International Epidemiology Databases to EvaluateAIDS (IeDEA) Renewal 4

项目摘要/摘要 西非的艾滋病毒疫情负担沉重，约有350万艾滋病毒携带者 (PLHIV)。尽管呼吁采取行动支持该区域的普遍检测和治疗，但西非 经历重大挑战，确保利用最新的联合国艾滋病规划署充分提供持续的艾滋病毒护理 建议。为了应对这些核心挑战，IeDEA西非合作依靠一种独特的 西非队列网络，任务是进行假说驱动的流行病学研究 获得护理方面的障碍以及对艾滋病毒的预后和结果的障碍，包括成人、青少年和 在看护中的儿童，以及感染艾滋病毒的儿童。我们的五年研究计划将集中在科学问题上 这一贡献群体很难单独回答，因为说英语的人和说英语的人之间的独特伙伴关系 该地区讲法语的国家。我们计划的主要具体目标将是：1)确定一个 描述与艾滋病毒护理的连续体有关的个人和结构性障碍，从艾滋病毒检测到保留 在整个西非的护理和病毒抑制方面，2)利用我们现有的网络来建立队列 西非IeDEA艾滋病毒关键人群包括女性性工作者和男男性行为者，3) 确定非传染性疾病的负担，并评估其与艾滋病毒感染的相互作用。我们的 合作支持了世界上最强大的流行病学和临床研究基础设施之一 该区域拥有近40,000名成年人(包括883名艾滋病毒-2和843名艾滋病毒-1/2)和15,814名儿童(6,515名)的数据 在七个国家，接触艾滋病毒的儿童、接受抗逆转录病毒治疗的7041名儿童和尚未接受抗逆转录病毒药物治疗的2258名艾滋病毒携带者) 在该地区(贝宁、布基纳法索、科特迪瓦、加纳、马里、多哥和塞内加尔)。下一轮谈判将涉及 在8个国家(贝宁、布基纳法索、科特迪瓦、加纳、马里、尼日利亚、塞内加尔和 多哥)。其中，有8家诊所是新的合作中心。IeDEA西非合作项目是 在法国波尔多大学与由PACCI方案主办的区域办事处协调， 设在科特迪瓦阿比让的研究型非政府组织。这个研究团队有一个 在观察艾滋病毒研究方面的长期经验，包括在西非的大规模预期队列。 每年将按照标准化程序从关联队列中收集数据并进行合并 在波尔多的协调中心。参与中心的能力建设将包括为当地 人力资源、数据质量培训、现场技术支持和年度会议，以加强 科技网络。在这一资金周期结束时，我们打算处理主要研究 差距，包括更好地了解影响西非艾滋病毒感染者的各种共病。我们的队伍将会是 更能代表区域艾滋病毒流行情况，并将收集关键人群的重要数据以供参考 针对这些弱势群体的干预措施。

PROJECT SUMMARY/ABSTRACT West Africa holds a significant burden of the HIV epidemic with approximately 3.5 million people living with HIV (PLHIV). Despite calls for action to support access to universal test and treat in the region, West Africa experience major challenges ensuring a continuum of HIV care in adequacy with the latest UNAIDS recommendations. To address these core challenges, the IeDEA West Africa Collaboration relies on a unique network of cohorts in West Africa with a mission to conduct hypothesis-driven epidemiological research on barriers in access to care as well as on the prognosis and outcomes of PLHIV, including adults, adolescents and children in care, as well as HIV-exposed children. Our five-year research plan will focus on scientific questions that contributing cohorts can hardly answer separately with a unique partnership between English-speaking and French-speaking countries in the region. The overarching specific aims of our program will be: 1) To identify an describe individual and structural barriers associated with the continuum of HIV care, from HIV testing to retention in care and viral suppression throughout West Africa, 2) To leverage our existing network to establish a cohort of HIV Key Populations including female sex workers and men who have sex with men in IeDEA West Africa, 3) To determine the burden of non-communicable diseases and evaluate their interplay with HIV infection. Our collaboration has supported one of the most robust epidemiological and clinical research infrastructure in the region, housing data on close to 40,000 adults (including 883 HIV-2 et 843 HIV-1/2) and 15,814 children (6,515 children exposed to HIV, 7,041 on ART and 2,258 children living with HIV not already on ART) in seven countries in the region (Benin, Burkina Faso, Côte d’Ivoire, Ghana, Mali, Togo and Senegal). The next round will involve 21 HIV clinical centers in eight countries (Benin, Burkina Faso, Cote d’Ivoire, Ghana, Mali, Nigeria, Senegal and Togo). Among them, eight clinics are new collaborating centers. The IeDEA West Africa collaboration is coordinated at the University of Bordeaux, France with a regional Office hosted by the PACCI program, a research-oriented non-governmental organization situated in Abidjan, Côte d’Ivoire. This research team has a long-lasting experience in observational HIV research including large-scale prospective cohorts in West Africa. Data will be collected from affiliated cohorts every year according to standardized procedures and will be merged at the coordinating center in Bordeaux. Capacity building in participating centers will include funding for local human resources, training on data quality, on-site technical support and annual meetings to reinforce the technical and scientific network. At the completion of this funding cycle, we intend to address major research gaps including a better knowledge the various comorbidities affecting PLHIV in West Africa. Our cohorts will be more representative of the regional HIV epidemic and will capture important data on Key Populations to inform target interventions for these vulnerable groups.