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、酗酒和吸毒以及失业等交叉流行病。R34旨在通过解决现有循证计划(EBP)中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-逃离应对战略；捐赠者不愿投资于滥用物质的男性；以及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男性极具吸引力的新教学模式：足球和职业培训。社区层面的艾滋病毒预防战略将塑造男性在有组织的足球联赛中积极的日常生活：准时、完成练习、戒酒和戒毒、展示体育精神，以及非暴力。工匠培训师/导师的就业培训将临时提供给在两个月内80%的时间里表现出积极的日常生活习惯的青年男子。随机将两个社区的年轻乡镇男性接受包括足球、工作培训和应急管理在内的干预措施，以塑造行为(N=1个社区；n=60名男性)，或接受足球控制条件和没有应急管理的工作培训(n=1个社区；60名男性)。评估将以基线进行，并进行6个月的跟踪。我们假设该计划将显著减少与艾滋病毒相关的性行为和药物滥用，并维持更多的就业机会。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。我们将初步评估干预的可行性和接受性，初步评估干预对减少HIV危险行为和药物使用的影响和中介因素。我们还将通过关键的线人采访记录利益相关者对该计划挑战和成功的看法，通过观察记录随着时间的推移在Shebeens中的年轻男性人数，以及男性倡导运动Sonke Gender Justice的社会运动战略的关键特征。 与公共卫生相关：在南非，18-25岁的年轻男子面临着全球艾滋病毒、酒精和药物滥用以及失业率最高的一些问题。男性在获得和利用艾滋病毒预防计划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，为年轻人创造一个成功的、社区层面的艾滋病毒预防战略和结构性脱贫途径。

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.