Reducing Stigma to Improve HIV/AIDS Prevention, Treatment, and Care among Adolescents Living with HIV in Botswana

减少耻辱感，改善博茨瓦纳艾滋病毒感染青少年的艾滋病毒/艾滋病预防、治疗和护理

• 批准号: 9921510
• 负责人: Bagele M Chilisa
• 金额: $ 17.29万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-04-15 至 2022-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9921510
• 关键词: 17 year old; AIDS prevention; Address; Adherence; Adolescent; Adverse effects; Affect; African; Age; Alcohol or Other Drugs use; Applications Grants; Botswana; Caregivers; Caring; Child; Communities; Conflict (Psychology); Consequences of HIV; Consult; Counseling; Country; Data Collection; Depression and Suicide; Development; Discrimination; Divorce; Drops; Educational workshop; Ensure; Focus Groups; Fright; Goals; HIV; HIV risk; Health; High Prevalence; Household; Husband; Impairment; Intervention; Intervention Studies; Knowledge; Learning; Malawi; Mental Depression; Outcome; Parents; Pennsylvania; Pharmaceutical Preparations; Population; Preparation; Prevalence; Prevention; Probability; Quality of life; Randomized Controlled Trials; Recording of previous events; Research; Research Methodology; Research Personnel; Risk; Risk Reduction; Safe Sex; Science; Series; Sexual Partners; Side; South Africa; Suicide; Surveys; Tanzania; Teenagers; Testing; Thailand; Treatment Efficacy; Uganda; United States; Universities; Vertical Disease Transmission; Viral Load result; Work; Zimbabwe; adolescent health; antiretroviral therapy; base; behavior change; clinical center; experience; improved; member; multidisciplinary; peer; programs; recruit; rural area; rural setting; self esteem; social cognitive theory; social stigma; theories; therapy adherence; transmission process; urban area; urban setting; willingness

PROJECT SUMMARY Considerable research has been conducted on HIV stigma, documenting its high prevalence worldwide. HIV stigma has been tied to adverse effects on HIV prevention, treatment engagement, adherence to antiretroviral therapy (ART). HIV stigma and its accompanying fear of discrimination also adversely affect viral load, depression, suicidality, self-esteem, quality of life, and HIV-transmission risk. Despite the progress in documenting the prevalence and negative consequences of HIV stigma, little is known about the best way to reduce stigma’s deleterious impact. Accordingly, the broad objective of this research is to identify interventions to reduce HIV stigma and its impact on HIV prevention, treatment, and care and health among adolescents living with HIV (ALWH) in Botswana, a sub-Saharan African nation with the third highest HIV prevalence in the world. Another important goal is to improve the capacity of researchers in Botswana to develop interventions to improve HIV prevention, treatment, and care. This project is a collaborative effort of a multidisciplinary team of researchers from the United States and the Republic of Botswana who have a history of collaborating and draws on a more than decade-long University of Botswana-University of Pennsylvania partnership. Members of the team have developed several efficacious HIV risk-reduction interventions for a variety of populations of adolescents. Specifically, the team will conduct preliminary exploratory research to develop a theory-based, developmentally and culturally appropriate HIV stigma-reduction intervention to improve ART adherence and reduce HIV stigma’s adverse impact on adolescents’ health. The intervention will be an adaptation of Teen Club, an intervention implemented with Batswana ALWH ages 13 to 17 years since 2005 that does not address HIV stigma. The bane of intervention research is that resulting efficacious interventions too often are not disseminated because they are not sustainable in the settings that need them. We seek to circumvent this problem by adapting an intervention employed for over 10 years in the proposed setting, resulting in an intervention with a high probability of sustainability. We will conduct focus groups with ALWH, peer educators who implement the existing program, and parents and other caregivers of ALWH, conduct a survey with ALWH to examine correlates of stigma, consult with a Community Advisory Board, and integrate what we learn with Social Cognitive Theory to adapt the intervention to address HIV stigma while ensuring that it is theory-based and developmentally and culturally appropriate. We will conduct a pilot feasibility randomized controlled trial (RCT) to determine the adapted intervention’s feasibility and acceptability. The proposed work includes a Science of Behavior Change Fellows Program with a series of workshops implemented in concert with the project’s activities to improve the capacity of researchers in Botswana to develop interventions to improve HIV prevention, treatment, and care. Based on the preliminary research, we will develop a grant application to test the stigma-reduction intervention’s efficacy in a full-scale RCT with ALWH.

项目摘要 已经对艾滋病毒污名进行了大量研究，记录了其在全球范围内的高流行。艾滋病病毒 污名与对HIV预防，治疗参与，遵守抗逆转录病毒的不利影响有关 治疗（艺术）。艾滋病毒的污名及其对歧视的参与恐惧也对病毒负荷产生不利影响， 抑郁，自杀，自尊，生活质量和艾滋病毒转变风险。尽管取得了进展 记录艾滋病毒污名的患病率和负面后果，对最佳方法的了解知之甚少 减少污名的有害影响。彼此之间，这项研究的广泛目标是确定干预措施 减少艾滋病毒污名及其对青少年预防，治疗以及护理和健康的影响 在博茨瓦纳（Botswana 世界。另一个重要目标是提高博茨瓦纳研究人员开发干预措施的能力 改善艾滋病毒预防，治疗和护理。这个项目是一个多学科团队的合作努力 来自美国和博茨瓦纳共和国的研究人员，他们有合作历史 借助宾夕法尼亚州的博茨瓦纳大学长达十多的大学合作伙伴关系。成员 该团队已为各种人群开发了几种有效的HIV风险干预措施 青少年。具体而言，团队将进行初步探索性研究，以开发基于理论的， 发育和文化上适当的艾滋病毒污名干预措施，以提高艺术依从性和 减少艾滋病毒污名对青少年健康的不利影响。干预将是对青少年的改编 俱乐部，自2005年以来与Batswana ALWH 13至17岁的Batswana Alwh进行的干预措施 地址HIV污名。干预研究的祸根是，由此产生的有效干预措施经常是 没有传播，因为它们在需要它们的环境中不可持续。我们试图绕过这个 通过调整在拟议的环境中进行10年以上的干预措施来解决问题，从而导致 干预具有很高的可持续性可能性。我们将与同伴教育者ALWH进行焦点小组 谁实施现有计划以及ALWH的父母和其他护理人员，与ALWH进行了调查 要检查污名的相关性，请咨询社区顾问委员会，并将我们学到的知识整合在一起 社会认知理论适应干预措施以应对艾滋病毒污名，同时确保这是基于理论的 并在文化上开发和文化适当。我们将进行一个飞行员可行性随机对照试验 （RCT）确定改编的干预措施的可行性和可接受性。拟议的工作包括 行为改变科学研究员计划，并与一系列的讲习班一起实施 项目的活动旨在提高博茨瓦纳研究人员开发干预措施以改善艾滋病毒的能力 预防，治疗和护理。根据初步研究，我们将开发一个赠款应用程序来测试 降低污名干预效率在与ALWH的全尺度RCT中的效率。