Peer delivered HIV/syphilis self-testing with assisted partner notification services for men who have sex with men (MSM) in Uganda

项目摘要/摘要 拟议的K43新兴全球领袖奖的总体目标是支持Stephen Okoboi博士的 研究培训，以发展为独立的全球卫生艾滋病毒研究人员。Okoboi博士目前是 年Makerere大学传染病研究所博士后研究员兼研究副主任 乌干达。在本申请中进行建议的研究将有助于他的培训目标：1)获得 在行为科学方法方面的专门知识，以更好地理解过程和预防行为 基础同行交付艾滋病毒和梅毒自我检测结合协助合作伙伴通知(APN) 服务，2)获得在真实世界环境中设计和实施随机试验的专业知识，以及3)获得 具有卫生经济评估方面的高级技能。这项提议建立在他已经拥有的独特技能的基础上 流行病学和护理学，同时利用多学科导师团队最终成为 在艾滋病毒预防研究中富有成效和影响力的独立调查者。本课题的研究目标是 建议进行严格的概念验证评估，以评估可行性、可接受性、 同伴传递的艾滋病毒和梅毒自我检测的初步效果和成本效益 协助合作伙伴通知服务。与其他男性发生性关系的男性(MSM)是 受艾滋病毒和梅毒的影响不成比例。在乌干达，男男性接触者艾滋病毒感染率为13.2%，而在乌干达为4.7%。 同样，老年男性梅毒患病率为8.3%，而15岁男性梅毒患病率为5.8%--。梅毒和 艾滋病毒传播共享共同的传播途径，梅毒增加了感染艾滋病毒的风险， 传播和疾病进展。世界卫生组织建议进行艾滋病毒/梅毒双重检测 对于男男性接触者来说，但由于医疗保健领域的耻辱和歧视，基于设施的检测的接受率很低 设置。差异化服务提供模式，例如同行提供的艾滋病毒/梅毒自我检测和与 对检测呈阳性的人的护理，可以绕过卫生机构的耻辱和其他结构性障碍 获取医疗服务。然而，据我们所知，还没有研究评估同伴递送的有效性 与MSM合作伙伴服务相联系的艾滋病毒/梅毒自我检测。为了解决这一研究差距，Okoboi博士将 开展形成性研究，为实施同行传递的艾滋病毒/梅毒联合自检提供信息 与乌干达MSM的APN(目标1)，进行随机试验，以试点测试的初步效果 与护理标准(目标2)相关的同行提供的艾滋病毒/梅毒自检和APN，并估计费用 与以设施为基础的检测相比，同行提供的艾滋病毒/梅毒自我检测和APN的影响(目标3)。 奥科布伊博士S的研究目标与他的培训目标相一致，在这个奖项完成后，他将 在提交R01申请以进一步推进男男性行为者艾滋病毒预防研究方面处于有利地位 在撒哈拉以南非洲。

PROJECT SUMMARY/ABSTRACT The overall goal of the proposed K43 Emerging Global Leader Award is to support Dr. Stephen Okoboi’s research training to develop as an independent global health HIV researcher. Dr. Okoboi is currently a postdoctoral fellow and Deputy Head of Research at Makerere University Infectious Disease Institute in Uganda. Conducting the proposed studies in this application will facilitate his training goals to: 1) gain expertise in behavioural science methods to better understand the processes and preventive behaviours underlying peer delivery of HIV and syphilis self-tests combined with assisted partner notification (APN) services, 2) gain expertise in the design and conduct of randomized trials in real world settings, and 3) acquire advanced skills in health economic evaluation. This proposal builds on the unique skills he already has in epidemiology and nursing while leveraging a multidisciplinary team of mentors to ultimately become a productive and influential independent investigator in HIV prevention research. The research goal of this proposal is to conduct a rigorous proof-of-concept evaluation to assess the feasibility, acceptability, preliminary effectiveness, and cost effectiveness of peer delivered HIV and syphilis self-testing coupled with assisted partner notification services. Men who engage in sexual relations with other men (MSM) are disproportionately affected by HIV and syphilis. In Uganda, MSM HIV prevalence is 13.2% versus 4.7% in similarly aged males, while syphilis prevalence is 8.3% versus 5.8% in males aged 15-64 years. Syphilis and HIV transmission share common transmission routes and syphilis increases risk of HIV acquisition, transmission, and disease progression. The World Health Organization recommends dual HIV/syphilis testing for MSM, but uptake of facility-based testing is low because of stigma and discrimination in healthcare settings. Differentiated service delivery models, such as peer delivered HIV/syphilis self-tests and linkage to care for those who test positive, could circumvent health facility stigma and other structural barriers to accessing care. However, no studies to our knowledge have evaluated the effectiveness of peer delivered HIV/syphilis self-testing linked to partner services for MSM. To address this research gap, Dr. Okoboi will conduct formative research to inform the implementation of peer-delivered HIV/syphilis self-tests combined with APN for Ugandan MSM (Aim 1), conduct a randomized trial to pilot test the preliminary effectiveness of peer delivered HIV/syphilis self-tests and APN relative to standard of care (Aim 2), and estimate the cost implications of peer-delivered HIV/syphilis self-testing and APN compared to facility-based testing (Aim 3). Dr. Okoboi’ s research goals correspond with his training goals, and at the completion of this award, he will be in an excellent position to submit an R01 application to further advance HIV prevention research for MSM in sub-Saharan Africa.