دورية أكاديمية
Appraising the HIV Prevention Cascade methodology to improve HIV prevention targets: Lessons learned from a general population pilot study in east Zimbabwe.
| العنوان: | Appraising the HIV Prevention Cascade methodology to improve HIV prevention targets: Lessons learned from a general population pilot study in east Zimbabwe. |
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| المؤلفون: | Moorhouse LR; MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, United Kingdom., Imai-Eaton JW; MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, United Kingdom.; Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA., Maswera R; Biomedical and Research Training Institute, Harare, Zimbabwe., Tsenesa B; Biomedical and Research Training Institute, Harare, Zimbabwe., Magoge-Mandizvidza P; Biomedical and Research Training Institute, Harare, Zimbabwe., Moyo B; Zimbabwe Ministry of Health and Child Care, Harare, Zimbabwe., Mugurungi O; Zimbabwe Ministry of Health and Child Care, Harare, Zimbabwe., Nyamukapa C; MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, United Kingdom.; Biomedical and Research Training Institute, Harare, Zimbabwe., Hallett TB; MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, United Kingdom., Gregson S; MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, United Kingdom.; Biomedical and Research Training Institute, Harare, Zimbabwe. |
| المصدر: | MedRxiv : the preprint server for health sciences [medRxiv] 2024 Sep 07. Date of Electronic Publication: 2024 Sep 07. |
| نوع المنشور: | Journal Article; Preprint |
| اللغة: | English |
| بيانات الدورية: | Country of Publication: United States NLM ID: 101767986 Publication Model: Electronic Cited Medium: Internet NLM ISO Abbreviation: medRxiv Subsets: PubMed not MEDLINE |
| مستخلص: | Introduction: Multiple HIV Prevention Cascades (HPC) formulations have been proposed to assist advocacy, monitoring of progress of HIV prevention implementation and research to identify ways to increase use of HIV prevention methods. Schaefer and colleagues proposed a unifying formulation suitable for widespread use across different populations which could be used for routine monitoring or advocacy. Robust methods for defining and interpreting this HPC formulation using real world data is required. Methods: Data collected as part of the Manicaland Pilot HIV Prevention Cascades Study, east Zimbabwe, in 2018-19, was used to validate the HPC framework for PrEP, VMMC, male condom and combination prevention method use. Validation measures included feasibility of populating the HPC, contrasting simple vs complex measures of the HPC (using 2-sample proportion test), and testing ability of main bars to predict prevention use and testing whether sub-bars explained why people were lost from the HPC using logistic regression. Results: It was possible to populate the HPC for both individual and combined prevention methods using pilot survey data. Most steps were associated with prevention method usage outcomes, except for VMMC. There were significant overlaps between individuals reporting positive responses for the main bar and those citing barriers to motivation. To refine the HPC's access bar definition, it is suggested to also consider individuals who report access barriers. While the HPC framework identifies barriers to individual prevention methods, challenges arise in identifying those for combined prevention. Discussion: Our study successfully utilised questionnaires from the Manicaland HPC pilot survey to measure the HPC for individual and combined prevention methods. This demonstrates the feasibility of populating this framework using general population survey data and designated questionnaire modules. We propose a final formulation of the HPC, questionnaire modules and methods to create it. With proper evaluation and promotion, the HPC can enhance prevention services, aiding in the crucial reduction of HIV incidence. Competing Interests: This work was supported by the Bill and Melinda Gates Foundation (BMGF) (INV-09999) and the National Institute of Mental Health (NIMH) (R01MH114562-01). LM, SG, JI-E and CN acknowledge funding from the MRC Centre for Global Infectious Disease Analysis (reference MR/X020258/1), funded by the UK Medical Research Council (MRC). This UK funded award is carried out in the frame of the Global Health EDCTP3 Joint Undertaking. SG declares shareholdings in pharmaceutical companies GlaxoSmithKline and Astra Zeneca. All other authors have no conflicts of interest to declare. |
| معلومات مُعتمدة: | INV-009999 United States GATES Bill & Melinda Gates Foundation; R01 MH114562 United States MH NIMH NIH HHS |
| تواريخ الأحداث: | Date Created: 20240916 Latest Revision: 20240923 |
| رمز التحديث: | 20240923 |
| مُعرف محوري في PubMed: | PMC11398587 |
| DOI: | 10.1101/2024.09.07.24310075 |
| PMID: | 39281761 |
| قاعدة البيانات: | MEDLINE |
| DOI: | 10.1101/2024.09.07.24310075 |
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