Ukubandakanya abesilisisa: HIV self-testing for Partners of HIV-uninfected Postpartum Women to facilitate PrEP and ART uptake to promote HIV treatment and prevention

项目总结 南非的围产期妇女是世界上艾滋病毒感染率最高的国家之一，几乎 完全通过男性伴侣的性接触感染。产后期是风险增加的时期。 治疗艾滋病病毒。如果妇女在怀孕末期或产后期间感染艾滋病毒，艾滋病毒可能是 通过母乳喂养传染给婴儿。在南非，男女合伙并不总是相互认识的 其他人的艾滋病毒状况。这可能会使预防艾滋病毒变得困难，特别是在SA，在那里男性患艾滋病毒的可能性较小 接受艾滋病毒检测的女性比女性多。未感染艾滋病毒的妇女可以选择使用暴露前预防措施(PrEP) 帮助他们保持艾滋病毒未感染；艾滋病毒携带者(MWH)知道自己的状况并接受治疗的男性 实际上，她们不太可能将艾滋病毒传播给她们的女性伴侣。男性现在可以对自己进行艾滋病毒检测 使用HIV自我检测(HIVST)试剂盒；使用这些试剂盒有可能绕过传统的临床- 基于艾滋病毒检测，例如对污名或隐私的担忧，或相互竞争的需求，如忙碌的工作 日程表。我们早期的研究表明，男性愿意采取保护女性的行为 在试图怀孕期间防止伴侣感染艾滋病毒，以保护他们的后代，包括艾滋病毒检测。 向未感染艾滋病毒的妇女提供用于男性伴侣分发和艾滋病毒预防咨询的HIVST试剂盒 在产后早期可以帮助妇女在这一风险增加的时期保持艾滋病毒未感染， 还可以确定MWH，并帮助这些男性从事艾滋病毒护理。因此，这项研究有以下几点 目标：(1)细化联合干预的内容，以促进合作伙伴和PrEP的HIVST 未感染艾滋病毒的产后妇女(“H4P”)通过焦点小组讨论从妇女和 在过去一年中在南澳生育过孩子的男性(N=最多10名女性和10名男性)；(2)进行 H4P干预产后未感染HIV的妇女(N=60及其男性)的随机先导试验 在南卡罗来纳州夸祖鲁-纳塔尔(KwaZulu-Natal)，报告了一名血清状态不明的伴侣。所有女性都将收到HIVST试剂盒 和标准化的健康信息，分发给男性伴侣；那些随机接受H4P干预的人 ARM还将接受PrEP摄取咨询，男性伴侣将接受以生殖健康为中心的咨询 关于为什么艾滋病毒检测很重要的信息。将对可行性和可接受性进行评估。(3A)评估 通过计算干预后三个月干预/控制部门的初步有效性， 在伴侣检测呈阳性、没有检测或没有共同参与检测的人群中，启动PrEP的女性比例 检测结果，以及检测呈阳性的男性与艾滋病毒护理相关的比例。(3B)进行个人行为 年，对一部分登记的妇女及其伴侣(N=多达10-15名妇女和男子)进行了定性访谈 该干预臂探索优化干预的机会。

PROJECT SUMMARY Perinatal women in South Africa (SA) have one of the highest HIV infection rates in the world, and are almost exclusively infected via sexual contact from male partners. The postpartum period is an increased time of risk for HIV. If women become HIV infected at the end of pregnancy or during the postpartum period, HIV may be transmitted to the infant via breastfeeding. Women and men in partnerships in SA do not always know each other’s HIV statuses. This can make HIV prevention difficult, particularly in SA, where men are less likely to be tested for HIV than women. HIV-uninfected women have the option of using pre-exposure prophylaxis (PrEP) to help them remain HIV-uninfected; men with HIV (MWH) who know their status, and who take treatment effectively, are unlikely to transmit HIV to their female partners. Men are now able to test themselves for HIV using HIV self-test (HIVST) kits; use of these kits has the potential to circumvent barriers to traditional, clinic- based HIV testing, such as concerns about stigma or privacy, or competing demands, like busy work schedules. Our earlier work suggests that men are willing to engage in behaviors to protect their female partners from HIV during attempts to conceive in order to protect their offspring, including HIV testing. Providing HIV-uninfected women with HIVST kits for male partner distribution and HIV prevention counseling during the early postpartum period may help women remain HIV-uninfected during this time of increased risk, and may also identify MWH and help those men engage in HIV care. Thus, this study has the following objectives: (1) to refine the content of a combination intervention to promote HIVST for Partners and PrEP uptake for HIV-uninfected Postpartum Women (“H4P”) via focus group discussion feedback from women and men in SA who have had a child in the past year (N = up to 10 women and 10 men); (2) to conduct a randomized pilot trial of the H4P intervention for postpartum HIV-uninfected women (N = 60 and their male partners) in KwaZulu-Natal, SA, who report a partner of unknown serostatus. All women will receive HIVST kits and standardized health information for distribution to male partners; those randomized to the H4P intervention arm will also receive PrEP uptake counseling, and male partners will receive reproductive health-centered information about why HIV testing is important. Feasibility and acceptability will be assessed. (3a) To evaluate preliminary effectiveness by calculating, across intervention/control arms at three months post-intervention, the proportion of women initiating PrEP among those whose partners test positive, do not test, or do not share a test result, and the proportion of men with a positive test who link to HIV care. (3b) To conduct individual qualitative interviews with a subset of enrolled women and their partners (N = up to 10-15 women and men) in the intervention arm to explore opportunities to optimize the intervention.