Zikhethele - choose for you: evaluating choice-based antiretroviral therapy support for patients returning to HIV care after treatment interruption in South Africa

点击翻译按钮获取中文摘要

PROJECT SUMMARY People living with HIV (PLH) are likely to cycle into and out of antiretroviral therapy (ART) services over time. Even after return to HIV care (RTC), PLH who have interrupted treatment remain vulnerable to attrition and poor treatment outcomes. A range of evidence-based ART support interventions exist including community- based and mobile health (mHealth) ART support interventions. The overarching goals of this proposal are to understand existing RTC practices, incorporate patient preference to refine a community-based and mHealth ART support intervention, and examine the role of choice in delivering RTC ART support. Candidate: Dr. Phillips is an HIV epidemiologist with training in quantitative research methods and experience with field research implementation in South Africa. She is applying for a five-year Fogarty Emerging Global Leader Award to obtain the additional training, mentorship and experience required to become a leading independent investigator capable of obtaining R-series funding. Mentoring: She has assembled an exceptional multidisciplinary team with extensive expertise in HIV intervention research in sub-Saharan Africa (SSA). Drs. Myer (University of Cape Town (UCT)) and Chi (University of North Carolina (UNC)) will serve as primary mentors providing complementary expertise on HIV intervention research and implementation science. Drs Maman (UNC) and Knight (UCT), co-mentors, are social scientists with expertise in qualitative and behavioral research particularly in the context of intervention design and evaluation. Dr. Thirumurthy (University of Pennsylvania: expertise in behavioral economics and measuring patient preference), Dr. Bekker (UCT: expertise in HIV care interventions and preference trials for contraceptive and HIV prevention methods), Dr. Hosseinipour (UNC: expertise in clinical, health service and implementation science with long-term adult HIV care in SSA) and Dr. Clouse (Vanderbilt University: expertise in mHealth intervention research in South Africa) will provide scientific advice in these areas. Training: Specific training in intervention design and evaluation – specifically incorporating implementation science, social and behavioral methods, and patient preference – will be achieved through intensive mentored training and formal coursework. This, combined with the experience gained through implementing my research aims, will establish Dr. Phillips’ independent research career investigating interventions to support lifelong HIV care. Research: The specific aims of this research are to: 1) characterize existing practices for providing RTC ART support and patient experience following RTC, 2) refine existing community-based and mHealth ART support interventions based on RTC patient preferences for modifiable attributes, and 3) determine the feasibility, acceptability and preliminary impact of offering a choice of ART support intervention to RTC patients. The results of this study will inform our understanding of RTC ART support including the role of patient choice. They will provide preliminary data needed to apply for an R01 to conduct a patient preference trial to rigorously examine the impact of patient choice in ART support delivery.