Peer health workers: Impact on retention, care and secondary prevention of PLHIV

描述（由申请人提供）：我的职业目标是在资源有限的环境中成为多学科艾滋病毒/艾滋病研究的全球领导者，重点研究整合艾滋病毒临床护理和二级艾滋病毒预防策略。我的短期目标是建立自己作为一个独立的调查员作为终身跟踪初级教员在约翰霍普金斯和开发一个富有成效的和可持续的研究计划在乌干达。研究项目。我提出的研究包括两个阶段：第一阶段-进行二次行为结果分析的试验数据集进行评估艾滋病护理成果在Rakai，乌干达的同行保健工作者的影响。同时，我将进行成本效益分析，这种同伴卫生工作者的干预。第2阶段-进行全面的形成性研究，然后实施以社区为基础的同伴卫生工作者干预试验，以综合（i）提高患者保留率，（ii）增加基本护理包的利用率，（iii）减少尚未接受抗逆转录病毒治疗的艾滋病毒感染者的危险性行为。同伴保健工作者的干预将集中在对个别患者的家访上。随后，我将对这种干预措施进行成本效益分析。职业发展计划。我建议的培训和指导活动将集中在（i）行为干预研究和ii）艾滋病毒预防和护理干预的成本效益分析研究。我提出的应用研究，这将与我的培训活动密切协调，将集中在同伴卫生工作者的影响，一组社区卫生工作者谁是艾滋病毒感染者，综合病人保留，护理和二级艾滋病毒预防工作在Rakai，乌干达。研究环境。我将在约翰霍普金斯大学资金充足、受人尊敬的传染病科得到很好的支持。我还将拥有乌干达Rakai健康科学计划的优秀和经过验证的研究基础设施，以支持我的研究计划的设计和实施。

DESCRIPTION (provided by applicant): My career goal is to become a global leader in multidisciplinary HIV/AIDS research in resource- limited settings with a focus on research integrating HIV clinical care and secondary HIV prevention strategies. My short term goal is to establish myself as an independent investigator as a tenure-track junior faculty member at Johns Hopkins and to develop a productive and sustainable program of research in Uganda. Research Project. My proposed research consists of two phases: Phase 1-Perform secondary behavioral outcomes analyses on a dataset of a trial conducted to assess the effect of peer health workers on AIDS care outcomes in Rakai, Uganda. Concurrently, I will perform cost-effectiveness analysis of this peer health worker intervention. Phase 2- Perform comprehensive formative research and then implement a community-based trial of a peer health worker intervention to integratively (i) improve patient retention, (ii) increase basic care package utilization, and (iii) decrease risky sexual behaviors among PLHIV not yet on antiretroviral therapy. The peer health worker intervention will center on home visits to individual patients. Subsequently, I will perform cost-effectiveness analysis of this intervention. Career Development Plan. My proposed training and mentoring activities will center on (i) behavioral intervention research and ii) cost-effectiveness analysis research of HIV prevention and care interventions. My proposed applied research, which will be closely coordinated with my training activities, will focus on the impact of peer health workers, a group of community health workers who are people living with HIV, on integrated patient retention, care, and secondary HIV prevention efforts in Rakai, Uganda. Research Environment. I will be well supported within the well funded and respected Division of Infectious Diseases at Johns Hopkins. I will also have the excellent and proven research infrastructure of the Rakai Health Sciences Program in Uganda to support the design and implementation of my research plan.