Young Africans’ Changing Understandings of HIV/AIDS Risk

非洲年轻人对艾滋病毒/艾滋病风险的认识不断变化

• 批准号: 8993502
• 负责人: S KATE WINSKELL
• 金额: $ 50.63万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-04 至 2018-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8993502
• 关键词: AIDS prevention; AIDS/HIV problem; Address; Africa South of the Sahara; African; Age; Behavior Therapy; Behavioral; Burkina Faso; Characteristics; Communication; Country; Cross-Sectional Studies; Data; Data Analyses; Development; Education; Ensure; Environment; Epidemic; Epidemiology; Ethnography; Evolution; Film; Funding; Gender; Goals; HIV; Intervention; Kenya; Life; Methodology; Modeling; National Institute of Child Health and Human Development; Nigeria; Outcome; Pattern; Play; Policies; Prevention; Process; Recommendation; Recording of previous events; Research; Risk; Role; Rural; Sampling; Senegal; Services; Sex Behavior; Source; Swaziland; Technology; Testing; Time; Treatment outcome; Woman; Writing; Youth; age group; comparative; contextual factors; experience; improved; insight; interest; literacy; longitudinal analysis; member; programs; public health relevance; residence; response; skills; social; social stigma; statistics; treatment adherence; uptake

 DESCRIPTION (provided by applicant): The past two decades have seen unprecedented scientific, technical and programmatic advances in the prevention and treatment of HIV in sub-Saharan Africa. However, HIV-related stigma continues to have negative effects across the prevention and treatment continuum. Communication efforts play a central role in HIV prevention and treatment literacy, in normalizing testing and uptake of prevention technologies, and in informing stigma and its effects. As interest in treatment-as-prevention grows, it is increasingly important to assess and address the evolving HIV communication needs of young Africans in order to ensure that they are equipped with the contextualized understanding and skills to promptly access services themselves and to contribute to an enabling environment that supports HIV prevention, testing, treatment, and adherence for others. Unique longitudinal qualitative data from 47 countries, collected during a critical 18-year period (1997- 2014) in the history of the epidemic, offer an unprecedented opportunity to examine how young Africans are making sense of evolving developments in HIV prevention and treatment and to identify cultural meanings and contextual factors that inform uptake of key biomedical interventions and behavioral practices. More than 150,000 young people from across sub-Saharan Africa took part in HIV-themed scriptwriting contests held at 8 discreet time points between 1997 and 2014, creating over 75,000 narratives. The proposed project will analyze a stratified random sample of 2,681 of these narratives written at each of the time points (1997, 2000, 2002, 2005, 2008, 2011, 2013, 2014) and by young people in five countries with diverse epidemiological and sociocultural profiles (Burkina Faso, Senegal, Nigeria, Kenya and Swaziland). It will use validated, rigorous methodologies developed in an earlier NICHD-funded study that combine in-depth narrative analysis, thematic qualitative data analysis, and descriptive statistics on quantifiable characteristics of the narratives. Patterns across the narratives will illuminate the cross-national, age, and gender distribution and longitudinal evolution of young people's social representations of biomedical interventions and behavioral practices across the prevention and treatment continuum and of people living with HIV (PLWH) and women. The overall goal of the proposed project is to contribute to efforts to improve prevention and treatment and stigma-reduction outcomes among young people in sub-Saharan Africa by identifying communication needs and best practices at country levels. The study will also generate comparative findings of importance for assessing national responses to HIV and for increasing understanding of processes of sociocultural change. Research team members from the five countries with extensive experience at program and policy levels will ensure contextual sensitivity of analysis, increase their own research capacity, and disseminate findings to key national stakeholders. The research has the advantage of being readily applicable in programmatic practice as the narratives provide a goldmine of authentic scenarios for the development of culturally adapted interventions.

 描述(申请人提供)：在过去的二十年里，撒哈拉以南非洲在预防和治疗艾滋病毒方面取得了前所未有的科学、技术和方案进步。然而，与艾滋病毒有关的耻辱在整个预防和治疗过程中继续产生负面影响。传播努力在艾滋病毒预防和治疗扫盲、使预防技术的检测和采用正常化以及宣传污名及其影响方面发挥核心作用。随着人们对“治疗即预防”的兴趣与日俱增，评估和解决非洲青年不断变化的艾滋病毒传播需求变得越来越重要，以确保他们具备能够迅速获得服务的背景理解和技能，并有助于创造有利的环境，支持艾滋病毒的预防、检测、治疗和对他人的坚持。从47个国家收集的独特的纵向定性数据，是在该流行病历史上关键的18年期间(1997-2014年)收集的，提供了一个前所未有的机会，以审查非洲青年如何理解艾滋病毒预防和治疗方面不断演变的发展，并确定影响采用关键生物医学干预措施和行为做法的文化含义和背景因素。1997年至2014年，来自撒哈拉以南非洲的15万多名年轻人参加了以艾滋病毒为主题的编剧比赛，比赛在8个保密的时间点举行，创作了超过7.5万个叙事故事。拟议的项目将对每个时间点(1997年、2000年、2002年、2005年、2008年、2011年、2013年、2014年)的2681个此类叙述的分层随机抽样进行分析，这些叙述是由流行病学和社会文化特征不同的五个国家(布基纳法索、塞内加尔、尼日利亚、肯尼亚和斯威士兰)的年轻人撰写的。它将使用在NICHD资助的早期研究中开发的经过验证的、严格的方法，该方法结合了深入的叙述分析、专题定性数据分析和关于叙述的可量化特征的描述性统计。整个叙述模式将阐明跨国家、年龄和性别分布以及年轻人在整个预防和治疗过程中以及艾滋病毒携带者(PLWH)和妇女的生物医学干预和行为实践的社会表征的纵向演变。拟议项目的总体目标是，通过确定国家一级的交流需求和最佳做法，为改善撒哈拉以南非洲青年的预防和治疗以及减少耻辱成果的努力作出贡献。这项研究还将产生比较结果，对评估各国对艾滋病毒的反应和增进对社会文化变化进程的了解具有重要意义。来自这五个国家的研究团队成员在计划和政策层面拥有丰富的经验，将确保分析的背景敏感性，提高自己的研究能力，并将研究结果传播给关键的国家利益攸关方。这项研究的优点是易于在方案实践中应用，因为叙述为制定适应文化的干预措施提供了真实情景的金矿。