A COGNITIVE BEHAVIORAL AND STRUCTURAL HIV PREVENTION INTERVENTION FOR YOUNG UGANDAN WOMEN ENGAGING IN HIGH RISK SEXUAL BEHAVIOR

针对从事高风险性行为的乌干达年轻女性的认知行为和结构性艾滋病毒预防干预措施

• 批准号: 8991370
• 负责人: Rachel Lisa King
• 金额: $ 31.76万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-08-24 至 2020-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8991370
• 关键词: AIDS prevention; Address; Adolescent; Adult; Affect; Age; Area; Attitude; Behavior; Behavioral; Caring; Characteristics; Client; Clinic; Clinical; Cognitive; Communities; Consent; Counseling; Country; Data; Data Collection; Decision Making; Development; Discrimination; Economics; Educational Status; Effectiveness; Emotional; Enrollment; Epidemic; Family Planning; Female; Female Adolescents; Fertility Rates; Focus Groups; Frequencies; Gender; Guidelines; HIV; Health Status; Healthcare; High Risk Woman; Hot Spot; Human immunodeficiency virus test; Incidence; Income; Individual; Intervention; Interview; Knowledge; Life; Link; Maps; Mediating; Mediation; Mediator of activation protein; Mentors; Motivation; Outcome; Participant; Peer Group; Policies; Population; Populations at Risk; Pregnancy; Prevalence; Prevention; Preventive Intervention; Professional counselor; Psychological reinforcement; Randomized; Randomized Controlled Trials; Recruitment Activity; Recurrence; Reproductive Health; Reproductive Health Services; Research; Resources; Risk; Risk Behaviors; Risk Reduction Behavior; Safe Sex; Self Efficacy; Services; Sex Behavior; Sexually Transmitted Diseases; Staging; Technology; Testing; Time; Trust; Uganda; Unplanned pregnancy; Unsafe Sex; Violence; Visit; Woman; Work; Youth; aged; arm; base; behavioral outcome; condoms; evidence base; follow-up; health literacy; health training; high risk; high risk sexual behavior; informant; intervention effect; male; prevention service; primary outcome; public health relevance; reproductive; response; secondary outcome; sex; skills; social; social stigma; standard care; standard of care; unintended pregnancy; uptake; young woman

 DESCRIPTION (provided by applicant): There are about six million young people (15-24 years) with HIV globally. Young women age 15 to 24 years who engage in high risk (YWHR) sexual activity are one of the most-at-risk populations in Uganda; HIV prevalence among this group has been estimated at 26% compared to national prevalence of 4.9%, and Uganda's total fertility rate continues to rank among the highest in the world. Young HIV-uninfected women are especially vulnerable to sexually transmitted infections (STI) including HIV and unplanned pregnancies and thus are in particular need of effective HIV prevention, care, support, and reproductive health services. Young Ugandan women who engage in transactional sex work, are particularly vulnerable. This study aims to develop and test a structural and cognitive behavioral prevention intervention package for HIV-uninfected young women aged 15-24 engaging in high risk sexual behavior in Kampala, Uganda. The prevention intervention will use a three-prong approach for these high-risk women consisting in: 1) peer group sessions that include alternative livelihood options and mentoring, 2) networking and healthy behavior reinforcement through mobile technology, and 3) cognitive behavioral counselling by a trusted adult. We will conduct a stratified randomized controlled trial among a total of 450 HIV-uninfected high risk women 15-24 years old followed for 18 months in an existing specialized community-based clinic in Kampala, Uganda providing services to 2300 female sex workers aged 15 and older. The specific aims of the study will be: 1) To conduct formative research exploring the dynamics of the social and sexual networks, mobility and context of young women (aged 15-24) in Kampala, Uganda; 2) To assess the effectiveness of a combination prevention intervention on the frequency of unprotected sex and 3) To assess the effect of combination prevention intervention on reducing the unmet need for family planning (FP) and the incidence of unintended pregnancies. Women will be consented, enrolled and randomized to receive either the intervention including 4 interactive group sessions and two one-on-one counselling sessions or standard prevention services for HIV and other STI guided by Ministry of Health trained counsellors including condom distribution. Participants will be followed for 18 months. This study will be an important first step towards informing national policy and guidelines about the effect of a structural/cognitive behavioral, youth-friendly approach to HIV care and treatment for young high risk women in Uganda.

 描述（由申请人提供）：全球约有 600 万年轻人（15-24 岁）感染艾滋病毒。从事高风险 (YWHR) 性活动的 15 至 24 岁年轻女性是乌干达风险最高的人群之一；据估计，该群体的艾滋病毒感染率为 26%，而全国感染率为 4.9%，乌干达的总生育率继续位居世界最高之列。未感染艾滋病毒的年轻女性特别容易感染性传播感染（STI），包括艾滋病毒和意外怀孕，因此特别需要有效的艾滋病毒预防、护理、支持和生殖健康服务。从事性交易的年轻乌干达妇女尤其容易受到伤害。本研究旨在针对乌干达坎帕拉未感染艾滋病毒、从事高风险性行为的 15-24 岁年轻女性开发和测试结构性和认知行为预防干预方案。针对这些高危女性，预防干预措施将采用三管齐下的方法，包括：1）同伴小组会议，包括替代生计选择和指导；2）通过移动技术加强网络和健康行为；3）由值得信赖的成年人提供认知行为咨询。我们将对总共 450 名 15-24 岁未感染 HIV 的高危女性进行分层随机对照试验，在乌干达坎帕拉现有的专门社区诊所为 2300 名 15 岁及以上女性性工作者提供服务，随访 18 个月。该研究的具体目标是： 1) 开展形成性研究，探索乌干达坎帕拉年轻女性（15-24 岁）的社会和性网络动态、流动性和背景； 2) 评估综合预防干预措施对无保护性行为频率的有效性，以及 3) 评估综合预防干预措施对减少未满足的计划生育 (FP) 需求和意外怀孕发生率的影响。妇女将获得同意、登记并随机接受干预措施，包括 4 次互动小组会议和两次一对一咨询会议，或由卫生部培训的咨询师指导的艾滋病毒和其他性传播感染标准预防服务，包括分发安全套。参与者将被跟踪 18 个月。这项研究将是重要的第一步，旨在为乌干达年轻高危女性的艾滋病毒护理和治疗提供结构/认知行为、青年友好型方法的影响，为国家政策和指南提供信息。