Yunnan-ADARC HIV Prevention Program: Developing and Testing a Model to Implement and Sustain PrEP Delivery in China.

7.项目摘要 暴露前预防（PrEP）是一项重要的生物医学艾滋病毒预防策略， 降低现实世界中的艾滋病发病率。然而，PrEP的引入和全球推广 进展缓慢部分挑战是，PrEP通常被引入现有的健康 系统通过一个命中或错过的过程，这是很少研究。我们建议云南-ADARC 艾滋病毒预防方案，一项关于艾滋病毒预防方案的实施过程的科学研究， 在面临艾滋病毒高发病率的特定国际卫生系统中实施PrEP 在男男性行为者中YAHPP将介绍和评估 中国云南省8个市1000多名男男性行为者的PrEP 利用吉利德科学公司捐赠的富马酸替诺福韦二异丙酯/恩曲他滨（TDF/FTC）。的 研究以实施阶段完成框架（SIC）为指导，并将使用SIC- 相关的评估工具，以衡量八个预定阶段的进展情况， 执行情况，包括记录成本和所需资源。YAHPP有两个具体的 目的：1）评估在标准中增加增强的实施战略是否 卫生系统PrEP提供改善了客户服务结果; 2）比较时间，成本， 标准与增强PrEP实施所需的资源。增强PrEP 实施工作将依靠一项集中的技术援助战略， 知识，技能和最佳实践提供PrEP诊所。研究的结果将是 一份可在中国和其他中低收入国家使用的实施蓝图， 各国指导将PrEP引入现有卫生系统。

7. Project Abstract Pre-exposure prophylaxis (PrEP), a key biomedical HIV prevention strategy, can significantly reduce HIV incidence in real-world settings. However, introduction and global scale-up of PrEP have been slow. Part of the challenge is that PrEP is typically introduced into existing health systems through a hit-or-miss process that is rarely studied. We propose the Yunnan-ADARC HIV Prevention Program, an implementation science study of the process of introduction and implementation of PrEP in a specific international health system facing high rates of HIV incidence among men who have sex with men. YAHPP will introduce and evaluate the implementation of PrEP among over 1000 men who have sex with men, in eight municipalities in Yunnan, China utilizing tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) donated by Gilead Sciences. The study is guided by the Stages of Implementation Completion Framework (SIC) and will use SIC- associated assessment tools to measure progression across eight pre-defined stages of implementation, including documenting costs and required resources. YAHPP has two specific aims: 1) To evaluate whether the addition of Enhanced implementation strategies to Standard health system PrEP delivery improves client-services outcomes; 2) To compare the time, costs, and resources required for Standard versus Enhanced PrEP implementation. Enhanced PrEP implementation will rely on a centralized technical assistance strategy to deliver PrEP-related knowledge, skills, and best practices to clinics delivering PrEP. The outcome of the study will be an implementation blueprint that may be used across China and in other low- and middle-income countries to guide the introduction of PrEP into existing health systems.