Structural and Social Transitions Among Adolescents in Rakai (SSTAR)

项目摘要 撒哈拉以南非洲的青少年在过渡到成年时面临着相当大的风险 艾滋病毒感染；这一风险对年轻女性来说尤其高。了解社会过程， 产生艾滋病毒风险和保护年轻人是培养下一代青年的关键 艾滋病毒预防计划。超越个人特征和行为，社会 结构性因素(社会经济地位、教育机会、性别、艾滋病孤儿、 公共政策)和青少年和青壮年社会角色转变的时机(离开学校， 开始性行为、迁徙和离家、婚姻的形成和解除) 是青年感染艾滋病毒和其他生殖结果的关键驱动因素。然而，这些发现 提出新的问题：社会转型和时机之间的相互关系是如何产生的， 这些转变的顺序和节奏会影响艾滋病毒的危险行为，并最终影响艾滋病毒 感染？社会结构性因素如何影响艾滋病毒感染？社会转型是如何 调节艾滋病毒风险？要回答这些问题，就需要应用创新的新研究。 对高质量的纵向数据采用定量和定性相结合的方法。在过去的六年里， Rakai青年项目使用了新的定性数据和现有的定量和纵向数据 来自Rakai社区队列研究(RCCS)的数据，以成功定义 从1994年开始，15-24岁青年感染艾滋病毒的社会和直接决定因素 2013年。在这项工作的基础上，青少年和青年之间的结构和社会转型 Rakai的成年人(SSTAR)将调查社会结构性决定因素对 使用创新的统计和定性研究从青春期到成年期的转变 方法论。SSTAR将定义关键社会转型中的风险因素和随时间变化的趋势 (性启蒙、离校、婚姻的形成和解除、迁徙、启蒙 生育)；转变之间的相互关系(顺序、时机、节奏)；以及后果 (艾滋病毒危险行为，获得)在青少年和青壮年中使用混合方法。 拟议的项目将审查社会结构对艾滋病毒感染的影响 决定因素(受教育机会、社会保障、孤儿、家庭结构、性别、政府 政策、艾滋病毒方案)直接和通过社会转型为中介，使用农村信用社。最后， SSTAR将探索社会决定因素和社会转型对艾滋病毒感染的影响 在：1-艾滋病毒高发热点社区，2-艾滋病毒中发交易和 交通枢纽社区、三低艾滋病低发区、农村社区落户。

Project Abstract Adolescents in sub-Saharan Africa make the transition to adulthood facing considerable risk of HIV infection; this risk is particularly high for young women. Understanding social processes that produce HIV risk and protect young people is critical to developing the next generation of youth HIV prevention programs. Looking beyond individual characteristics and behaviors, social structural factors (socioeconomic status, educational opportunities, gender, AIDS orphanhood, public policies) and timing of adolescent and young adult social role transitions (leaving school, initiation of sexual behaviors, migration and leaving home, marriage formation and dissolution) are critical drivers of youth HIV acquisition and other reproductive outcomes. Yet, these findings raise new questions: how do the interrelationships among social transitions and the timing, ordering and tempo of these transitions influence HIV risk behaviors, and, ultimately, HIV infection? How do social structural factors influence HIV infection? How do social transitions mediate HIV risk? To answer these questions, new research is needed which applies innovative quantitative and qualitative methods to high quality longitudinal data. Over the past six years, the Rakai Youth Project has used new qualitative data and existing quantitative and longitudinal data from the Rakai Community Cohort Study (RCCS) to successfully define a continuum of social and proximate determinants for HIV acquisition among youth ages 15–24 from 1994– 2013. Building on this work, Structural and Social Transitions among Adolescents and young adults in Rakai (SSTAR) will investigate the influence of social structural determinants on transitions from adolescence to adulthood using innovative statistical and qualitative research methodologies. SSTAR will define risk factors for and trends over time in key social transitions (sexual initiation, school leaving, marital formation and dissolution, migration, initiation of childbearing); interrelationships among transitions (ordering, timing, tempo); and consequences (HIV risk behaviors, acquisition) among adolescents and young adults using mixed methods. The proposed project will examine the influence on HIV acquisition of social structural determinants (access to schooling, SES, orphanhood, household structure, gender, government policy, HIV programs) directly and as mediated by social transitions, using the RCCS. Finally, SSTAR will explore the influence of social determinants and social transitions on HIV acquisition in: 1-high HIV incidence hotspot communities, 2- intermediate HIV incidence trading and transport hub communities, and 3- low HIV incidence settled, rural communities.