STDS, FERTILITY, MARRIAGE AND DEMOGRAPHIC PROJECTION

性传播疾病、生育力、婚姻和人口预测

• 批准号: 6657959
• 负责人: RONALD H GRAY
• 金额: $ 8.76万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-03-19 至 2003-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6657959
• 关键词: AIDS /HIV test; Africa; HIV infections; age difference; bias; clinical research; counseling; disease /disorder onset; family planning; female; fertility; high risk behavior /lifestyle; human data; human population study; human subject; interview; longitudinal human study; male; marriage /marital status; pregnancy; sex behavior; sexually transmitted diseases; spontaneous abortion; syphilis; women's health

DESCRIPTION: STDs and HIV reduce fertility and increase pregnancy loss. Sub-fertility may lead to marital instability and dissolution, resulting in increased high risk sexual behaviors and thus enhanced M/MV risk. HIV testing also places stress on marriages. We propose to use a unique data set from a community-based study in rural Rakai District, Uganda. Data are available for 11,315 women and 10,698 men who provided detailed socio-demographic, health and behavioral information, and samples for STD diagnosis, at 5 home visits conducted at 10-month intervals (40 months follow up). These panel data will be used to address the following specific aims using an instrumental variable approach and fixed-effects models to control for endogeneity and unobserved heterogeneity. 1) Among women at risk of conception, we will estimate the effects of HIV and other STDs on pregnancy and pregnancy loss rates in HIV+ and HIV- women, with or without other STDS, after adjustment for covariates such as age, marital status, sub-fertility, frequency of intercourse, contraception and knowledge of HIV status. 2) Longitudinal analyses will be used to assess the effects of prevalent HIV/STD infections, reduced fertility and HIV testing/counseling on family planning use (condom /other modem methods) and rates of marital dissolution, subsequent sexual behaviors and STD/HIV acquisition. Data on couples and sexual networks will also be considered. 3) Reduced fertility of HIV+ women causes bias in antenatal surveillance of HIV, leading to underestimation of population HIV prevalence and artifacts in HIV trends. We will estimate the magnitude of this bias in HIV prevalence estimates among pregnant women relative to the population of reproductive age, and assess how such bias varies by age, parity, duration of marriage, and over time. Demographic projections of the impact of the HIV epidemic are largely based on antenatal HIV seroprevalence estimates and fail to account for the fertility inhibiting effects of HIV. In collaboration with the U.S. Bureau of Census, data from the proposed study will be used to revise demographic projections of the effects of HIV on population growth, composition and AIDS orphanhood.

描述：性病和艾滋病毒降低生育能力，增加妊娠损失。 低生育率可能导致婚姻不稳定和解体， 增加高风险性行为，从而增加M/MV风险。艾滋病毒检测 也会给婚姻带来压力。我们建议使用一个独特的数据集， 在乌干达Rakai区农村进行的一项社区研究。数据可用 11 315名妇女和10 698名男子提供了详细的社会人口、健康和 行为信息和STD诊断样本，5次家访 每隔10个月进行一次（随访40个月）。这些面板数据将 用于使用工具变量解决以下具体目标 方法和固定效应模型，以控制内分泌和未观察 异质性1)在有受孕风险的女性中，我们将估计 艾滋病毒和其他性传播疾病对艾滋病毒+和 艾滋病毒-妇女，有或没有其他性病，调整后的协变量，如 年龄、婚姻状况、生育力低下、性交频率、避孕和 了解艾滋病毒状况。2)纵向分析将用于评估 艾滋病毒/性传播疾病流行、生育率下降和艾滋病毒/艾滋病的影响 关于计划生育使用的测试/咨询（避孕套/其他现代方法）， 婚姻解体率、随后的性行为和性病/艾滋病毒 采集还将考虑关于夫妇和性网络的数据。第三章 艾滋病毒阳性妇女生育率的降低导致产前艾滋病毒监测的偏差， 导致低估了人口艾滋病毒感染率和艾滋病毒中的人为因素 趋势我们将估计艾滋病毒流行率估计中这种偏差的程度 孕妇与育龄人口的比例，并评估 这种偏见是如何随着年龄、产次、婚姻持续时间和时间而变化的。 对艾滋病毒流行病影响的人口预测主要是基于 产前艾滋病毒血清阳性率估计数， 抑制HIV的作用。与美国人口普查局合作， 拟议研究的数据将用于修订人口预测， 艾滋病毒对人口增长、构成和艾滋病感染率的影响。

项目成果

Marriage and the risk of incident HIV infection in Rakai, Uganda.

乌干达拉凯的婚姻和艾滋病毒感染事件的风险。

• DOI: 10.1097/qai.0b013e3182a7f08a
• 发表时间: 2014
• 期刊: Journal of acquired immune deficiency syndromes (1999)
• 作者: Nalugoda,Fred;Guwatudde,David;Bwaninka,JohnB;Makumbi,FredrickE;Lutalo,Tom;Kagaayi,Joseph;Sewankambo,NelsonK;Kigozi,Godfrey;Serwadda,DavidM;Kong,Xiangrong;Wawer,MariaJ;Wabwire-Mangen,Fred;Gray,RonaldH
• 通讯作者: Gray,RonaldH