HAART Adherence Interventions in Africa: an RCT

描述（由申请人提供）： 候选人：迈克尔·H博士。钟是华盛顿大学过敏和传染病系的高级研究员。他毕业于芝加哥普利兹克医学院和哈佛公共卫生学院，自2002年以来一直在肯尼亚内罗毕进行HIV-1随机临床试验。他的近期目标是完成几项国际HIV-1实地研究，并加强他在流行病学和生物统计学方面的知识。他的长期职业目标是成为资源匮乏环境中抗逆转录病毒治疗依从性和空间流行病学方面的专家。 工作环境：华盛顿大学在艾滋病研究经费方面在美国大学中排名第三，它拥有艾滋病研究中心、艾滋病临床试验单位和国际艾滋病研究和培训计划。在内罗毕，华盛顿大学自1985年以来一直参与HIV-1的合作研究，自1992年以来一直在进行随机临床试验。在这个理想的研究环境中，钟博士将通过接受专家指导，参加相关领域的课程，并领导肯尼亚HIV-1研究的实施来发展他的研究事业。 调研：随着非洲大规模免费HAART治疗项目的出现，坚持使用抗逆转录病毒药物对于保护健康和防止耐药HIV-1变异的传播至关重要。 在这种资源匮乏的环境中，依从性知识是有限的，没有任何随机临床试验的支持。因此，本研究提出在肯尼亚内罗毕进行一项4组析因随机临床试验，以确定认知和行为干预对HAART依从性的影响。在这项试验中，该研究还建议检查对坚持干预措施的态度，并确定社会人口和空间相关的坚持。该研究假设，教育咨询和药物报警设备可以显着提高依从性，而依从性差可能与社会经济地位低，流动性增加和距离诊所有关。

DESCRIPTION (provided by applicant): Candidate: Dr. Michael H. Chung is a Senior Fellow in the Division of Allergy and Infectious Diseases at the University of Washington. A graduate of the University of Chicago Pritzker School of Medicine and the Harvard School of Public Health, he has been conducting HIV-1 randomized clinical trials in Nairobi, Kenya since 2002. His immediate goal is to complete several international HIV-1 field studies and to strengthen his knowledge of epidemiology and biostatistics. His long-term career goal is to become an expert in antiretroviral adherence in resource-poor settings and spatial epidemiology. Environment: Ranking third among U.S. universities in HIV/AIDS research funding, the University of Washington counts the Center for AIDS Research, the AIDS Clinical Trials Unit, and the International AIDS Research and Training Program among its many HIV/AIDS resources. In Nairobi, the University of Washington has been involved in collaborative HIV-1 research since 1985 and has been conducting randomized clinical trials continuously since 1992. In this ideal research environment, Dr. Chung will develop his research career by receiving expert mentorship, taking courses in relevant fields, and leading the implementation of HIV-1 studies in Kenya. Research: With the advent of large-scale free HAART treatment programs in Africa, good adherence to antiretrovirals will be essential to preserve health and prevent the spread of resistant HIV-1 variants. Adherence knowledge in this resource-poor setting is limited and not supported by any randomized clinical trials. Consequently, this study proposes a 4-armed factorial randomized clinical trial in Nairobi, Kenya to determine the effect of cognitive and behavioral interventions on HAART adherence. Within this trial, the study also proposes to examine attitudes towards adherence interventions and identify sociodemographic and spatial correlates of adherence. The study hypothesizes that educational counseling and medication alarm devices may significantly improve adherence, and that poor adherence may be associated with low socioeconomic standing, increased mobility, and distance from clinic.