Alcohol, Risky Behavior, and HIV/AIDS in Zimbabwe

描述(摘自申请者的摘要)：艾滋病毒在整个撒哈拉以南非洲正以高速度增长(艾滋病规划署/世卫组织，2001年)。目前估计，撒哈拉以南非洲有2850万成人和儿童感染艾滋病毒/艾滋病(艾滋病规划署，2002a)。津巴布韦是艾滋病毒感染率最高的国家之一，估计有33.7%的15至49岁成年人艾滋病毒呈阳性(艾滋病规划署，2002年)。在津巴布韦和撒哈拉以南非洲的其他地区，艾滋病毒的主要传播方式已经有了很好的记录。虽然饮酒似乎会影响艾滋病毒的危险行为，但在撒哈拉以南非洲，人们对同时饮酒和危险行为导致艾滋病毒/艾滋病的原因和后果知之甚少。关于酒精对撒哈拉以南非洲地区艾滋病毒/艾滋病进展的影响，人们知之甚少。这项拟议的研究将通过调查个人和环境因素如何影响津巴布韦农村地区同时饮酒和危险行为，以及艾滋病毒感染和疾病进展来弥补这些研究空白。这项研究将审查艾滋病毒感染风险在两年内受到以下因素影响的过程：典型的酒精使用；行为信仰、态度、社会规范、保护因素和障碍，以及在危险行为之前使用酒精的意图；酒精使用和危险行为的同时发生；其他个人因素；关系特征；以及津巴布韦农村的社区条件。这项研究还将评估舆论领袖社区层面干预模式对典型饮酒、行为信念、社会规范、酒精和危险行为共存的保护因素和障碍以及两年内艾滋病毒感染风险的影响。最后，这项研究将调查在两年的时间里，典型的酒精使用、共病(乙肝、丙型肝炎)、其他个人因素、家庭支持、卫生保健使用和社区特征如何影响艾滋病毒/艾滋病疾病的进展。拟议的项目将利用正在进行的ZiCHIRe研究创造的机会，在两年期间的三个时间点从津巴布韦农村32个村庄的大约5440人(18至30岁)收集额外的调查和生物数据。拟议的研究将使人们更好地了解酒精使用如何影响资源贫乏国家的艾滋病毒感染风险和艾滋病毒/艾滋病的进展，从而可以用来制定更有效的政策，以减少艾滋病毒/艾滋病在撒哈拉以南非洲的传播和影响。

DESCRIPTION (adapted from the applicant's abstract): HIV is increasing at high rates across sub-Saharan Africa (UNAIDS/WHO 2001). Current estimates are that 28.5 million adults and children are living with HIV/AIDS in sub-Saharan Africa (UNAIDS 2002a). Zimbabwe has one of the highest levels of HIV infection with an estimated 33.7% of adults 15 to 49 years old being HIV positive (UNAIDS 2002). The predominant mode of HIV transmission has been well documented in Zimbabwe and other parts of sub-Saharan Africa. While alcohol use appears to influence HIV risk behaviors, little is known about the causes and consequences of concurrent alcohol use and risky behavior for HIV/AIDS in sub-Saharan Africa. Even less is known about alcohol effects on HIV/AIDS disease progression in sub-Saharan Africa. The proposed study will address these research gaps by investigating how individual and environmental factors influence the concurrence of alcohol use and risky behavior, as well as HIV infection and disease progression, in rural Zimbabwe. The study will examine the process through which the risk of HIV infection is influenced over a two-year period by: typical alcohol use; behavioral beliefs, attitudes, social norms, protective factors and barriers, and intentions regarding the use of alcohol before risky behavior; concurrence of alcohol use and risky behavior; other individual factors; relationship characteristics; and, community conditions in rural Zimbabwe. The study also will evaluate the impact of a public opinion leader community-level intervention model on typical alcohol use, behavioral beliefs, social norms, and protective factors and barriers to concurrence of alcohol and risky behavior, and the risk of HIV infection over a two-year period. Finally, the study will investigate how HIV/AIDS disease progression is affected by typical alcohol use, co-morbidities (HBV, HCV), other individual factors, family support, health care use, and community characteristics over a two-year period. The proposed project will capitalize on an opportunity created by the ongoing ZiCHIRe study to collect additional survey and biological data at three time points over a two-year period from approximately 5,440 individuals (18 to 30 years old) across 32 villages in rural Zimbabwe. The proposed study will provide a better understanding of how alcohol use influences the risk of HIV infection and HIV/AIDS disease progression in resource-poor countries that can be used to develop more effective policies to reduce the spread and impact of HIV/AIDS in sub-Saharan Africa.