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: 6650099
• 负责人: Danuta Kasprzyk
• 金额: $ 61.31万
• 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/6650099
• 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.

艾滋病大流行继续以惊人的速度蔓延，特别是在南部非洲。预计不会有疫苗可用，而且有效治疗的费用对于支持大多数艾滋病病例的大多数发展中国家来说是令人望而却步的。在发展中国家，艾滋病毒正在造成毁灭性的文化和经济影响，因此显然需要通过改变行为来预防艾滋病毒。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、自我延续的干预措施，如果适当调整，可以在艾滋病毒流行的资源匮乏地区发挥作用。津巴布韦就是南部非洲的这样一个国家，需要立即采取创新干预措施来阻止病毒的快速传播。虽然津巴布韦 20A9 岁成年人的艾滋病毒总体感染率高达 30%，但 20 岁以下青少年的感染率较低（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。我们打算与 NIMH 资助的另外三个艾滋病合作小组 (ACT) 和一个数据协调中心 (DCC) 合作，在津巴布韦农村地区 16-20 岁的青少年中调整、实施和评估舆论领袖社区层面的干预模式。将进行一项人种学研究，对 24 个社区进行社区评估，并在 8 个社区进行人种学访谈，以设计干预方案。干预和调查将在一个试点社区进行实地测试，并在必要时修改协议和工具。然后，干预措施将在 16 个社区中实施，随机分配干预条件或控制条件。将通过对 16 个地点各 240 名青少年的访谈和生物样本收集评估暴露、中间、行为和生物学结果变化的措施。将在干预前和干预后 12 个月和 24 个月时获得测量结果。出于伦理原因，干预措施也将在干预地点一年后在对照地点实施。社区舆论领袖模型的调整和实施过程将在所有四个 NIMH ACT 研究中心进行记录，从而提高结果的普遍性。总体而言，预防试验将提供有关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程序的基本信息。