ZIMBABWE--COMMUNITY INTERVENTION TO REDUCE HIV/STD RISK

津巴布韦——降低艾滋病毒/性病风险的社区干预

• 批准号: 6666786
• 负责人: Danuta Kasprzyk
• 金额: $ 136.68万
• 依托单位: BATTELLE CENTERS/PUB HLTH RES & EVALUATN
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-09-30 至 2004-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6666786
• 关键词: AIDS education /prevention; Africa; African; adolescence (12-20); behavioral /social science research tag; clinical research; community health services; cooperative study; health services research tag; human subject; longitudinal human study; public opinion; rural area; safe sex /sex abstinence; young adult human (21-34)

The AIDS pandemic continues to spread at an alarming rate, particularly in Southern Africa. No vaccine is expected to become available and the cost for effective treatment is prohibitive to most developing counties which support the majority of AIDS cases. There is a clear need to prevent HIV through behavior change in developing countries where the epidemic is having devastating cultural and economic impacts. The public opinion leader community-level intervention, based on the theory of diffusion of innovation, has been shown to be effective in the US. This is an effective, self-perpetuating intervention which, if appropriately adapted, could be effective in resource poor settings with emerging HIV epidemics. Zimbabwe is one such country in southern Africa which requires immediate, innovative interventions to stem rapid spread of the virus. while overall HIV prevalence in Zimbabwe is as high as 30% among adults aged 20A9, rates among youth less than 20 years old are low (.66% nationally), creating the unique opportunity to intervene before this generation becomes infected. In collaboration with three other NIMH funded AIDS Collaborative Teams (ACTs) and a Data Coordinating Center (DCC), we intend to adapt, implement and evaluate the public opinion leader community level intervention model among youth aged 16-20 in rural areas of Zimbabwe. An ethnographic study with community assessment in 24 communities and ethnographic interviews in 8 communities will be conducted to design the intervention protocol. The intervention and surveys will be field tested in one pilot community and the protocol and instruments modified if necessary. The intervention will then be implemented in 16 communities randomized to either intervention or control conditions. Measures to assess changes in Exposure, Intermediate, Behavioral and Biologic outcomes will be collected through interviews and biologic samples from 240 youth in each of the 16 sites. Measures will be obtained pre-intervention and post-intervention at 12 and 24 months. For ethical reasons, the intervention will also be implemented in the control sites one year after the intervention sites. The process of adapting and implementing the community public opinion leader model will be documented in all four NIMH ACT study sites, increasing the generalizeability of the results. Overall, the prevention trial will provide essential information about the procedures required to successfully apply the community-based public opinion leader intervention model in a broad range of settings and cultures.

艾滋病继续以惊人的速度蔓延，特别是在南部非洲。预计不会有疫苗，有效治疗的费用对大多数支持大多数艾滋病病例的发展中国家来说是令人望而却步的。发展中国家显然需要通过改变行为来预防艾滋病毒，因为这一流行病正在对这些国家的文化和经济造成破坏性影响。基于创新扩散理论的舆论领袖社区干预在美国已被证明是有效的。这是一种有效的、自我维持的干预措施，如果加以适当调整，可以在资源匮乏、艾滋病毒流行病正在出现的环境中发挥有效作用。津巴布韦就是这样一个南部非洲国家，它需要立即采取创新的干预措施，以阻止病毒的迅速传播。虽然津巴布韦20岁至9岁成年人的总体艾滋病毒感染率高达30%，但20岁以下青年的感染率较低（全国为0.66%），这为在这一代人感染之前进行干预创造了独特的机会。在与其他三个NIMH资助的艾滋病合作小组（ACTs）和数据协调中心（DCC）合作，我们打算适应，实施和评估津巴布韦农村地区16-20岁青年中的民意领袖社区一级干预模式。将进行一项民族志研究，在24个社区进行社区评估，在8个社区进行民族志访谈，以设计干预方案。将在一个试点社区对干预措施和调查进行实地测试，并在必要时修改方案和工具。然后，将在16个社区实施干预措施，随机分为干预组和对照组。将通过16个地点中每个地点的240名青年的访谈和生物样本收集评估暴露、中间、行为和生物结果变化的措施。将在干预前和干预后12个月和24个月获得测量结果。出于伦理原因，干预措施也将在干预措施实施一年后在对照地点实施。适应和实施社区舆论领袖模式的过程将记录在所有四个NIMH ACT研究地点，增加结果的普遍性。总的来说，预防试验将提供必要的信息，说明在广泛的环境和文化中成功应用基于社区的舆论领袖干预模式所需的程序。