Structural Pathways for South African Men to Reduce Substance Abuse & HIV

描述（由申请人提供）：南非18-25岁的年轻男子面临艾滋病毒、酒精和药物滥用以及失业等交叉流行病。R34旨在通过解决现有循证方案（EBP）的三个问题来降低年轻男性的风险：干预措施的设计没有考虑到男性的战斗-逃跑应对策略;捐助者不愿意投资于滥用药物的男性;现有的职业培训没有考虑年轻男性的不良习惯。我们的目标是将行为经济学家的策略应用于对年轻人极具吸引力的新的交付形式：足球和职业培训。社区一级的艾滋病毒预防战略将在有组织的足球联赛中塑造男子积极的日常生活：准时，完成训练，清醒和无毒品，表现出运动精神和非暴力。在两个月的时间里，将向80%的日子里表现出积极的日常生活习惯的年轻人提供工匠培训员/导师的就业培训。两个社区的年轻乡镇男子将被随机分配到接受干预，包括足球，工作培训和应急管理，以塑造行为（N=1个社区; n=60名男性）或接受足球和工作培训没有应急管理的控制条件（n=1个社区; 60名男性）。将在基线和6个月随访时进行评估。我们假设该计划将显着减少艾滋病毒相关的性风险行为和药物滥用，并维持更多的就业。我们将评估生活目标，日常生活的一致性亲社会行为，和家庭关系。我们将主要评估干预的可行性和吸收，并初步评估干预的影响和中介因素，以减少艾滋病毒的风险行为和物质使用。我们还将记录利益相关者通过关键线人访谈对该计划的挑战和成功的看法，通过观察，随着时间的推移，在shebeens的年轻男性的数量，以及Sonke性别公正，男性倡导运动的社会运动战略的主要特点。 公共卫生相关性：在南非，18-25岁的青年男子面临着全球最高的艾滋病毒、酗酒和吸毒以及失业率。男子在获得和利用艾滋病毒预防方案方面处于多重不利地位。我们的目标是通过非污名化、亲社会的足球和工匠职业指导，为青年男子创造一个成功的、社区一级的艾滋病毒预防战略和摆脱贫困的结构性途径。

DESCRIPTION (provided by applicant): Young men aged 18-25 years in South Africa face the intersecting epidemics of HIV, alcohol and drug abuse, and unemployment. This R34 is designed to reduce young men's risk by addressing three problems with existing evidence-based programs (EBP): interventions are not designed considering men's fight-flight coping strategy; donors are unwilling to invest in substance abusing men; and existing job training does not consider young men's poor habits. Our goal is to apply behavioral economists' strategies to new delivery formats that are highly attractive to young men: soccer and job training. A neighborhood-level HIV prevention strategy will shape men's positive daily routines at an organized soccer league: being on time, completing practice, arriving sober & drug free, showing sportsmanship, and being nonviolent. Employment training by artisan trainers/mentors will be contingently offered to young men who demonstrate positive habits-of-daily-living on 80% of days over two months. Young township men in two neighborhoods will be randomized to receive the intervention that includes soccer, job training, and contingency management to shape behaviors (N=1 neighborhood; n=60 males) or to receive the control condition of soccer and job training without contingency management (n=1 neighborhood; 60 males). Assessments will be at baseline and 6 months follow-up. We hypothesize the program will significantly reduce HIV-related sexual risk acts and substance abuse, and sustain more employment. We will evaluate life goals, consistency of daily routines pro-social acts, & family relationships. We will primarily evaluate intervention feasibility and uptake, and preliminarily evaluate intervention impacts and mediating factors for reducing HIV risk acts & substance use. We will also document stakeholders' perceptions of the program's challenges and successes via Key informant interviews, the number of young men in shebeens over time via observations, and the key features of the social movement strategies of the Sonke Gender Justice, a men's advocacy movement. PUBLIC HEALTH RELEVANCE: In South Africa, young men aged 18-25 years face some of the highest rates globally of HIV, alcohol and drug abuse, and unemployment. Men are at multiple disadvantages for accessing and utilizing HIV prevention programs. Our goal is to create a successful, neighborhood-level HIV prevention strategy and structural pathway out of poverty for young men via non-stigmatizing, pro-social soccer and artisan vocational mentoring.