R21EB032229

CASI-PLUS: A mHealth Tool for Client Engagement to Improve Ukraine's Assisted Partner Services (APS) Program Workflow and HIV Testing Outcomes - Project Abstract

Assisted Partner Notification Services (APS) involves public health contract tracing for clients with HIV or other sexually transmitted infections, in order to confidentially notify contacts of their exposure and link them to testing and treatment services. Through several randomized controlled trials (RCTs), APS has been demonstrated as a cost-effective strategy for increasing HIV testing and case identification. However, some APS programs implemented at scale in low- and middle-income countries have fallen short of optimal outcomes, as APS participants typically only name their current sex partner or fail to notify their partners. Finding innovative ways to increase the number of partners elicited and the number completing HIV testing is critical to success in scale-up.

In Ukraine, HIV prevalence is estimated at 1% among adults, 7.5% among men who have sex with men (MSM), and 22.6% among persons who inject drugs (PWID). There is a substantial undiagnosed fraction of people living with HIV, estimated at 25% overall, 41% among MSM, and 42% among PWID. Ukraine scaled up APS in 40 public-sector health facilities in 2019-21; however, the contact index (number of partner contacts named per index client) was only 1.14 for sexual and needle-sharing partners, and 23.3% of partners with unknown status did not complete testing.

The CASI-PLUS mHealth tool leverages computer-assisted self-interviews (CASI) in 2 steps: 1) an initial contact elicitation interview designed to reduce social desirability bias associated with reporting multiple sexual partners, same-sex sexual partners, or needle-sharing partners; and 2) repeated client follow-up surveys and health worker engagement prompts to facilitate communication and case management through the partner notification and testing process.

The research team aims to conduct formative research from health worker and client perspectives to design the CASI-PLUS mHealth intervention, assess adoption of CASI-PLUS and its impact on contact elicitation, assess appropriateness and feasibility of the CASI-PLUS intervention and its impact on overall acceptability of APS services, test the HIV testing index in an expanded RCT, and translate research findings into policy and practice.

The research team includes experts in APS programs, digital health development, usability assessment, and mixed methods health services research from the University of Washington and the Ukraine Ministry of Health's Public Health Center. This partnership offers great potential to integrate the mHealth solution into the national health information system and translate research findings into policy and practice, should acceptability, appropriateness, feasibility, and effectiveness be strong.

University Of Washington

TO SUPPORT HYPOTHESIS-, DESIGN-, TECHNOLOGY-, OR DEVICE-DRIVEN RESEARCH RELATED TO THE DISCOVERY, DESIGN, DEVELOPMENT, VALIDATION, AND APPLICATION OF TECHNOLOGIES FOR BIOMEDICAL IMAGING AND BIOENGINEERING. THE PROGRAM INCLUDES BIOMATERIALS (BIOMIMETICS, BIOPROCESSING, ORGANOGENESIS, REHABILITATION, TISSUE ENGINEERING, IMPLANT SCIENCE, MATERIAL SCIENCE, INTERFACE SCIENCE, PHYSICS AND STRESS ENGINEERING, TECHNOLOGY ASSESSMENT OF MATERIALS/DEVICES), BIOSENSORS/BIOTRANSDUCERS (TECHNOLOGY DEVELOPMENT, TECHNOLOGY ASSESSMENT, DEVELOPMENT OF ALGORITHMS, TELEMETRY), NANOTECHNOLOGY (NANOSCIENCE, BIOMIMETICS, DRUG DELIVERY SYSTEMS, DRUG BIOAVAILABILITY, MICROARRAY/COMBINATORIAL TECHNOLOGY, GENETIC ENGINEERING, COMPUTER SCIENCE, TECHNOLOGY ASSESSMENT), BIOINFORMATICS (COMPUTER SCIENCE, INFORMATION SCIENCE, MATHEMATICS, BIOMECHANICS, COMPUTATIONAL MODELING AND SIMULATION, REMOTE DIAGNOSIS AND THERAPY), IMAGING DEVICE DEVELOPMENT, BIOMEDICAL IMAGING TECHNOLOGY DEVELOPMENT, IMAGE EXPLOITATION, CONTRAST AGENTS, INFORMATICS AND COMPUTER SCIENCES RELATED TO IMAGING, MOLECULAR AND CELLULAR IMAGING, BIOELECTRICS/BIOMAGNETICS, ORGAN AND WHOLE BODY IMAGING, SCREENING FOR DISEASES AND DISORDERS, AND IMAGING TECHNOLOGY ASSESSMENT AND SURGERY (TECHNIQUE DEVELOPMENT AND TECHNOLOGY DEVELOPMENT).

93.286 - Discovery and Applied Research for Technological Innovations to Improve Human Health

National Institute of Biomedical Imaging and Bioengineering (NIBIB) [HHS - NIH]

Seattle, Washington 98195 United States

Single Zip Code

Mobile Health: Technology and Outcomes in Low and Middle Income Countries (R21/R33 - Clinical Trial Optional) (PAR-21-303)

Amendment Since initial award the End Date has been extended from 07/31/24 to 10/31/25 and the total obligations have increased 33211% from $1,000 to $333,107.