Next generation partner notification and intervention services

下一代合作伙伴通知和干预服务

• 批准号: 8910524
• 负责人: Alida M Bouris
• 金额: $ 23.7万
• 依托单位: UNIVERSITY OF CHICAGO
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-08-15 至 2017-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8910524
• 关键词: 18 year old; AIDS prevention; Address; Adherence; Adoption; Anal Sex; Area; Attention; Behavioral; Birth; Caring; Centers for Disease Control and Prevention (U.S.); Characteristics; Chicago; Client; Clinic; Clinical; Clinical Services; Clinical Trials; Clinical assessments; Contact Tracing; Data; Development; Disease; Distal; Dose; Female; Funding; Geographic Locations; HIV; HIV risk; Health; Imagery; Incentives; Individual; Injection of therapeutic agent; Intervention; Link; Location; Low Income Population; Manufacturer Name; Motivation; Participant; Partner Notification; Persons; Pharmaceutical Preparations; Play; Population; Positioning Attribute; Prevalence; Prevention program; Prophylactic treatment; Protocols documentation; Provider; Public Health; Randomized; Randomized Controlled Trials; Recruitment Activity; Risk; Risk Behaviors; Role; Safety; Sampling; Services; Sexual Partners; Site; Specialist; Staging; Telephone; Testing; Text; Thinking; Time; Training; Underinsured; United States Public Health Service; Woman; clinical care; cohort; design; flexibility; high risk; improved; next generation; preference; programs; safety net; service intervention; sex; treatment as usual

DESCRIPTION (provided by applicant): This developmental application (R34) requests funds to refine and pilot test a flexible Partner notification services Pre-exposure Prophylaxis (PS-PrEP) intervention that will engage existing department of public health (DPH) partner notification services in linkage to clinical PrEP care for at risk HIV seronegative persons from diverse backgrounds. These funds are requested because there remains a stark efficacy implementation divide following randomized controlled trials which have demonstrated partial PrEP efficacy. Following these trials, DPHs have yet to integrate PrEP into existing HIV prevention programs resulting in few people on PrEP and those who might benefit most (highest risk populations) are not receiving it. To address these gaps, we aim to integrate PrEP into existing DPH activities, and in particular, DPH partner notification services. DPH partner notification services implemented by Disease Intervention Specialists (DIS) are widespread in high HIV prevalence areas domestically and have great potential. Partner notification services (engaging the risk partners of newly infected HIV persons), is recommended by the CDC for HIV prevention and is frequently conducted by public health departments. In data from South Chicago over 50% of these risk contacts are HIV infected. This high HIV prevalence outpaces that of traditional risk groups in the same geographic area and suggests that we shift our thinking of who an appropriate candidate for PrEP linkage is from individual risk (anal sex, injecting drugs), to network risk (people connected to HIV infected persons). PS-PrEP tests the integration of PrEP into routine DPH services by training DIS staff to provide brief tailored PrEP linkage planning/motivation, mini-booster sessions via text/phone, and to directly link clients int PrEP care. PS-PrEP will set the stage for a large trial by examining two key components of early PrEP care: 1) efficacy of PS-PrEP in linking high-risk seronegative clients to PrEP care as part of partner notification services; and 2) how personal characteristics (e.g. risk behavior) and downstream PrEP cascade metrics (e.g. retention and adherence to PrEP) of study participants identified through partner notification services compare to other individuals initiating PrEP withi the same clinical context and time frame. We aim to: 1) Refine the PS-PrEP intervention protocol, materials and assessments by shifting more of the intervention to focus on direct PrEP linkage and by developing a network visualization component where participants complete an interactive sociogram of individuals in their own risk network; 2) Pilot test the feasibility (reac, adoption, safety and implementation) and initial efficacy (higher linkage to care) of the PS-PrEP intervention versus treatment as usual at 3 months post randomization among a sample of contacts >18 years old recruited from partner notification services; and 3) Compare sociodemographic, HIV risk and two distal PrEP cascade metrics (retention and adherence) of PS-PrEP intervention participants linked to PrEP care with other individuals initiating PrEP within the same clinical context and time frame (12 months).

描述（由申请人提供）：本开发申请 (R34) 请求资金来完善和试点测试灵活的合作伙伴通知服务暴露前预防 (PS-PrEP) 干预措施，该干预措施将利用现有的公共卫生部 (DPH) 合作伙伴通知服务，与针对来自不同背景的高危 HIV 血清阴性人群的临床 PrEP 护理相结合。之所以需要这些资金，是因为随机对照试验证明了 PrEP 的部分功效，但在实施效果方面仍然存在明显分歧。在这些试验之后，DPH 尚未将 PrEP 纳入现有的 HIV 预防计划，导致接受 PrEP 的人很少，而那些可能受益最多的人（最高风险人群）却没有接受。为了弥补这些差距，我们的目标是将 PrEP 整合到现有的 DPH 活动中，特别是 DPH 合作伙伴通知服务中。由疾病干预专家 (DIS) 实施的 DPH 合作伙伴通知服务在国内艾滋病毒高流行地区广泛存在，具有巨大潜力。合作伙伴通知服务（让新感染艾滋病毒者的风险合作伙伴参与）是疾病预防控制中心推荐的用于艾滋病毒预防的服务，并且经常由公共卫生部门开展。根据南芝加哥的数据，这些风险接触者中超过 50% 感染了 HIV。这种高艾滋病毒患病率超过了同一地理区域的传统风险群体，这表明我们将我们对 PrEP 联系的合适候选者的想法从个人风险（肛交、注射毒品）转变为网络风险（与艾滋病毒感染者有联系的人）。 PS-PrEP 通过培训 DIS 工作人员提供简短的量身定制的 PrEP 联动计划/动机、通过短信/电话的迷你加强课程以及直接将客户与 PrEP 护理联系起来，来测试将 PrEP 整合到日常 DPH 服务中的情况。 PS-PrEP 将通过检查早期 PrEP 护理的两个关键组成部分为大型试验奠定基础：1）作为合作伙伴通知服务的一部分，PS-PrEP 在将高风险血清阴性客户与 PrEP 护理联系起来方面的功效； 2) 个人特征（例如风险行为）和 通过合作伙伴通知服务确定的研究参与者的下游 PrEP 级联指标（例如 PrEP 的保留率和依从性）与在相同临床背景和时间范围内启动 PrEP 的其他个体进行比较。我们的目标是： 1) 通过将更多的干预措施转移到直接 PrEP 联系上，并开发一个网络可视化组件，让参与者在自己的风险网络中完成个人的交互式社会图，从而完善 PS-PrEP 干预方案、材料和评估； 2) 在随机化后 3 个月，在从合作伙伴通知服务中招募的 18 岁以上接触者样本中，对 PS-PrEP 干预与照常治疗的可行性（反应、采用、安全性和实施）和初步疗效（与护理的更高联系）进行试点测试； 3) 将与 PrEP 护理相关的 PS-PrEP 干预参与者的社会人口统计学、HIV 风险和两个远端 PrEP 级联指标（保留率和依从性）与在相同临床背景和时间范围（12 个月）内启动 PrEP 的其他个体进行比较。