Adapting and testing a combination peer navigation and mHealth intervention to enhance treatment engagement and viral suppression among sexual and gender minority youth in Nigeria

调整和测试同伴导航和移动医疗干预相结合，以提高尼日利亚性少数群体青年的治疗参与度和病毒抑制能力

• 批准号: 10619071
• 负责人: Lisa Mary Kuhns
• 金额: $ 68.55万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10619071
• 关键词: Accounting; Acquired Immunodeficiency Syndrome; Address; Adoption; Adult; Age; Anti-Retroviral Agents; Atlases; Caring; Cessation of life; Cities; Climate; Clinic; Clinics and Hospitals; Communities; Continuity of Patient Care; Country; Data; Development; Disclosure; Disparity; Environment; Epidemic; Evidence based intervention; Feedback; Friends; General Population; Geographic Locations; Goals; Guidelines; HIV; HIV Infections; HIV-1; Health; Infection; Intervention; Laws; Legal; Maintenance; Medical Records; Methods; Modeling; Morbidity - disease rate; Nigeria; Outcome; Persons; Pharmaceutical Preparations; Population; Prevalence; Prisons; Process; Randomized, Controlled Trials; Recommendation; Risk; Same-sex; Services; Sexual and Gender Minority Youth; Social support; Structure; Supportive care; Testing; Text Messaging; Universities; Viral; Viral Load result; Viremia; Youth; aged; antiretroviral therapy; burden of illness; care outcomes; community center; community setting; evidence base; implementation evaluation; implementation outcomes; improved; innovation; intervention participants; iterative design; mHealth; medication compliance; men; men who have sex with men; outreach; peer; preference; primary outcome; programs; psychosocial; routine care; same-sex marriage; same-sex partnership; satisfaction; secondary outcome; social; social stigma; therapy outcome; transgender women; viral transmission; young men who have sex with men

Project Summary Nigeria is one of the six countries with half of the global burden of youth with HIV. HIV prevalence among young men who have sex with men (YMSM) and young transgender women (YTW), ages 15-24 is over six-fold that of the general population of youth. Furthermore, across risk groups, youth have disproportionately worse HIV care outcomes in comparison to adults. There are challenges to treatment engagement and viral suppression among YMSM and YTW. While adult HIV care routinely begins at age 15, youth-adapted programs to support successful care engagement are rare, particularly for YMSM and YTW, who typically prefer to receive care in multipurpose key population-focused community-based centers, which often lack evidence-driven, youth-specific interventions that include psychosocial and medication adherence support for best outcomes. This preference for key population-focused community centers is rational given the country’s unfavorable social milieu which promotes social stigma, lack of disclosure, and low social support, and in the context of a legal environment which criminalizes same-sex relationships. Evidence-based and scalable approaches, incorporating preferences for community centers, are needed to have the greatest impact on ART outcomes among YMSM and YTW in Nigeria. Thus, we propose to adapt and test the Intensive Combination Approach to Rollback the Epidemic in Nigeria (iCARE Nigeria), to improve HIV treatment engagement, medication adherence, and viral suppression among YMSM and YTW where they receive care. The iCARE Nigeria model uses evidence-based and youth-specific approaches, including peer navigation and daily text message reminders in combination. iCARE Nigeria has demonstrated efficacy in a general population of youth with HIV in a traditional HIV clinic at the University of Ibadan, Nigeria. In this study, we will expand it to YMSM and YTW cared for in community centers using a community and outreach-based delivery approach. Our goal is to develop a practical and scalable enhancement to HIV treatment for YMSM and YTW where they receive care. Our aims are to: 1) adapt the iCARE Nigeria HIV clinic-based intervention to a community-based outreach approach for YMSM and YTW ages 15-24 living with HIV in Ibadan, Nigeria; 2) test the adapted iCARE intervention for initial efficacy, feasibility, satisfaction, and acceptability among YMSM and YTW and 3) evaluate implementation indicators based on RE-AIM (reach, adoption, implementation, maintenance) to inform widespread dissemination and scalability of the adapted iCARE Nigeria intervention.

项目摘要 尼日利亚是六个国家的艾滋病毒青年负担的一半。艾滋病毒患病率 与男性发生性关系（YMSM）和年轻跨性别女性（YTW）的年轻男子，年龄在15-24岁以上 年轻人的普通人群。此外，在风险群体中，青年的比例差得多 与成年人相比，艾滋病毒护理结果。治疗参与和病毒面临挑战 YMSM和YTW之间的抑制。当成人艾滋病毒护理通常从15岁开始时，青年适应 支持成功护理参与的计划很少，特别是对于YMSM和YTW，他们通常 宁愿在多用途以人口为基础的社区中心中接受护理，而这些中心通常缺乏 循证驱动的，特定于青年的干预措施，包括对心理和药物的依从性支持 最好的结果。考虑到该国 不利的社会环境，促进社会污名，缺乏披露和社会支持低的社会环境，以及 法律环境的背景，将同性关系定为犯罪。循证且可扩展 方法是对社区中心的编码偏好，对艺术产生最大的影响 尼日利亚的YMSM和YTW的结果。这，我们建议适应和测试密集型组合 在尼日利亚（尼日利亚ICARE）中回滚流行的方法，以改善HIV治疗参与， YMSM和YTW的药物依从性和病毒抑制。 ICARE 尼日利亚模型使用循证和针对青年的方法，包括同行导航和每日文本 消息组合提醒。尼日利亚伊卡雷（Icare Nigeria）在一般年轻人中表现出效率 尼日利亚伊巴丹大学的艾滋病毒在传统的艾滋病毒诊所中。在这项研究中，我们将将其扩展到YMSM YTW使用社区和基于外展的交付方法在社区中心进行照顾。我们的目标 是为YM​​SM和YTW的艾滋病毒治疗开发一种实用且可扩展的增强 关心。我们的目的是：1）将基于社区的ICARE尼日利亚艾滋病毒诊所的干预调整 尼日利亚伊巴丹的YMSM和YTW年龄15-24岁的YMSM和YTW的外展方法； 2）测试适应的 ICARE干预YMSM和YTW的初始效率，可行性，满意度和可接受性以及3） 基于RE-AIM（触及，采用，实施，维护）的评估实施指标 为尼日利亚ICARE干预的适应性ICARE的传播和可扩展性提供信息。