HIV status and achieving fertility desires: Implications for HIV prevention and t

艾滋病毒状况和实现生育愿望：对艾滋病毒预防和治疗的影响

• 批准号: 7477616
• 负责人: Akinrinola Bankole
• 金额: $ 31万
• 依托单位: GUTTMACHER INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-05-01 至 2013-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7477616
• 关键词: AIDS prevention; Accounting; Address; Affect; Africa South of the Sahara; African; Age; Age-Years; Anti-Retroviral Agents; Attention; Attitude; Behavior; Biological Markers; Caring; Client; Communities; Contraceptive Agents; Contraceptive Usage; Contraceptive methods; Counseling; Country; Couples; Data; Data Collection; Data Set; Demographic and Health Surveys; Depth; Effectiveness; Epidemic; Face; Family Sizes; Federal Government; Fertility; Fertility Preferences; Fertility Rates; Future; Goals; Government; Government Agencies; HIV; HIV Infections; HIV Seropositivity; HIV diagnosis; Hand; Health Personnel; Health Services; Health Services Accessibility; Health care facility; Healthcare; High Prevalence; Human immunodeficiency virus test; Individual; Infection; Intention; International Agencies; Intervention; Interview; Joints; Laws; Measures; Multivariate Analysis; Nigeria; Patients; Perception; Pharmaceutical Preparations; Policies; Population; Pregnancy; Pregnant Women; Prevalence; Prevention; Protocols documentation; Provider; Public Health; Range; Reproductive Behavior; Reproductive Health; Reproductive Health Services; Research; Resolution; Respondent; Risk; Role; Sampling; Services; Sex Behavior; Social support; Stigmata; Structure; Surveys; Technology; Termination of pregnancy; Test Result; Testing; Thinking; Time; Vertical Disease Transmission; Visit; Woman; Zambia; abortion; base; behavioral/social science; child bearing; condoms; coping; design; desire; experience; improved; men; preference; prevent; prevention service; programs; reproductive; social stigma; transmission process; trend; unintended pregnancy; willingness

DESCRIPTION (provided by applicant): The objective of this study is to help individuals and couples in African countries facing generalized HIV epidemics to achieve their family size goals and prevent unintended pregnancies while avoiding or coping with HIV infection. To do so, we propose to undertake new research that will improve provision of sexual and reproductive health services, including HIV- related care. Research on the influence of HIV status on childbearing intentions and contraceptive use in sub-Saharan Africa is very scarce. Existing studies have important limitations: most are small-scale and designed to assess the impact of interventions; most study HIV-positive people, sampled at health facilities, and most include women only, and lack the perspective of men, especially important in sub-Saharan Africa. To meet the study's objective, we propose three research efforts: (a) We will undertake new analyses of existing nationally representative survey data on men and women of reproductive age in 14 countries of sub-Saharan Africa, to provide a regional overview of the interrelationships between HIV status (based on biomarker testing, done in the surveys) and fertility desires and sexual and reproductive behaviors; bivariate and multivariate analyses will be done, as well as multilevel analyses for the 5 countries that also have information on availability of HIV-related services. (b) To provide deeper understanding of relationships between HIV status and attitudes regarding HIV-testing and services and the actions women and men are taking to achieve their fertility aspirations and prevent or cope with HIV infection, we will conduct a two-part study in one moderate-HIV-prevalence country (Nigeria) and one high prevalence country (Zambia): a quantitative survey of a community-based sample of 1300 men and women and a facility-based sample of 200 HIV positive people in each country; and in-depth interviews with 48 respondents systematically selected from the quantitative survey in each country. (c) We will conduct semi-structured interviews with about 80 health care providers in each country (Nigeria and Zambia) that provide sexual and reproductive health care, to improve understanding of the roles of providers in helping men and women meet their fertility aspirations and avoid or cope with HIV infection, with special attention to recent efforts to routinize and expand HIV testing. Project Narrative From the public health perspective, preventing the transmission of HIV and unintended pregnancy are very high priorities in sub-Saharan Africa, a region where HIV prevalence and unmet need for contraception are the highest in the world. Two recent trends} increased availability of HIV testing and of drug treatments for the HIV-positive} add to the urgency of the need for new research on the relationships between HIV prevention, HIV-related care, and prevention of unintended pregnancy. The proposed research will guide providers who face difficult choices and decisions in meeting these dual needs.

描述(申请人提供)：这项研究的目的是帮助面临普遍艾滋病毒流行的非洲国家的个人和夫妇实现他们的家庭规模目标，防止意外怀孕，同时避免或应对艾滋病毒感染。为此，我们建议进行新的研究，以改善性健康和生殖健康服务的提供，包括与艾滋病毒有关的护理。在撒哈拉以南非洲，关于艾滋病毒状况对生育意愿和避孕用具使用的影响的研究非常缺乏。现有的研究有重要的局限性：大多数是小规模的，旨在评估干预措施的影响；大多数研究在卫生机构抽样的艾滋病毒阳性者，大多数只包括妇女，缺乏男性的观点，这在撒哈拉以南非洲尤为重要。为了实现这项研究的目标，我们建议开展三项研究工作：(A)我们将对撒哈拉以南非洲14个国家具有国家代表性的育龄男子和妇女的现有调查数据进行新的分析，以提供区域概览，说明艾滋病毒状况(基于调查中进行的生物标志物测试)与生育意愿、性行为和生殖行为之间的相互关系；(A)将对5个也有艾滋病毒相关服务提供信息的国家进行双变量和多变量分析，并进行多水平分析。(B)为了更深入地了解艾滋病毒状况与对艾滋病毒检测和服务的态度以及妇女和男子为实现生育愿望和预防或应对艾滋病毒感染正在采取的行动之间的关系，我们将在一个艾滋病毒中度流行国家(尼日利亚)和一个艾滋病毒高流行国家(赞比亚)进行一项由两部分组成的研究：在每个国家对1300名男女进行基于社区的定量调查，对200名艾滋病毒呈阳性的人进行基于设施的抽样；对从每个国家系统地进行定量调查的48名受访者进行深入访谈。(C)我们将在每个国家(尼日利亚和赞比亚)对大约80名提供性保健和生殖保健的保健提供者进行半结构化访谈，以增进对提供者在帮助男子和妇女满足生育愿望和避免或应对艾滋病毒感染方面的作用的了解，并特别注意最近将艾滋病毒检测常规化和扩大的努力。从公共卫生的角度来看，预防艾滋病毒传播和意外怀孕是撒哈拉以南非洲非常高的优先事项，该地区的艾滋病毒流行率和未得到满足的避孕需求是世界上最高的。最近的两个趋势：艾滋病毒检测和艾滋病毒阳性者药物治疗的可获得性增加}增加了对艾滋病毒预防、艾滋病毒相关护理和预防意外怀孕之间关系的新研究的紧迫性。拟议的研究将指导那些在满足这些双重需求方面面临困难选择和决定的提供商。