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NIH 资助的 HIV 实施研究项目组合概况,以为终结 HIV 流行策略提供信息。

Profile of the Portfolio of NIH-Funded HIV Implementation Research Projects to Inform Ending the HIV Epidemic Strategies.

机构信息

Northwestern University Institute for Sexual and Gender Minority Health and Wellbeing, Chicago, IL.

Third Coast Center for AIDS Research, Chicago, IL.

出版信息

J Acquir Immune Defic Syndr. 2022 Jul 1;90(S1):S23-S31. doi: 10.1097/QAI.0000000000002962.

Abstract

BACKGROUND

The US government created an initiative to end the HIV epidemic in the United States by the year 2030 (EHE). This multiagency initiative was structured around four pillars: Prevent, Diagnose, Treat, and Respond to improve HIV programs, resources, and service delivery infrastructure. In support of its research mission, the National Institutes of Health (NIH) has funded implementation research (IR) projects by addressing the four pillars and encouraging investigators to collaborate with local partners and Health and Human Services (HHS) grantees in 57 priority jurisdictions.

METHODS

This paper analyzed data from the NIH funded CFAR/ARC supplement projects from 2019 to 2021. The Exploration, Preparation, Implementation, Sustainment (EPIS) framework was used to characterize projects by stage of implementation.

RESULTS

The Prevent pillar was most frequently studied, with Pre-Exposure Prophylaxis (PrEP) being the most studied intervention. The most common partners were health departments, community-based organizations (CBOs), and Federally Qualified Health Centers (FQHCs). The Consolidated Framework for Implementation Research (CFIR) framework was the most utilized to investigate implementation determinants, followed by the RE-AIM framework and Proctor model to assess implementation outcomes.

CONCLUSION

Monitoring the projects resulting from NIH investments is fundamental to understanding the response to EHE, and achieving these results requires systematic and continuous effort that can support the generalizable implementation knowledge emerging from individual studies. There are some remaining gaps in the project portfolio, including geographical coverage, range of implementation outcomes being measured, and interventions still requiring further research to ensure equitable scale-up of evidence based interventions and achieve EHE goals.

摘要

背景

美国政府制定了一项倡议,旨在 2030 年之前终结美国的艾滋病毒疫情(EHE)。这项多机构倡议围绕着四个支柱构建:预防、诊断、治疗和应对,以改善艾滋病毒项目、资源和服务提供基础设施。为了支持其研究使命,美国国立卫生研究院(NIH)通过解决这四个支柱问题,为实施研究(IR)项目提供资金,并鼓励研究人员与当地合作伙伴和卫生与公众服务部(HHS)的受赠者在 57 个优先司法管辖区合作。

方法

本文分析了 2019 年至 2021 年 NIH 资助的 CFAR/ARC 补充项目的数据。采用探索、准备、实施、维持(EPIS)框架来描述项目所处的实施阶段。

结果

预防支柱研究最多,暴露前预防(PrEP)是研究最多的干预措施。最常见的合作伙伴是卫生部门、社区组织(CBO)和合格的联邦卫生中心(FQHCs)。实施研究综合框架(CFIR)框架最常被用来调查实施决定因素,其次是 RE-AIM 框架和 Proctor 模型来评估实施结果。

结论

监测 NIH 投资项目对于了解对 EHE 的反应至关重要,实现这些结果需要系统和持续的努力,这可以支持从个别研究中出现的可推广实施知识。项目组合中仍存在一些差距,包括地理覆盖范围、正在测量的实施结果范围以及仍需要进一步研究的干预措施,以确保基于证据的干预措施的公平推广并实现 EHE 目标。

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