The "Teach HADITHI" teacher training intervention to reduce classroom HIV- related stigma in Kenya

项目概要：对于资源有限环境中感染艾滋病毒的儿童和青少年，艾滋病毒/艾滋病- 相关的耻辱（H/A耻辱）塑造了他们艾滋病毒管理的各个方面，从坚持服药到 关于艾滋病毒的披露。青年报告说，H/A在学校的耻辱，通过教师的态度表现出来 和行动以及课程中的限制，塑造了他们同龄人的信念和他们自己的感受 艾滋病病毒，并经常伤害他们的艾滋病毒管理。我们不知道最有效的战略，以减少 H/A耻辱这些青年的经验。我们研究团队的长期目标是提供证据， 在资源有限的环境中，艾滋病毒感染儿童和青少年的慢性病管理。的 本建议的目的是评估是否创新，电影为基础，多媒体教师培训 课程干预将减少肯尼亚教师对艾滋病毒的消极态度和信念， H/A的耻辱在他们的教学和教室。这项工作将通过一个长期的学术 肯尼亚和北美大学之间的伙伴关系，称为学术模式， 医疗保健（AMPATH），我们还保持长期的社区合作伙伴关系。具体目标为 本研究的目的是：目标1：编制一套以艾滋病和艾滋病为重点的多媒体教师培训课程 耻辱和适应最大的文化相关性，课程凝聚力和肯尼亚小学之间的影响 和中学教师。目标2：评估教授哈迪西运动干预措施对肯尼亚的影响 教师对艾滋病毒的态度、信念和知识，以及教师中与艾滋病毒有关的污名化程度。 探索性目标3：检查感染艾滋病毒的儿童和青少年是否在教师 接受教授HADITHI干预报告的人较少被感知、颁布或内化的耻辱感 相比之下，那些在教室里的老师谁没有。制定和修改教师培训 包，我们将利用定性方法，包括焦点小组和认知访谈的主题 问题专家。为了评估疗效，我们将进行一项整群随机对照试验，按学校随机分组。 干预学校的所有教师都将接受教师培训干预，其中包括观看 当地制作的电影，捕捉感染艾滋病毒的肯尼亚儿童的耻辱经历， 与艾滋病毒感染的青少年内容专家和卫生保健专业人员的互动。控制学校 不会有训练干预。我们将评估所有教师，包括干预和控制，对他们的 知识，态度和信念有关的艾滋病毒感染者使用标准化的问卷，给出6 相隔数月我们还将对参加AMPATH的艾滋病毒感染青年进行探索性评估， 在参与调查的学校中，测量他们所感知、经历或内化的H/A污名 在干预后的六个月内。这项研究将极大地影响我们对 社区战略，以减少影响艾滋病毒感染儿童和青少年的H/A耻辱。

PROJECT SUMMARY: For HIV-infected children and adolescents in resource-limited settings, HIV/AIDS- related stigma (H/A stigma) shapes every aspect of their HIV management, from medication adherence to decisions about HIV disclosure. Youth report that H/A stigma in schools, manifest through teacher attitudes and actions as well as limitations in the curriculum, shapes the beliefs of their peers and their own feelings about HIV, and often hurts their HIV management. We do not know the most effective strategies to reduce the H/A stigma these youth experience. The long-term goal of our research team is to provide evidence to improve chronic disease management among HIV-infected children and adolescents in resource-limited settings. The purpose of this proposal is to evaluate whether an innovative, film-based, multimedia teacher training curriculum intervention would decrease Kenyan teachers' negative attitudes and beliefs about HIV and reduce the H/A stigma in their teaching and classrooms. This work will take place through a long-standing academic partnership between Kenyan and North American universities called the Academic Model Providing Access to Healthcare (AMPATH), where we also maintain long-standing community partnerships. The specific aims for this study are to: Aim 1: Assemble a multimedia teacher training curriculum package, focused on HIV and H/A stigma and adapted for maximum cultural relevance, curricular cohesion, and impact among Kenyan primary and secondary school teachers. Aim 2: Assess the impact of the Teach HADITHI intervention on Kenyan teachers' attitudes, beliefs, and knowledge about HIV and the level of HIV-related stigma among teachers. Exploratory Aim 3: Examine whether HIV-infected children and adolescents in classrooms with teachers who have received the Teach HADITHI intervention report less perceived, enacted, or internalized stigma compared to those in classrooms with teachers who have not. To develop and modify the teacher training package, we will utilize qualitative approaches, including focus groups and cognitive interviews with subject matter experts. To assess efficacy, we will conduct a cluster randomized control trial, randomizing by school. All teachers within the intervention schools will go through a teacher training intervention that includes viewing locally created films capturing the stigma experiences of HIV-infected Kenyan children and structured interactions with an HIV-infected adolescent content expert and a health care professional. The control schools will have no training intervention. We will evaluate all teachers, both intervention and control, on their knowledge, attitudes and beliefs related to persons living with HIV using a standardized questionnaire given 6 months apart. We will also conduct an exploratory evaluation of HIV-infected youth enrolled in both AMPATH and in the participating schools, measuring the H/A stigma they have perceived, experienced, or internalized during the six months following the intervention. This research will significantly impact our understanding of community strategies to reduce H/A stigma impacting HIV-infected children and adolescents.