Reaching 90 90 90 in Adolescents in Zambia: Using all our SKILLZ

项目概要/摘要 尽管取得了相当大的进展，但许多国家仍在努力实现 艾滋病规划署90 90这些目标在以下方面特别具有挑战性： 青春期女孩，吸收、保持和病毒抑制能力较差3 -6 基层足球（GRS）和赞比亚传染病研究中心 （CIDRZ）合作开发了一套全面的青少年综合教材， 提供性健康和生殖健康服务，包括艾滋病毒检测， 治疗，在青少年友好的空间。该计划建立了强大的社会支持 通过同伴指导和使用社交网络以及对患者友好的临床 将艾滋病毒与性健康和生殖健康服务相结合的服务。的 塞族共和国政府为少女制定的“SKILLZ方案”产生了对所有人的需求 艾滋病毒在年轻妇女中蔓延的步骤。这是一个以体育为基础的学校干预， 增加对艾滋病毒和性健康和生殖健康服务的利用，并改善心理社会福祉， 包括自尊、赋权和自给自足。为了确保不间断的 我们将SKILLZ与CIDRZ青少年服务相结合， “SKILLZ Plus”，为赞比亚青少年提供的90-90-90无缝途径。而不是 重点是改变年轻妇女对自身风险的态度， 我们利用足球、当地同伴导师和女性生活教练的力量， 在年轻妇女和通常被视为无法获得、遥远的服务之间建立桥梁 或者无关紧要 我们的具体目标是：1.检查SKILLZ的增量成本效益 在卢萨卡中学青春期女孩中进行艾滋病毒检测的女孩， 准实验影响评估。2.评估SKILLZ Plus的影响， 6个月时病毒载量抑制（Aim 2a）2年，6个月时保持，12 个月和24个月（目标2b），通过个体水平随机对照 试验为那些谁测试阳性和3.确定中介因素、预测因素和障碍， SKILLZ Plus的摄取（检测、保留和病毒载量抑制）， 通过调解和适度分析，并通过焦点小组进行定性分析 与教练和女孩讨论（FGD）。

Project Summary/ Abstract Despite considerable progress, many countries are still struggling to achieve the UNAIDS 90 90 90 targets. These targets have been particularly challenging amongst adolescent girls, with poorer uptake, retention and viral suppression being reported3-6 Grassroot Soccer (GRS) and the Centre for Infectious Disease Research in Zambia (CIDRZ) have collaborated to develop a comprehensive adolescent package that providse sexual and reproductive health services (SRH), including HIV testing and treatment, in adolescent friendly spaces. This program builds off a strong social support with peer mentoring and the use of social networking and adolescent-friendly clinical services that integrate HIV with sexual and reproductive health services (SRH). The `SKILLZ programme' developed for adolescent girls by GRS generates demand for all steps in the HIV cascade among young women. It is a sport-based school intervention, to increase the use of HIV and SRH services and to improve psychosocial well-being, including self-esteem, empowerment, and self-sufficiency. To ensure an uninterrupted continuum of care, we have integrated SKILLZ with CIDRZ teen services to create `SKILLZ Plus', a seamless 90-90-90 pathway for adolescents in Zambia. Instead of focusing on changing young women's attitudes towards their own risk using a medical model, we leverage the power of soccer, local peer mentors and female life coaches to build bridges between young women and services often viewed as inaccessible, distant or irrelevant. Our Specific Aims are to 1.Examine the incremental cost effectiveness of SKILLZ Girl on HIV testing among adolescent girls in secondary schools in Lusaka using a quasi-experimental impact evaluation. 2. Assess the impact of SKILLZ Plus over two years on viral load suppression (Aim 2a) at 6 months and retention at 6 months, 12 months and 24 months (Aim 2b) through an individual-level randomized controlled trial for those who test positive and 3. Identify mediators, predictors and barriers to uptake of SKILLZ Plus (testing, retention and viral load suppression) both quantitatively through mediation and moderation analyses and qualitatively through focus groups discussions (FGD) with coaches and girls.