Optimizing Mechanisms for Identifying Older Children with Undiagnosed HIV-1

描述（由申请人提供）：这个多学科的实施科学项目嵌套在美国国立卫生研究院资助的一项更大的研究中，即家庭儿童HIV-1咨询和测试（CATCH）研究，该研究将检查通过父母确定的hiv感染儿童对治疗的吸收和反应。我的子研究将在CATCH的筛选和注册阶段进行；我们的目标是建立和优化操作机制，以识别肯尼亚未确诊的无症状艾滋病毒-1感染儿童，并将他们纳入艾滋病毒护理。为了找到这些未确诊的儿童，我们建议通过艾滋病毒检测和治疗中心的各种接入点接触感染艾滋病毒1的父母，并为他们的艾滋病毒状况未知的孩子提供家庭或诊所检测。我们的目的是比较临床和家庭为基础的测试，在产量，可接受性，可行性和成本方面。为了全面了解通过家庭或诊所检测识别未确诊儿童的挑战和促进因素，我们将收集三种类型的数据：传统的定量流行病学和项目数据，来自父母和护理提供者的定性数据，以及成本和影响数据。通过这三种方法的结合，我们希望通过针对执行挑战，将艾滋病毒检测和治疗形式的医学进步的好处转化为目前服务不足的未确诊儿童。

DESCRIPTION (provided by applicant): This multi-disciplinary, implementation science project is nested within a larger NIH-funded study, the HIV-1 Counseling and Testing for Children at Home (CATCH) Study, which will examine uptake of, and response to, treatment in HIV-infected children identified via their parents. My sub-study will take place during the screening and enrollment phase for CATCH; we aim to develop and optimize operational mechanisms to identify undiagnosed, asymptomatic HIV-1 infected children in Kenya and bring them into HIV care. To find these undiagnosed children, we propose to access their HIV-1 infected parents through various access points at HIV testing and treatment centers and offer them either home-based or clinic-based testing for their children of unknown HIV status. Our intent is compare clinic- versus home-based testing-in terms of yield, acceptability, feasibility, and cost. In order to holistically understand the challenges and facilitators to identifying undiagnosed children through home-based or clinic-base testing, we will collect three types of data: traditional quantitative epidemiological and program data, qualitative data from parents and care providers, and cost and impact data. Through the combination of these three methods, we hope to translate the benefit of medical advances in the form of HIV testing and treatment to a currently underserved population of undiagnosed children through targeting implementation challenges.