The Effects of HIV/AIDS Stigma on Use of Services by Pregnant Women in Kenya

艾滋病毒/艾滋病耻辱对肯尼亚孕妇使用服务的影响

• 批准号: 7483572
• 负责人: Janet M Turan
• 金额: $ 16.85万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-08-11 至 2012-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7483572
• 关键词: AIDS prevention; AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; Adult; Adverse effects; Affect; Africa; Africa South of the Sahara; African; Award; Caring; Centers for Disease Control and Prevention (U.S.); Childbirth; Collaborations; Communities; Country; Data; Depreciation; Depth; Discrimination; Education; Family; Fright; Funding; Goals; HIV; HIV Infections; HIV Seropositivity; Health; Health Services; Health care facility; Human immunodeficiency virus test; Individual; Infant; Intervention; Interview; Kenya; Life; Light; Literature; Maternal Health; Measures; Medical Records; Medical Research; Mental Health; Mentored Research Scientist Development Award; Mentorship; Patient currently pregnant; Perception; Persons; Pilot Projects; Postpartum Period; Pregnancy; Pregnant Women; Prevention; Prospective Studies; Province; Public Health; Qualitative Research; Randomized; Reproductive Health; Research; Research Methodology; Research Personnel; Research Training; Resources; Risk; Role; Services; Social Sciences; Standards of Weights and Measures; Statistical Methods; Stigmata; Structure; Testing; Training Programs; Upper arm; Vertical Disease Transmission; Woman; Work; base; care delivery; career; child bearing; design; experience; improved; mortality; response; social stigma; therapy development; uptake

DESCRIPTION (provided by applicant): My career goal is to conduct research that contributes to improvements in maternal health in low-resource settings through reduction of the adverse effects of HIV/AIDS on the physical and mental health of pregnant and childbearing women. For this K01 Award, I am proposing research and training on the role of HIV/AIDS stigma as a barrier to utilization of essential maternity and HIV services by pregnant women in Africa. This award will facilitate my transition from a background in maternal and reproductive health, to an independent investigator focusing on HIV/AIDS stigma and its effects on maternal health in Africa. My goals are to gain expertise in social science approaches to the study of stigma, advanced statistical methods for analyzing longitudinal and clustered data, the cultural context of HIV/AIDS in Africa, and intervention development. I propose to conduct a prospective study in Kenya using structured interviews and data from medical records, as well as a qualitative study using in-depth interviews. The aims are: 1) to identify the effects of anticipated stigma and perceived community stigma on acceptance of HIV testing among pregnant women who use ANC services, 2) to prospectively investigate the effects of anticipated stigma and perceived community stigma on pregnant women's subsequent use of ANC, delivery, and postpartum services, 3) to investigate whether stigma can shed light on the mechanisms through which ANC and HIV service integration may affect HIV-positive pregnant women's use of maternity and HIV services, and 4) to use qualitative research methods to elucidate the role of HIV/AIDS stigma as a barrier to health service use among women in the community who do not use facility-based maternity services. My research will be conducted in conjunction with a CDC-funded study to be carried out by the Kenya Medical Research Insititute-UCSF Collaborative Group and will take advantage of the resources of that larger study. The proposed program of training and research will prepare me to design and test an intervention for reducing HIV/AIDS stigma and discrimination experienced by pregnant women in Kenya. This research will contribute to public health efforts to improve the health of pregnant women in low-resource settings. HIV/AIDS stigma may constitute an important barrier to pregnant women's use of health services and efforts to understand and reduce HIV/AIDS stigma will have important implications for HIV prevention and treatment, as well as for maternal health and mortality.

描述(申请人提供)：我的职业目标是进行研究，通过减少艾滋病毒/艾滋病对孕妇和生育妇女身心健康的不利影响，在低资源环境下改善产妇健康。为了这个K01奖，我提议研究和培训艾滋病毒/艾滋病污名作为非洲孕妇利用基本的产妇和艾滋病毒服务的障碍所起的作用。这一奖项将有助于我从产妇和生殖健康背景过渡到一名专注于艾滋病毒/艾滋病污名及其对非洲产妇健康影响的独立调查员。我的目标是获得以下方面的专业知识：研究污名的社会科学方法、分析纵向和聚集数据的高级统计方法、非洲艾滋病毒/艾滋病的文化背景以及干预发展。我建议在肯尼亚进行一项前瞻性研究，使用结构化访谈和来自医疗记录的数据，以及使用深度访谈进行定性研究。其目的是：1)确定预期的耻辱和感知的社区耻辱对使用ANC服务的孕妇接受艾滋病毒检测的影响；2)前瞻性地调查预期的耻辱和感知的社区耻辱对孕妇随后使用ANC、分娩和产后服务的影响；3)调查耻辱是否可以揭示ANC和HIV服务整合可能影响艾滋病毒阳性孕妇对产妇和艾滋病毒服务的使用的机制。以及4)使用定性研究方法，阐明艾滋病毒/艾滋病污名在社区中不使用以设施为基础的产科服务的妇女中作为使用卫生服务的障碍的作用。我的研究将与疾病控制与预防中心资助的一项由肯尼亚医学研究所-加州大学旧金山分校合作小组进行的研究一起进行，并将利用这项更大研究的资源。拟议的培训和研究计划将为我设计和测试一项干预措施做好准备，以减少肯尼亚孕妇遭受的艾滋病毒/艾滋病污名和歧视。这项研究将有助于公共卫生努力，以改善低资源环境中孕妇的健康。艾滋病毒/艾滋病污名可能构成孕妇使用保健服务的一个重要障碍，了解和减少艾滋病毒/艾滋病污名的努力将对艾滋病毒预防和治疗以及产妇健康和死亡率产生重要影响。