Yunnan-ADARC HIV Prevention Program: Developing and Testing a Model to Implement and Sustain PrEP Delivery in China.

7.项目摘要 暴露前预防(PrEP)，一项关键的生物医学艾滋病毒预防策略，可以显著 减少现实世界环境中的艾滋病毒发病率。然而，PrEP的引入和全球推广 一直进展缓慢。部分挑战是PrEP通常被引入到现有的健康中 系统通过一个命中或未命中的过程，这是很少研究的。我们建议成立云南-亚洲区域发展中心。 艾滋病毒预防计划，一项关于引入和实施过程的科学研究 在面对艾滋病毒高发病率的特定国际卫生系统中实施PrEP 在与男性发生性关系的男性中。YAHPP将介绍和评估以下项目的实施情况 在云南省8个直辖市1000多名男男性接触者中，中国 利用吉列德科学公司捐赠的富马酸替诺福韦/恩曲他滨(TDF/FTC)。这个 研究以实施完成框架(SIC)的各个阶段为指导，并将使用SIC- 相关的评估工具，用于衡量以下八个预定义阶段的进度 实施，包括记录成本和所需资源。YAHPP有两个具体的 目标：1)评估标准中是否增加了增强的实施战略 医疗系统PrEP交付改善了客户服务结果；2)比较时间、成本、 以及实施标准PrEP与增强PrEP所需的资源。增强型PrEP 实施将依靠集中化的技术援助战略来交付与PrEP相关的 向诊所提供PrEP的知识、技能和最佳实践。研究的结果将是 一份可能适用于中国和其他中低收入者的实施蓝图 指导将PrEP引入现有卫生系统的国家。

7. Project Abstract Pre-exposure prophylaxis (PrEP), a key biomedical HIV prevention strategy, can significantly reduce HIV incidence in real-world settings. However, introduction and global scale-up of PrEP have been slow. Part of the challenge is that PrEP is typically introduced into existing health systems through a hit-or-miss process that is rarely studied. We propose the Yunnan-ADARC HIV Prevention Program, an implementation science study of the process of introduction and implementation of PrEP in a specific international health system facing high rates of HIV incidence among men who have sex with men. YAHPP will introduce and evaluate the implementation of PrEP among over 1000 men who have sex with men, in eight municipalities in Yunnan, China utilizing tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) donated by Gilead Sciences. The study is guided by the Stages of Implementation Completion Framework (SIC) and will use SIC- associated assessment tools to measure progression across eight pre-defined stages of implementation, including documenting costs and required resources. YAHPP has two specific aims: 1) To evaluate whether the addition of Enhanced implementation strategies to Standard health system PrEP delivery improves client-services outcomes; 2) To compare the time, costs, and resources required for Standard versus Enhanced PrEP implementation. Enhanced PrEP implementation will rely on a centralized technical assistance strategy to deliver PrEP-related knowledge, skills, and best practices to clinics delivering PrEP. The outcome of the study will be an implementation blueprint that may be used across China and in other low- and middle-income countries to guide the introduction of PrEP into existing health systems.