HIV acquisition and transmission: Multi-level longitudinal analysis, South Africa

总结 艾滋病毒/艾滋病流行病对社会的影响是史无前例的， 人类历史全球有4 000万人感染艾滋病毒/艾滋病，其中绝大多数 于撒哈拉以南非洲的制定和执行《公约》的一个先决条件是， 预防干预是了解谁处于危险之中以及为什么处于危险之中。许多 个人的特征，他们来自的社区和感染本身 有助于确定暴露和获取风险以及多种因果关系 存在将社会、人口、经济、文化和行为联系起来的途径， 变量虽然在了解疾病传播方面取得了许多进展， 从对不同人群中个体风险因素的研究中， 仍然不知道为什么人群经历了不同的流行病， 高风险的驱动因素与仅仅与风险相关的变量进行比较。 该项目将使用一个多层次的框架，以更好地了解因果途径 艾滋病毒感染率（包括感染和传播） 南非的环境，基于人口的调查衡量了艾滋病毒 某些年龄组的患病率> 50%。该研究旨在确定和量化 重要的环境、社区、家庭和个人层面的决定因素， 艾滋病毒的发病率和流行率，为干预战略提供信息。特别强调 被置于当地社区一级，这被视为至关重要， 了解疫情的蔓延情况并做好有效的预防工作。项目说明 为了能够实施有效的干预措施， 艾滋病流行的复杂性、多层次性是必要的。拟议研究 将导致更好地了解艾滋病毒感染的因果途径， 并量化重要的环境、社区、家庭和个人层面 艾滋病毒感染的决定因素。这些信息可以用来指导有效的 预防工作。

Summary The impact of the HIV/AIDS pandemic on societies is without precedent in recorded human history. Globally, 40 million people are living with HIV/AIDS, the vast majority in sub-Saharan Africa. A prerequisite for the development and implementation of prevention interventions is an understanding of who is at risk and why. Many characteristics of the individual, the community they are from and the infection itself contribute to determining the risk of exposure and acquisition and multiple causal pathways exist linking social, demographic, economic, cultural and behavioural variables. Whilst many advances have been made in understanding the spread of HIV from studies of individual risk factors in a diverse range of populations, much is still unknown about why populations have experienced different epidemics, and what the drivers of high risk are compared with variables that simply correlate with risk. The project will use a multi-level framework to better understand the causal pathways of HIV infection (both in terms of acquisition and transmission of infection) in a rural South African setting where population-based surveys have measured HIV prevalence at >50% in some age-groups. The research aims to identify and quantify important environmental, community, household and individual-level determinants of HIV incidence and prevalence to inform intervention strategies. Particular emphasis is placed at the level of the local community which is seen as being vital both to understanding the spread of the epidemic and to effective prevention efforts. Project narrative To be able to implement effective interventions a greater understanding of the complex multi-level nature of the HIV epidemic is necessary. The proposed research will lead to a greater understanding of causal pathways of HIV infection by identifying and quantifying important environmental, community, household and individual-level determinants of HIV infection. This information can be used to guide effective prevention efforts.