Expedited Partner Therapy and the HIV Prevention Cascade Among MSM in Peru

项目摘要/摘要 快速伙伴疗法(EPT)提供了一种独特的工具，通过以下方式将艾滋病毒预防和性传播感染控制结合起来 一个综合的艾滋病毒预防级联。在提供经验性的、患者提供的抗生素治疗方面 细菌性传播感染个人的性伴侣，EPT促进性伴侣通知，艾滋病毒/性传播感染检测，以及 治疗，并触发艾滋病毒预防级联的关键第一步，最终导致对 以抗逆转录病毒为基础的预防方法(如PrEP或暴露前预防)，并最终 降低社区层面的艾滋病毒传播风险。通过针对患有新性传播感染的个人的性伴侣 诊断，EPT提供了一个机会来识别高危人群中活跃的HIV和STI传播节点 性网络，以促进艾滋病毒检测以及与其中的预防和治疗服务的联系 这有助于减少个人感染艾滋病毒/性传播疾病的风险，并有可能减少艾滋病毒/性传播感染在较大人群中的传播。 在MSM中使用EPT控制HIV/STI提出了未来研究的三个关键问题： I)EPT对MSM中持续或反复出现的细菌性传播感染的生物学结果有何影响？ 二)EPT对伴侣艾滋病毒/性传播感染检测的预防级联结果和与艾滋病毒的联系有何影响 预防/治疗服务？和 三)观察到的预防级联结果的任何增加是否会导致社区一级减少 艾滋病毒/性传播疾病？ 目标1(个人)。确定EPT对合作伙伴通知的个人级别结果的影响，以及 男男性接触者持续或反复的GC/CT感染。 目标2(伙伴关系)。评估EPT对合作伙伴级别的通知、测试、STI结果的影响 治疗以及与艾滋病毒预防和治疗服务的联系。 目标3(人口)。用基于主体的建模方法评估男男性接触者计划免疫治疗对HIV/STI的影响 在网络和人口层面上的传播。

PROJECT SUMMARY/ABSTRACT Expedited Partner Therapy (EPT) offers a unique tool to combine HIV prevention and STI control through an integrated HIV Prevention Cascade. In providing empiric, patient-delivered antibiotic treatment to the recent sexual partners of individuals with bacterial STIs, EPT promotes partner notification, HIV/STI testing, and treatment, and triggers the critical first step of an HIV prevention cascade culminating in uptake of antiretroviral-based prevention methods (such as PrEP or pre-exposure prophylaxis), and ultimately a reduction in community-level HIV transmission risk. By targeting the sexual partners of individuals with new STI diagnoses, EPT provides an opportunity to identify nodes of active HIV and STI transmission within high-risk sexual networks, to promote HIV testing and linkage to prevention and treatment services among these individuals, and to potentially reducing the incidence of HIV/STI transmission within the larger population. Use of EPT for HIV/STI control among MSM presents three key questions for future research: i) What is the impact of EPT on biological outcomes of persistent or recurrent bacterial STIs among MSM? ii) What is the effect of EPT on prevention cascade outcomes of partner HIV/STI testing and linkage to HIV prevention/treatment services? and iii) Would any observed increases in prevention cascade outcomes lead to community-level reductions in HIV/STI transmission? Aim 1 (Individual). To determine the effect of EPT on individual-level outcomes of partner notification and persistent or recurrent GC/CT infection among MSM. Aim 2 (Partnership). To assess the impact of EPT on partner-level outcomes of notification, testing, STI treatment, and linkage to HIV prevention and treatment services. Aim 3 (Population). To use Agent Based Modeling to estimate the impact of EPT for MSM on HIV/STI transmission at network- and population-levels.