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这一目标 联合国艾滋病规划署 90 90 90 目标。这些目标尤其具有挑战性 据报道，青春期女孩的吸收、保留和病毒抑制能力较差3-6 草根足球 (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一揽子计划， 提供性健康和生殖健康服务（SRH），包括艾滋病毒检测和 在青少年友好的空间进行治疗。该计划建立了强大的社会支持 通过同伴指导、社交网络和青少年友好型临床的使用 将艾滋病毒与性健康和生殖健康服务 (SRH) 相结合的服务。的 GRS 为少女制定的“SKILLZ 计划”为所有人带来了需求 年轻女性中艾滋病毒连锁反应的步骤。这是一种以体育为基础的学校干预措施， 增加艾滋病毒和性健康和生殖健康服务的使用并改善心理社会福祉， 包括自尊、赋权和自给自足。为了保证不间断 为了持续提供护理，我们将 SKILLZ 与 CIDRZ 青少年服务相结合，以创建 “SKILLZ Plus”是为赞比亚青少年提供的 90-90-90 无缝衔接途径。而不是 专注于利用医疗手段改变年轻女性对自身风险的态度 模型中，我们利用足球、当地同伴导师和女性生活教练的力量 在年轻女性和通常被视为遥不可及、遥远的服务之间架起桥梁 或无关紧要。 我们的具体目标是 1. 检查 SKILLZ 的增量成本效益 卢萨卡中学少女使用艾滋病毒检测仪进行艾滋病毒检测 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（目标 2a）两年，6 个月时保留，12 个月和 24 个月（目标 2b），通过个体水平随机对照 3. 确定测试结果呈阳性的调节因素、预测因素和障碍 SKILLZ Plus 的摄取（测试、保留和病毒载量抑制）均定量 通过调解和调节分析以及通过焦点小组进行定性分析 与教练和女孩进行讨论（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.