.

• DOI: 10.1111/mcn.13281
• 发表时间: 2022-01
• 期刊: Maternal & child nutrition
• 影响因子: 3.4
• 作者: Barnett W;Nhapi R;Zar HJ;Halligan SL;Pellowski J;Donald KA;Stein DJ
• 通讯作者: Stein DJ

Systematic review of research focused on pregnant and postpartum women living with HIV: A relational ethics perspective.

• DOI: 10.1111/bioe.12917
• 发表时间: 2021-10
• 期刊: BIOETHICS
• 影响因子: 2.2
• 作者: Weber, Alison Z.;Harrison, Abigail;Pellowski, Jennifer A.
• 通讯作者: Pellowski, Jennifer A.

Empowerment in pregnancy: ART adherence among women living with HIV in Cape Town, South Africa.

• DOI: 10.1016/j.socscimed.2022.114738
• 发表时间: 2022-03
• 期刊: Social science & medicine (1982)
• 作者: DiClemente-Bosco K;Weber AZ;Harrison A;Tsawe N;Rini Z;Brittain K;Colvin CJ;Myer L;Pellowski JA
• 通讯作者: Pellowski JA