Peer delivered HIV/syphilis self-testing with assisted partner notification services for men who have sex with men (MSM) in Uganda

项目总结/摘要 K43新兴全球领袖奖的总体目标是支持斯蒂芬·奥科博伊博士的 研究培训，发展成为一个独立的全球健康艾滋病毒研究员。奥科博伊博士目前是一名 马凯雷雷大学传染病研究所博士后研究员和研究副主任， 乌干达进行本申请中的拟议研究将有助于他的培训目标：1）获得 行为科学方法方面的专门知识，以更好地了解过程和预防行为 艾滋病毒和梅毒自我检测与辅助性伴通知（APN）相结合的基础同伴交付 服务，2）获得在真实的世界环境中设计和进行随机试验的专业知识，以及3）获得 先进的卫生经济学评估技能。这一建议建立在他已经拥有的独特技能， 流行病学和护理，同时利用多学科的导师团队，最终成为一个 在艾滋病毒预防研究中富有成效和有影响力的独立调查员。本研究的目的是 建议是进行严格的概念验证评估，以评估可行性，可接受性， 艾滋病毒和梅毒自我检测的初步效果和成本效益， 协助合作伙伴通知服务。与其他男性发生性关系的男性（MSM） 艾滋病毒和梅毒的感染率极高。在乌干达，男男性行为者艾滋病毒感染率为13.2%， 在15-64岁的男性中，梅毒流行率为8.3%，而男性为5.8%。梅毒和 艾滋病毒传播有共同的传播途径，梅毒增加了感染艾滋病毒的风险， 传播和疾病进展。世界卫生组织建议进行艾滋病毒/梅毒双重检测 但由于医疗保健中的耻辱和歧视， 设置.提供差别化服务的模式，例如同伴提供艾滋病毒/梅毒自我检测， 对那些检测呈阳性的人进行护理，可以规避卫生设施的耻辱和其他结构性障碍， 获得护理。然而，据我们所知，没有研究评估了同伴传递的有效性。 艾滋病毒/梅毒自我检测与男男性行为者的伙伴服务挂钩。为了解决这一研究空白，Okoboi博士将 开展形成性研究，为实施同伴提供的艾滋病毒/梅毒联合自测提供信息 与APN乌干达MSM（目标1），进行随机试验，初步测试的初步效果， 同伴提供的HIV/梅毒自我检测和APN相对于护理标准（目标2），并估计成本 同伴提供的艾滋病毒/梅毒自我检测和APN与基于设施的检测相比的意义（目标3）。 博士Okoboi的研究目标与他的训练目标相一致，在完成这项奖励时，他将 在一个很好的位置提交R 01申请，以进一步推进艾滋病毒预防研究的男男性接触者 于撒哈拉以南非洲的

PROJECT SUMMARY/ABSTRACT The overall goal of the proposed K43 Emerging Global Leader Award is to support Dr. Stephen Okoboi’s research training to develop as an independent global health HIV researcher. Dr. Okoboi is currently a postdoctoral fellow and Deputy Head of Research at Makerere University Infectious Disease Institute in Uganda. Conducting the proposed studies in this application will facilitate his training goals to: 1) gain expertise in behavioural science methods to better understand the processes and preventive behaviours underlying peer delivery of HIV and syphilis self-tests combined with assisted partner notification (APN) services, 2) gain expertise in the design and conduct of randomized trials in real world settings, and 3) acquire advanced skills in health economic evaluation. This proposal builds on the unique skills he already has in epidemiology and nursing while leveraging a multidisciplinary team of mentors to ultimately become a productive and influential independent investigator in HIV prevention research. The research goal of this proposal is to conduct a rigorous proof-of-concept evaluation to assess the feasibility, acceptability, preliminary effectiveness, and cost effectiveness of peer delivered HIV and syphilis self-testing coupled with assisted partner notification services. Men who engage in sexual relations with other men (MSM) are disproportionately affected by HIV and syphilis. In Uganda, MSM HIV prevalence is 13.2% versus 4.7% in similarly aged males, while syphilis prevalence is 8.3% versus 5.8% in males aged 15-64 years. Syphilis and HIV transmission share common transmission routes and syphilis increases risk of HIV acquisition, transmission, and disease progression. The World Health Organization recommends dual HIV/syphilis testing for MSM, but uptake of facility-based testing is low because of stigma and discrimination in healthcare settings. Differentiated service delivery models, such as peer delivered HIV/syphilis self-tests and linkage to care for those who test positive, could circumvent health facility stigma and other structural barriers to accessing care. However, no studies to our knowledge have evaluated the effectiveness of peer delivered HIV/syphilis self-testing linked to partner services for MSM. To address this research gap, Dr. Okoboi will conduct formative research to inform the implementation of peer-delivered HIV/syphilis self-tests combined with APN for Ugandan MSM (Aim 1), conduct a randomized trial to pilot test the preliminary effectiveness of peer delivered HIV/syphilis self-tests and APN relative to standard of care (Aim 2), and estimate the cost implications of peer-delivered HIV/syphilis self-testing and APN compared to facility-based testing (Aim 3). Dr. Okoboi’ s research goals correspond with his training goals, and at the completion of this award, he will be in an excellent position to submit an R01 application to further advance HIV prevention research for MSM in sub-Saharan Africa.