Young Adults' Strategies for Navigating Reproduction in an AIDS Epidemic

描述(申请人提供)：尽管撒哈拉以南非洲的艾滋病流行严重，怀孕和生育对生活至关重要，但人们对艾滋病及其后果如何改变生殖目标和战略知之甚少。青年家庭和艾滋病研究(YAFAS)将收集及时和创新的数据，以调查在普遍流行的流行病中过渡到为人父母的年轻人如何同时实现避免艾滋病毒/艾滋病和健康生育的双重目标。我们将这项研究设在马拉维的农村，是因为可能影响生殖的艾滋病毒咨询和检测在农村地区才刚刚开始。综合纵向数据集将包括：2 000名年轻妇女的数据，她们将接受怀孕测试，并在三年内每季度接受一次访谈；将数据与其男性性伴侣联系起来；男女艾滋病毒的生物标志物，测试随机化，以评估了解艾滋病毒血清状况的因果影响；以及来自传统文化当局的数据，以说明当地环境在塑造生殖欲望方面的作用。利用这些新数据，我们解决了对个人、夫妇、国家和国际努力在高生育率和高艾滋病毒流行率环境下实现健康生育至关重要的问题。

DESCRIPTION (provided by applicant): Despite the severity of the AIDS epidemic and the centrality of pregnancy and fertility to life in sub-Saharan Africa, little is known about how AIDS and its consequences alter reproductive goals and strategies. The Young Adult Families and AIDS Study (YAFAS) will collect timely and innovative data to investigate how young adults transitioning to parenthood amid a generalized epidemic simultaneously navigate the dual goals of avoiding HIV/AIDS and healthy childbearing. We situate the study in rural Malawi because counseling and testing for HIV, which are likely to influence reproduction, are just becoming available in the rural areas. An integrated longitudinal data set will include: Data from 2000 young women who will be tested for pregnancy and interviewed at quarterly intervals over a period of three years; linked data to their male sexual partners; biomarkers for HIV for both men and women, with the testing randomized in order to assess the causal influence of learning HIV serostatus; and from traditional cultural authorities to illuminate the role of local context in shaping reproductive desires. Using these new data, we address questions critical for individual, couple, national and international efforts to achieve health childbearing in a high-fertility and high HIV-prevalence setting.