Building Implementation Science Capacity in HIV at Makerere University

描述(申请人提供)：虽然在艾滋病毒项目上投入了大量资源，但乌干达距离普及80%的目标还很远。虽然扭转全球疫情的潜力从未像现在这样大，但成功将需要循证干预成为常规护理的一部分。我们认为，艾滋病毒/艾滋病目前最紧迫的问题是如何实施和传播行之有效的公共卫生干预措施。参与护理是患者和公共卫生系统之间的接口。需要研究如何让患者参与进来，以最佳地提供护理。自20世纪80年代末以来，乌干达在艾滋病毒、结核病和疟疾研究方面开展了许多大型合作，其中许多都非常成功。然而，对实施科学研究的重视不足，无法加强对艾滋病毒流行病的反应。预防艾滋病毒和以最佳方式提供艾滋病毒护理和治疗的工具已经具备并得到证实，而成功的公共卫生现在取决于通过患者参与--在整个护理级联中--提供高效和有效的服务。我们建议利用实施科学框架，利用多学科观点及时识别艾滋病毒感染者。 这些措施包括加强与护理的联系，适当启动抗逆转录病毒治疗，以及将艾滋病毒感染患者留在护理中。艾滋病毒感染者之间的医疗服务参与度和治疗依从性将使抗逆转录病毒药物达到其最佳公共卫生影响。Makerere大学是东非排名最高的大学，该医学院20年来一直处于应对艾滋病毒/艾滋病的中心。Makerere大学科学院(MakCHS)与加州大学旧金山分校在一系列科学研究上合作了30多年，目前正在为NIH资助的一些研究和培训赠款进行合作。我们计划利用这一基础来创建一个世界级的实施科学平台，以研究护理的级联。这项计划拨款的目标是申请实施科学研究(ISR)的综合研究培训计划，重点是在MakCHS参与护理。培训计划将建立在现有的艾滋病毒研究和护理计划的基础上，以影响公共健康。这笔规划赠款的具体目标是：(1)正式成立一个规划委员会，以制定和提交完整的申请；(2)巩固MakCHS和加州大学旧金山分校之间正在进行的合作研究活动，并形成新的联系；(3)进行系统调查，以评估MakCHS在ISR方面的现有研究和培训能力；(4)确定可以为ISR培训招募的潜在受训者；以及(5)根据确定的需求制定培训计划。这些目标将通过MakCHS、加州大学旧金山分校、乌干达卫生部和其他合作小组的调查人员之间的一系列规划工作来实现。

DESCRIPTION (provided by applicant): Although significant resources have been invested in HIV programs, Uganda is still far from the universal access target of 80%. While the potential to turn the tide on the global epidemic has never been greater, success will require that evidence-based interventions become part of routine care. We believe that the most urgent question in HIV/AIDS today is how to implement and disseminate proven public health interventions. Engagement in care is the interface between patients and the public health system. Research on how to engage patients is required to optimally deliver care. Since the late 1980s, a number of large collaborations were developed in Uganda for research in HIV, tuberculosis, and malaria, and many of these have been highly successful. However, there has been insufficient focus on implementation science research to strengthen the response to the HIV epidemic. The tools to prevent HIV and to optimally provide HIV care and treatment are available and proven, and successful public health now depends on efficient and effective delivery- through patient engagement- across the cascade of care. We propose to use the implementation science framework to bring multi-disciplinary perspectives to bear on timely identification of HIV-infected individuals, accelerated linkage to care, appropriate initiation of antiretroviral therapy, and retention of HIV-infected patients in care. Medical care engagement and treatment adherence among HIV-infected individuals will allow antiretroviral medications to reach their optimal public health impact. Makerere University is the highest ranked university in East Africa and the medical school has been at the center of the response to HIV/AIDS for two decades. Makerere University College of Sciences (MakCHS) has collaborated with UCSF for over three decades on a range of scientific studies and is currently collaborating on a number of NIH funded research and training grants. We plan to leverage this foundation to create a world-class platform for implementation science to study the cascade of care. The goal of this planning grant is to develop an application for a comprehensive research training program in Implementation Science Research (ISR) focused on engagement in care at MakCHS. The training program will build on established HIV research and care programs to impact upon public health. The specific objectives of this planning grant are to: (1) formalize a planning committee to develop and submit a full application, (2) solidify ongoing collaborative research activities between MakCHS and UCSF and form new linkages, (3) conduct a systematic survey to assess existing research and training capacity in ISR at MakCHS, (4) define a pool of potential trainees that could be recruited for ISR training, and (5) develop a training plan tailord to identified needs. These objectives will be met through a series of planning exercises between investigators at MakCHS, UCSF, the Uganda MOH and other collaborating groups.