Peer Intervention as Pedagogic Paradigm in Kinshasa SPH

描述(由申请人提供)：非洲对艾滋病毒预防/控制的有限支持将不会使发达国家目前存在的那种昂贵的计划成为可能。以个人为导向的方法可能是不够的。有效的战略必须以对非洲的背景有清楚的了解为依据。基于同伴接触作为一种干预策略在美国的明显效果，最近在非洲涌现了几个“示范”项目，包括在刚果民主共和国的金沙萨。然而，在非洲，这种有吸引力的/廉价的方法的效果仍然没有得到很好的评估。 为了促进行为科学、流行病学和研究方法的研究基础设施，金沙萨公共卫生学院(KSPH)建议与北卡罗来纳大学(UNC)和约翰霍普金斯大学(JHU)的公共卫生学院合作，以提高其行为/环境/研究能力。调查人员将首先建立一个KSPH研究单位，作为KSPH公共卫生公共卫生硕士课程中的研究和研究培训的重点。目前的北卡罗来纳大学/JHU共享的Fogarty AITRP资金将使北卡罗来纳大学和JHU在行为/环境影响/研究方面进行中长期培训。作为一种教学范式2，将进行随机对照干预研究，以评估同伴教育对降低包括艾滋病毒在内的性传播感染(STI)风险的有效性。KSPH/UNC/JHU将与金沙萨两个有效的一线非政府社区非政府组织--青年家乐福(青年十字路口)和性病马通日中心合作，对最近感染艾滋病毒以外的性传播疾病的青少年(TA)和年轻女性性工作者(CSWS)进行同伴领袖/网络研究。 实验情境为同伴外展教育情境，平等注意控制情境为个体聚焦的社会认知情境。这两项研究将包括400名指数参与者(具有艾滋病毒以外的近期性传播感染的TA或CSW)，随机分配到两种情况(200种/条件)之一，以及随机选择每个指数的2名同行网络成员，总计1200名TA和1200名CSW。每项试验的结果评估将包括在干预后3、6、12和18个月对400名指数参与者及其800名同行网络成员进行的测试前/测试后评估。主要观察指标将是自我报告的性行为危险行为和性传播感染/艾滋病毒发病率。这项工作将为艾滋病毒预防政策提供信息，并加强KSPH的研究和培训

DESCRIPTION (provided by applicant): The limited support for HIV prevention/control in Africa will not enable expensive programs of the type now present in developed countries. Individual-orientated approaches may not be sufficient. Effective strategies must be informed by a clear understanding of the African context. Based on the apparent efficacy of peer outreach as an intervention strategy in the USA, several "demonstration" projects have recently sprung up in Africa, including in Kinshasa, Democratic Republic of Congo. Yet the efficacy of this attractive/inexpensive approach remains poorly evaluated in Africa. To promote research infrastructure in behavioral science, epidemiology and research methodology (behav/epi/research), Kinshasa School of Public Health (KSPH) proposes to partner with the Schools of Public Health at the University of North Carolina (UNC) and Johns Hopkins University (JHU) to improve its behav/epi/research capacity. The investigators will first establish a KSPH Research Unit as a focus for research and research training in the KSPH MPH curriculum. Current UNC/JHU shared Fogarty AITRP funds will then enable medium and long term training in behav/epi/research at UNC and JHU. As a pedagogic paradigm 2 randomized, controlled intervention studies to assess efficacy of peer education to decrease risk of sexually transmitted infections (STIs) including HIV will be performed. KSPH/UNC/JHU will partner with two effective front-line Kinshasa non-governmental community-based organizations, Carrefour des Jeunes (Crossroads for Youth) and Centre STD Matonge to conduct peer leader/network studies in teenagers (TAs) and young female sex workers (CSWs) with a recent STI other than HIV. The experimental condition is a peer outreach education condition and the equal attention control condition is an individually-focused social cognitive condition. Both studies will include 400 index participants (TAs or CSWs with a recent STI other than HIV) randomly assigned to one of the two conditions (200/condition) and 2 randomly chosen peer network members of each index, for a total of 1200 TAs and 1200 CSWs. Outcome evaluation in each trial will include pre-test/post-test assessments of 400 index participants and 800 of their peer network members at 3, 6, 12 and 18 months post intervention. Main outcome measures will be self reported sexual risk behaviors and STI/HIV incidence. The work will inform HIV prevention policy and strengthen research and training at KSPH