The Problem With Male Sexual/Repro Health:Qualitative/Quantitative Study, Uganda

男性性/生殖健康问题：定性/定量研究，乌干达

• 批准号: 8331347
• 负责人: Maria J Wawer
• 金额: $ 48.76万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-09 至 2014-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8331347
• 关键词: Adolescent; Adoption; Adult; Africa; Africa South of the Sahara; African; Attitude; Behavior; Behavioral; Belief; Caring; Censuses; Characteristics; Charge; Clinic; Cohort Studies; Communities; Consent; Contraceptive methods; Couples; Data; Data Collection; Databases; Development; Effectiveness; Elderly; Enrollment; Family; Family Planning; Fathers; Female Contraceptive Agents; Fertility Rates; Focus Groups; Funding; Future; Gatekeeping; Gender Role; General Population; HIV; HIV/STD; Health; Health Personnel; Health Sciences; Health Services; Health behavior; Household; Influentials; Information Services; Intervention; Intervention Studies; Interview; Knowledge; Male Circumcision; Methods; Mothers; Outcome; Parents; Participant; Peer Pressure; Perception; Persons; Planned Pregnancy; Play; Policy Research; Population; Prevention; Preventive Health Services; Provider; Qualitative Methods; Qualitative Research; Reproductive Health; Reproductive Health Services; Research; Risk; Risk Behaviors; Risk Reduction; Role; Services; Sexual Health; Site; Social Health Services; Social Work; Son; Spouses; Stigmata; Structure; Suggestion; Surveys; System; Testing; Uganda; Wife; Woman; aged; antiretroviral therapy; base; behavior influence; community setting; condoms; consistent condom use; cost; design; experience; health care service utilization; improved; male; member; men; peer; programs; role model; service utilization; social; social stigma; therapy outcome; transmission process; uptake

DESCRIPTION (provided by applicant): Men play a pivotal role in the adoption of currently proven methods of sexual HIV/STI risk reduction, including consistent condom use and male circumcision (MC). Men also influence partners' use of contraception. However, males have fewer entry points to sexual and reproductive health (SRH) information and services, since most family planning and pregnancy-related programs are woman-centered. Finally, men tend to utilize many health care services less than women; in the case of HIV, these results in delayed treatment, poorer antiretroviral therapy (ART) outcomes, and potentially more HIV transmission. The Rakai Health Sciences Program (RHSP), Uganda, has documented many challenges related to male use of SRH services in the general population of the ongoing Rakai Community Cohort Study (RCCS) - a longitudinal behavioral and HIV study of 50 villages - despite the fact that the RHSP offers services free of charge through PEPFAR. In this RO1, we propose to conduct mixed method qualitative and quantitative research on personal, social and structural facilitators and barriers to the acceptance and use of key SRH-associated services by adolescent and adult men, and to explore attitudes regarding potential approaches to increase SRH use. Qualitative research, conducted among male users and non-users of services, family (e.g., spouses, parents) and community members (e.g., influential peers, service providers), will include focus groups to examine community norms; and in-depth interviews to explore personal factors, social influences and perceived structural barriers (such as quality of services) which influence use of SRH. We will also conduct structured observations in service provision sites to identify venue-related obstacles and in other community settings to examine if selected services may be provided there. The qualitative research will be embedded within the RCCS, providing a unique opportunity to purposively enroll male participants on the basis of risk behaviors and service use/nonuse, and to explore social and familial contexts of and influences on male SRH behaviors. On the basis of FGD and IDI data, we will also design and incorporate a module on male SRH into the annual RCCS survey of ~14,000 adults, in order to examine the generalizability of the qualitative findings in the Rakai population and to determine the distribution of key attitudes, perceptions and behaviors. This RO1 will provide the most comprehensive information to date on barriers to and potential motivators of male SRH service acceptance/use in an African setting, and will inform the design of future intervention studies of community and clinic-based strategies to improve male uptake of services such as condoms, MC, family planning, and for HIV+ men, ART. Findings, which will be disseminated in the African region, will also have implications for improving male use of other health and preventive services.

描述（由申请人提供）：男性在采用目前行之有效的降低性 HIV/STI 风险的方法（包括持续使用安全套和男性包皮环切术 (MC)）方面发挥着关键作用。男性也会影响伴侣使用避孕措施。然而，男性获得性与生殖健康 (SRH) 信息和服务的切入点较少，因为大多数计划生育和怀孕相关项目都是以女性为中心的。最后，男性往往比女性更少利用许多医疗保健服务；就艾滋病毒而言，这会导致治疗延迟、抗逆转录病毒治疗 (ART) 效果较差，并可能导致更多艾滋病毒传播。乌干达拉凯健康科学计划 (RHSP) 在正在进行的拉凯社区队列研究 (RCCS)（一项针对 50 个村庄的纵向行为和艾滋病毒研究）中记录了与一般人群中男性使用性健康和生殖健康服务相关的许多挑战，尽管 RHSP 通过 PEPFAR 免费提供服务。 在本 RO1 中，我们建议对青少年和成年男性接受和使用与性健康和生殖健康相关的关键服务的个人、社会和结构性促进因素和障碍进行混合方法定性和定量研究，并探讨对增加性健康和生殖健康使用的潜在方法的态度。在服务的男性使用者和非使用者、家庭（例如配偶、父母）和社区成员（例如有影响力的同伴、服务提供者）中进行的定性研究将包括焦点小组，以审查社区规范；以及深入访谈，探讨影响性健康和生殖健康使用的个人因素、社会影响和感知的结构性障碍（例如服务质量）。我们还将在服务提供地点进行结构化观察，以识别与场地相关的障碍，并在其他社区环境中进行结构化观察，以检查是否可以在那里提供选定的服务。定性研究将纳入 RCCS，提供独特的机会，根据风险行为和服务使用/不使用情况有目的地招募男性参与者，并探索男性 SRH 行为的社会和家庭背景及其影响。在 FGD 和 IDI 数据的基础上，我们还将设计一个关于男性 SRH 的模块，并将其纳入约 14,000 名成年人的年度 RCCS 调查中，以检验定性研究结果在 Rakai 人群中的普遍性，并确定关键态度、看法和行为的分布。 该 RO1 将提供迄今为止关于非洲环境中男性接受/使用性健康和生殖健康服务的障碍和潜在动机的最全面信息，并将为未来社区干预研究和基于临床的策略的设计提供信息，以提高男性对安全套、MC、计划生育以及艾滋病毒阳性男性的 ART 等服务的接受。研究结果将在非洲地区传播，还将对改善男性使用其他健康和预防服务产生影响。