Creating a Global fRAmework of Data collection Used for Adolescent HIV Transition Evaluation (GRADUATE)

项目摘要 今天，全世界有400多万青少年和年轻人感染艾滋病毒。然而，在这方面， 在当前的全球监视数据系统中，没有机制来区分这些数据中有多少是 年轻人在婴儿时感染或在青春期/成年初期通过危险行为感染艾滋病毒， 以及有多少比例随后从儿童艾滋病护理过渡到成人艾滋病护理。为了解决这一 严重的差距，迫切需要协调艾滋病毒临床和方案数据， 艾滋病毒护理过渡期的方式，将在低收入和中等收入国家（LMIC）实施 设置.拟议的研究倡议，建立全球数据收集框架， 青少年艾滋病毒过渡评估（毕业生），旨在建立一个数据收集和 管理平台，可以指导临床计划，如人口统计，社会经济， 临床和实验室数据，他们应该记录，以描述如何青少年是 在临床护理系统中经历过渡期。毕业生将在 在LMIC的背景下，它可以用来进行流行病学研究和监测，以了解 过渡如何影响年轻人的方案保留和抗逆转录病毒疗法的成功或失败。 GRADUATE将促进数据粒度的水平，允许按年龄，性别和性别分列数据。 感染暴露组，这可能会极大地改变我们对年轻女性如何经历 与年轻男性相比， 那些在老年时感染的人。新的数据管理框架和研究倡议将包括1） 确定关键变量和数据定义，以反映转型过程以及 过渡期内的临床和社会经济预测因素和结局，2）创建数据表 和在线工具，以促进诊所一级的数据收集和用于研究目的，以及3） 在亚洲和撒哈拉以南非洲，在个体诊所的患者层面上， 区域研究队列数据库，并通过一个大型省级艾滋病毒规划管理和监测 程序.我们假设，转型过程的一些核心指标可以从以下方面得出： 常规队列数据，或者可以通过最少的额外数据收集容易地捕获。我们还假设 过渡的成功将因环境和性别而异， 可能需要采取具体干预措施的转型成果不佳的因素。拟议的倡议将 创建第一个广泛实施和开放访问的数据平台，以支持青少年的测量 艾滋病毒护理过渡成果。

PROJECT SUMMARY There are more than four million adolescents and young adults living with HIV in the world today. However, there are no mechanisms within current global surveillance data systems to distinguish how many of these young people were infected as infants or acquired HIV through risk behaviors in adolescence/young adulthood, and what proportion has subsequently transitioned from pediatric to adult HIV care. In order to address this serious gap, there is a critical need to harmonize HIV clinical and program data across the adolescent-to-adult HIV care transition period in a way that would be implementable in low- and middle-income country (LMIC) settings. The proposed research initiative, Creating a Global fRAmework of Data collection Used for Adolescent HIV Transition Evaluation (GRADUATE), seeks to establish a data collection and management platform that can guide clinical programs as to the demographic, socio-economic, clinical, and laboratory data they should be documenting in order to describe how adolescents are moving through the transition period within clinical care systems. GRADUATE would be created in the context of LMICs, where it could be used to conduct epidemiologic research and surveillance to understand how transition impacts program retention and antiretroviral therapy success or failure among young people. GRADUATE would promote a level of data granularity allowing disaggregation of data by age, sex, and infection exposure group that could dramatically change our understanding of how young women experience transitions in HIV care compared to young men, and of long-term survivors of perinatal infection compared to those infected at older ages. The new data management framework and research initiative would include 1) the identification of key variables and data definitions that capture the process of transition as well as the clinical and socio-economic predictors and outcomes across the transition period, 2) creation of data tables and online tools to facilitate data collection at the clinic level and for research purposes, and 3) pilot testing of the data-capture methods in Asia and sub-Saharan Africa at the patient level in individual clinics, within regional research cohort databases, and through a large provincial HIV program management and surveillance program. We hypothesize that a number of core indicators of the transition process can be derived from routine cohort data or can readily be captured through minimal additional data collection. We also hypothesize that transition success will vary across different settings and by sex, and that it will be possible to identify risk factors for poor transition outcomes that may be amenable to specific interventions. The proposed initiative will create the first broadly implementable and open access data platform to support measurement of adolescent HIV care transition outcomes.