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Conceptualising engagement with HIV care for people on treatment: the Indicators of HIV Care and AntiRetroviral Engagement (InCARE) Framework.概念化接受抗逆转录病毒治疗者的 HIV 护理：HIV 护理和抗逆转录病毒参与（InCARE）框架的指标。
BMC Health Serv Res. 2023 May 4;23(1):435. doi: 10.1186/s12913-023-09433-4.
3
Adaptation, acceptability and feasibility of Problem Management Plus (PM+) intervention to promote the mental health of young people living with HIV in Kenya: formative mixed-methods research.问题管理强化版（PM+）干预措施在肯尼亚促进感染艾滋病毒青少年心理健康方面的适应性、可接受性和可行性：形成性混合方法研究
BJPsych Open. 2022 Aug 24;8(5):e161. doi: 10.1192/bjo.2022.564.
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Development of a theory-informed questionnaire to assess the acceptability of healthcare interventions.理论导向型问卷评估医疗干预措施可接受性的开发。
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5
Effects of behavioural interventions on postpartum retention and adherence among women with HIV on lifelong ART: the results of a cluster randomized trial in Kenya (the MOTIVATE trial).行为干预对接受终身抗逆转录病毒治疗的 HIV 感染产妇产后坚持治疗的影响：肯尼亚一项群组随机试验的结果（MOTIVATE 试验）
J Int AIDS Soc. 2022 Jan;25(1):e25852. doi: 10.1002/jia2.25852.
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Adherence to HIV antiretroviral therapy among pregnant and postpartum women during the Option B+ era: 12-month cohort study in urban South Africa and rural Uganda.在“B+方案”时代，城市南非和农村乌干达的孕妇和产后妇女对 HIV 抗逆转录病毒治疗的依从性：12 个月队列研究。
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Community Mental Health Care Delivery During the COVID-19 Pandemic: Practical Strategies for Improving Care for People with Serious Mental Illness.COVID-19 大流行期间的社区精神卫生保健服务：改善严重精神疾病患者护理的实用策略。
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Human-Centered Design Lessons for Implementation Science: Improving the Implementation of a Patient-Centered Care Intervention.以人为本的设计在实施科学中的应用：改善以患者为中心的护理干预措施的实施。
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Gendered dimensions of population mobility associated with HIV across three epidemics in rural Eastern Africa.东非农村地区三种艾滋病流行情况中与艾滋病毒相关的人口流动的性别层面
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肯尼亚HIV感染孕妇的风险分层与强化问题管理（PM+）评估（塔图阿研究）：方案文件

Evaluation of risk stratification and problem management plus (PM+) for pregnant women with HIV in Kenya (Tatua study): Protocol paper.

作者信息

Helova Anna, Onono Maricianah, Ogolla-Onyando Mercelline, Ouma Emmah, Imran Rabbia, Beres Laura K, Hampanda Karen, Owuor Kevin, Szychowski Jeff M, Ongeri Linnet, Abuogi Lisa L, Turan Janet M

机构信息

Department of Health Policy and Organization, School of Public Health, The University of Alabama at Birmingham, 1665 University Blvd, Birmingham, 35233, AL, United States; Sparkman Center for Global Health, School of Public Health, The University of Alabama at Birmingham, 1665 University Blvd, Birmingham, 35233, AL, United States.

Centre for Microbiology Research, Kenya Medical Research Institute, Karume Road/ Jairo Street Junction, Kisumu, Kenya.

出版信息

Contemp Clin Trials. 2025 Apr;151:107838. doi: 10.1016/j.cct.2025.107838. Epub 2025 Feb 6.

DOI:10.1016/j.cct.2025.107838
PMID:39921155
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12316509/
Abstract

BACKGROUND

While many pregnant and postpartum women with HIV (PPWH) in the African Region successfully engage in HIV care, a substantial number still face significant barriers, including poor mental health and HIV stigma. These psychosocial barriers contribute to poor medication and clinic visit adherence, poor health outcomes, including unsuppressed viral load, and increased risk of perinatal transmission of HIV. To efficiently improve health outcomes within a resource-constrained health system, responsive and effective interventions are urgently needed to support women who are at the highest risk of sub-optimal outcomes.

OBJECTIVE

To determine whether risk stratification of PPWH in conjunction with an evidence-based, tailored, lay health worker-delivered psychological intervention can optimize health outcomes for PPWH and their infants.

METHODS

Using human-centered design, we will adapt Problem Management Plus (PM+) with PPWH for in-person and mobile delivery formats to prevent sub-optimal treatment adherence and HIV care disengagement among PPWH in Kisumu, Kenya. We will test the adapted PM+ intervention among 120 PPWH randomized 1:1:1 to standard of care, in-person PM+, or mobile PM+ in a hybrid type 2 implementation effectiveness pilot trial. Implementation outcomes, including feasibility, acceptability, and intervention satisfaction, as well as preliminary effectiveness outcomes in mental health and HIV, will be evaluated.

EXPECTED STUDY OUTCOMES

We anticipate that the adapted PM+ intervention will be highly acceptable and feasible to implement and have the potential to be effective at reducing care disengagement, viremia, and psychological distress in PPWH.

摘要

背景

虽然非洲地区许多感染艾滋病毒的孕妇和产后妇女（PPWH）成功接受了艾滋病毒治疗，但仍有相当一部分人面临重大障碍，包括心理健康不佳和艾滋病毒污名化。这些社会心理障碍导致药物治疗和门诊就诊依从性差、健康结果不佳，包括病毒载量未得到抑制，以及围产期艾滋病毒传播风险增加。为了在资源有限的卫生系统中有效改善健康结果，迫切需要有针对性和有效的干预措施来支持那些最有可能出现次优结果的妇女。

目的

确定对PPWH进行风险分层并结合基于证据的、量身定制的、由非专业卫生工作者提供的心理干预措施是否能优化PPWH及其婴儿的健康结果。

方法

采用以人为本的设计，我们将对PPWH采用问题管理强化版（PM+），以面对面和移动服务的形式，防止肯尼亚基苏木的PPWH出现次优治疗依从性和艾滋病毒治疗中断的情况。我们将在一项混合型2期实施效果试点试验中，对120名PPWH进行1:1:1随机分组，分别接受标准治疗、面对面PM+或移动PM+，测试经过调整的PM+干预措施。将评估实施结果，包括可行性、可接受性和干预满意度，以及心理健康和艾滋病毒方面的初步有效性结果。

预期研究结果

我们预计，经过调整的PM+干预措施将非常易于接受且实施可行，并且有可能有效减少PPWH的治疗中断、病毒血症和心理困扰。