Pathways to Sexual Health among Adolescent Orphans across sub-Saharan Africa

撒哈拉以南非洲地区青少年孤儿的性健康之路

• 批准号: 9121608
• 负责人: Rachel Kidman
• 金额: $ 7.82万
• 依托单位: STATE UNIVERSITY NEW YORK STONY BROOK
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-08-06 至 2017-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9121608
• 关键词: AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; Adolescence; Africa South of the Sahara; Area; Attention; Behavior; Charge; Child; Country; Data; Demographic and Health Surveys; Development; Disadvantaged; Economics; Emergency Situation; Empirical Research; Epidemic; Family; Female; Future; Gender; General Population; Generations; Glare; Government; HIV; HIV Infections; HIV risk; Health; Individual; Infection; Intervention; Investigation; Investments; Knowledge; Life; Link; Mediating; Orphan; Outcome; Parents; Pathway interactions; Perinatal; Policies; Policy Maker; Policy Research; Population; Populations at Risk; Prevalence; Prevention program; Recording of previous events; Research; Resources; Risk; Risk Factors; Sex Behavior; Sexual Health; Social Welfare; Stream; Testing; UNICEF; Variant; Vulnerable Populations; Work; adolescent sexual health; effective intervention; experience; health disparity; health knowledge; high risk; high risk sexual behavior; improved; orphaned adolescents; programs; psychologic; residence; resilience; sexual debut; sexual victimization; sexual violence; social; sound; theories; transmission process

 DESCRIPTION (provided by applicant): In sub-Saharan Africa, 56 million children have lost a parent. As these orphans reach adolescence, there is mounting concern that they may be experiencing heightened levels of sexual victimization, risky sexual behavior, and STD transmission. The little available research on orphan sexual disparities, however, lacks the technical rigor, geographic scope and consistency needed to draw broad programmatic and policy conclusions. Moreover, there has been almost no investigation of the modifiable pathways by which orphan disparities form or the factors that create resilience. The proposed study will address these gaps through the analysis of 34 existing Demographic and Health Surveys in 22 sub-Saharan Africa countries and has the following specific aims: Aim 1) To test whether orphanhood is a risk factor for adverse sexual outcomes, including sexual violence, high risk sexual behaviors and STD infection. Although orphan disadvantage is often assumed, there is a glaring lack of evidence in support. Our findings will improve scientific knowledge by examining the existence and geographic consistency of disparities. Aim 2) To simultaneously test multiple pathways between orphanhood and the above adverse sexual outcomes. We propose a conceptual framework that will allow us to identify the most salient pathways, and thus guide the development of appropriate prevention programs for orphans. Aim 3) To identify protective factors that moderate the association between orphanhood and the above adverse sexual outcomes. Although most research and policy focuses on orphan disadvantage, many orphans successfully navigate difficult circumstances and engage in sexually healthy behaviors. We will investigate protective individual assets and family resources that moderate risk and that may be strengthened through future intervention. Thus, the proposed study will advance the field by providing rigorous, generalizable evidence on the sexual health of adolescent orphans living in resource- deprived areas. Importantly, there is already substantial commitment from humanitarian groups, governments, and donors to improve the welfare of orphaned adolescents. This represents a critical window of opportunity: strong evidence can be immediately leveraged to generate new programmatic initiatives to improve sexual health among this marginalized population.

 描述(申请人提供)：在撒哈拉以南非洲，有5600万儿童失去了双亲。随着这些孤儿进入青春期，人们越来越担心他们可能会经历更高水平的性侵害、危险的性行为和性病传播。然而，关于孤儿性别差异的现有研究很少，缺乏得出广泛的方案和政策结论所需的技术严谨性、地理范围和一致性。此外，几乎没有关于孤儿差异形成的可改变的途径或创造韧性的因素的调查。这项拟议的研究将通过分析22个撒哈拉以南非洲国家现有的34项人口和健康调查来解决这些差距，并有以下具体目标：1)测试孤儿身份是否是导致不良性行为结果的风险因素，包括性暴力、高危性行为和性传播疾病感染。尽管人们经常认为这是孤儿的劣势，但却明显缺乏支持的证据。我们的发现将通过检查差异的存在和地理一致性来提高科学知识。目的2)同时检验孤儿身份与上述不良性行为结局之间的多条路径。我们提出了一个概念性框架，使我们能够确定最突出的途径，从而指导为孤儿制定适当的预防计划。目的3)找出保护因素，缓和孤儿与上述不良性行为结局之间的联系。尽管大多数研究和政策都集中在孤儿的不利地位上，但许多孤儿成功地度过了艰难的环境，并从事性健康行为。我们将调查具有保护性的个人资产和家庭资源，这些资产和家庭资源可以缓和风险，并可能通过未来的干预得到加强。因此，拟议的研究将通过提供关于生活在资源匮乏地区的青少年孤儿的性健康的严格、普遍的证据来推动这一领域的发展。重要的是，人道主义团体、政府和捐助者已经做出了大量承诺，以改善孤儿青少年的福利。这是一个关键的机会之窗：可以立即利用强有力的证据来产生新的方案倡议，以改善这一边缘化人口的性健康。