Affecting the epidemiology of HIV in Uganda through older adolescents

通过老年青少年影响乌干达艾滋病毒的流行病学

• 批准号: 9267536
• 负责人: Michele L. Ybarra
• 金额: $ 21.07万
• 依托单位: CENTER FOR INNOVATIVE PUBLIC HEALTH RESEARCH
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-08-17 至 2019-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9267536
• 关键词: 17 year old; 19 year old; AIDS prevention; Adolescence; Adolescent; Affect; Africa South of the Sahara; Age; Age-Years; Behavior; Control Groups; Country; Data; Developing Countries; Development; Eligibility Determination; Ensure; Epidemic; Epidemiology; Feedback; Focus Groups; HIV; HIV Infections; HIV Seropositivity; HIV risk; Hand; Health Services Accessibility; Heterosexuals; Human immunodeficiency virus test; Intervention; Length; Measures; Outcome Measure; Participant; Population; Prevalence; Prevention program; Preventive; Public Health; Randomized; Reaction; Recruitment Activity; Research; Research Personnel; Resources; Risk; Services; Sexual Abstinence; Technology; Testing; Text; Translating; Uganda; Visit; Voice; Woman; Youth; adolescent HIV prevention; arm; base; condoms; control trial; cost; design; experience; healthy sexuality; high risk; improved; interest; male; multidisciplinary; online resource; post intervention; programs; public health relevance; research study; retention rate; scale up; sex; sexually active; skills; tool; transmission process; web site; young woman

 DESCRIPTION (provided by applicant): Heterosexual sex is the primary mode of HIV transmission in Uganda, which is likely why prevalence increases dramatically from middle to late adolescence as young people become sexually active. Indeed, the percent of women with HIV jumps from 1.6% among 15- to 17-year-olds to 5.1% among 18- to 19-year-olds, and increases further to 7.1% among 20- to 22-year-olds. For males, rates also rise from 1.8% to 2.3% as they age from 15-17 years to 20-22 years of age. Clearly, curbing the HIV epidemic in Uganda requires culturally salient and theoretically-driven HIV prevention programming that is easily accessible to adolescents as they age through this period of risk. Given the epidemiology of the HIV epidemic in Uganda, intervention during late adolescence (i.e., 18-22 years of age) is key. We propose to develop the first-of-its-kind comprehensive HIV prevention program for Ugandan adolescents, timed to arm them with the skills necessary to reduce their HIV risk precisely as they move through a high-risk period. Being text messaging-based will ensure that the program is low-cost and easily scalable. By harnessing Facebook and other online resources, this proposal will be one of the first to develop and test an intervention nationally in Sub-Saharan Africa. Specifically, we aim to: Specific Aim 1: Design a 6-week text messaging-based HIV prevention and healthy sexuality program for adolescents 18-22 years old. Older adolescents will be recruited as focus group participants (n = 40) to explore acceptability of proposed program components (e.g., program length) and identify vernacular and "voice" that can be integrated into program messages. Once a draft of the messaging has been written, we will recruit a Content Advisory Council (CAC; n = 15) that will provide reactions to the content, scope, style, and tone of the messages. After integrating feedback, a second CAC (n = 15) will be conducted to confirm the suggested improvements have been translated effectively. Specific Aim 2: Pilot test the intervention for feasibility and acceptability among 18- to 22-year-old Ugandans (n = 200). Participants will be randomly assigned to the intervention or inactive control group. Our main outcome measures will focus on feasibility (e.g., recruitment and retention rates) and acceptability (e.g., Text Buddy, message content). Participants will be recruited online, mainly through Facebook. Specific Aim 3: Obtain preliminary data needed for a larger-scale controlled trial services study to examine program efficacy.

 描述（由申请人提供）：异性性行为是乌干达艾滋病毒传播的主要方式，这可能是为什么从青春期中期到晚期，随着年轻人性活跃，流行率急剧增加的原因。事实上，15至17岁的妇女艾滋病毒感染者的比例从1.6%跃升至18至19岁的5.1%，20至22岁的妇女艾滋病毒感染者的比例进一步上升至7.1%。对于男性，随着年龄从15-17岁上升到20-22岁，发病率也从1.8%上升到2.3%。显然，遏制艾滋病毒在乌干达的流行需要文化上突出和理论驱动的艾滋病毒预防规划，这是很容易获得的青少年，因为他们的年龄通过这一风险时期。鉴于乌干达艾滋病毒流行病的流行病学，在青春期后期（即，18-22岁是关键。我们建议为乌干达青少年制定第一个全面的艾滋病毒预防计划，及时为他们提供必要的技能，以便在他们度过高风险时期时降低艾滋病毒风险。基于文本消息传递将确保该程序成本低且易于扩展。通过利用Facebook和其他在线资源，该提案将成为首批在全国范围内开发和测试干预措施的提案之一， 撒哈拉以南非洲具体而言，我们的目标是：具体目标1：为18-22岁的青少年设计一个为期6周的基于短信的艾滋病预防和健康性行为方案。年龄较大的青少年将被招募为焦点小组参与者（n = 40），以探索拟议计划组成部分的可接受性（例如，节目长度），并识别可以集成到节目消息中的方言和“语音”。一旦撰写了消息草稿，我们将招募一个内容咨询理事会（CAC; n = 15），该理事会将对消息的内容、范围、风格和语气做出反应。在整合反馈后，将进行第二次CAC（n = 15），以确认建议的改进已得到有效转化。具体目标2：在18至22岁的乌干达人（n = 200）中对干预措施的可行性和可接受性进行试点测试。参与者将被随机分配到干预组或非活动对照组。我们的主要成果指标将侧重于可行性（例如，招聘和保留率）和可接受性（例如，文本巴迪，消息内容）。参与者将在网上招募，主要是通过Facebook。具体目标3：获得大规模对照试验服务研究所需的初步数据，以检查项目的有效性。

项目成果

A Pilot RCT Evaluating InThistoGether, an mHealth HIV Prevention Program for Ugandan Youth.

• DOI: 10.1007/s10461-021-03237-5
• 发表时间: 2021-10
• 期刊: AIDS AND BEHAVIOR
• 影响因子: 4.4
• 作者: Ybarra, Michele L.;Agaba, Edgar;Nyemara, Novatus
• 通讯作者: Nyemara, Novatus