Young Africans’ Changing Understandings of HIV/AIDS Risk

 描述（由申请人提供）：过去二十年来，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，技术和方案进展。然而，与艾滋病毒有关的耻辱感继续对整个预防和治疗过程产生负面影响。宣传工作在普及艾滋病毒预防和治疗知识、规范检测和采用预防技术以及宣传污名化及其影响方面发挥着核心作用。 随着人们对“以治疗预防”的兴趣日益增长，越来越有必要评估和解决非洲青年不断变化的艾滋病毒宣传需求，以确保他们具备因地制宜的理解和技能，自己能够迅速获得服务，并有助于创造一个有利的环境，支持艾滋病毒的预防、检测、治疗和其他人的坚持。在艾滋病历史上关键的18年期间（1997- 2014年）收集的来自47个国家的独特纵向定性数据提供了前所未有的机会，以审查非洲青年如何理解艾滋病毒预防和治疗方面不断发展的情况，并确定为采取关键生物医学干预措施和行为做法提供信息的文化意义和背景因素。1997年至2014年期间，来自撒哈拉以南非洲的15万多名年轻人参加了在8个不同时间点举行的艾滋病毒主题剧本创作比赛，创作了75 000多个故事。拟议的项目将分析在每个时间点（1997年、2000年、2002年、2005年、2008年、2011年、2013年、2014年）由流行病和社会文化状况各不相同的五个国家（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2 681份叙述的分层随机样本。它将使用在早期NICHD资助的研究中开发的经过验证的严格方法，该方法结合了联合收割机深入的叙述分析，主题定性数据分析和叙述的可量化特征的描述性统计。整个叙述模式将照亮跨国，年龄和性别分布和纵向演变的年轻人的社会代表的生物医学干预措施和行为的做法，在整个预防和治疗的连续性和艾滋病毒感染者（PLWH）和妇女。拟议项目的总体目标是，通过确定国家一级的沟通需求和最佳做法，促进努力改善撒哈拉以南非洲青年人的预防和治疗以及减少耻辱的成果。这项研究还将产生比较结果，这些结果对于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。来自五个国家的研究团队成员在项目和政策层面拥有丰富的经验，他们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主要的国家利益相关者。该研究的优势是易于适用于方案实践的叙述提供了一个金矿的真实场景的发展文化适应的干预措施。

 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.