Reaching 90 90 90 in Adolescents in Zambia: Using all our SKILLZ

使赞比亚青少年达到 90 90 90 岁：利用我们所有的技能

• 批准号: 10212923
• 负责人: Jenny Xin Liu
• 金额: $ 45.4万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-25 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10212923
• 关键词: AIDS prevention; Achievement; Adherence; Adolescent; Africa South of the Sahara; Age; Attitude; Books; Caring; Clinical Services; Communities; Computers; Continuity of Patient Care; Counseling; Country; Distant; Education; Effectiveness; Ensure; Epidemic; Evaluation; Female; Female Adolescents; Focus Groups; Future; Generations; HIV; HIV Infections; HIV Seropositivity; Health; Home visitation; Human immunodeficiency virus test; Impact evaluation; Incidence; Individual; Infectious Diseases Research; Intervention; Learning; Life; Mediation; Mediator of activation protein; Medical; Mentors; Modeling; Pathway interactions; Personal Satisfaction; Public Health; Randomized Controlled Trials; Reproductive Health Services; Rewards; Risk; Risk Behaviors; Schools; Secondary Schools; Services; Sex Behavior; Sexual Health; Soccer; Social Network; Social support; Sports; Surveys; Teenagers; Testing; Training; Trust; Viral; Viral Load result; Woman; Work; Youth; Zambia; adolescent health; age group; aged; antiretroviral therapy; base; design; empowerment; follow-up; gender disparity; girls; high risk; high risk population; implementation science; improved; incremental cost-effectiveness; innovation; peer; peer coaching; population based; programs; psychosocial; risk perception; self esteem; social; sociodemographics; success; uptake; young woman

Project Summary/ Abstract Despite considerable progress, many countries are still struggling to achieve the UNAIDS 90 90 90 targets. These targets have been particularly challenging amongst adolescent girls, with poorer uptake, retention and viral suppression being reported3-6 Grassroot Soccer (GRS) and the Centre for Infectious Disease Research in Zambia (CIDRZ) have collaborated to develop a comprehensive adolescent package that providse sexual and reproductive health services (SRH), including HIV testing and treatment, in adolescent friendly spaces. This program builds off a strong social support with peer mentoring and the use of social networking and adolescent-friendly clinical services that integrate HIV with sexual and reproductive health services (SRH). The `SKILLZ programme' developed for adolescent girls by GRS generates demand for all steps in the HIV cascade among young women. It is a sport-based school intervention, to increase the use of HIV and SRH services and to improve psychosocial well-being, including self-esteem, empowerment, and self-sufficiency. To ensure an uninterrupted continuum of care, we have integrated SKILLZ with CIDRZ teen services to create `SKILLZ Plus', a seamless 90-90-90 pathway for adolescents in Zambia. Instead of focusing on changing young women's attitudes towards their own risk using a medical model, we leverage the power of soccer, local peer mentors and female life coaches to build bridges between young women and services often viewed as inaccessible, distant or irrelevant. Our Specific Aims are to 1.Examine the incremental cost effectiveness of SKILLZ Girl on HIV testing among adolescent girls in secondary schools in Lusaka using a quasi-experimental impact evaluation. 2. Assess the impact of SKILLZ Plus over two years on viral load suppression (Aim 2a) at 6 months and retention at 6 months, 12 months and 24 months (Aim 2b) through an individual-level randomized controlled trial for those who test positive and 3. Identify mediators, predictors and barriers to uptake of SKILLZ Plus (testing, retention and viral load suppression) both quantitatively through mediation and moderation analyses and qualitatively through focus groups discussions (FGD) with coaches and girls.

项目摘要/摘要 尽管取得了很大进展，但许多国家仍在努力实现 UNAIDS 90 90 90目标。这些目标在 摄取较差，保留率和病毒抑制的青春期女孩被报告3-6 基层足球（GRS）和赞比亚的传染病研究中心 （Cidrz）已合作开发了一个全面的青少年包装 提供性和生殖健康服务（SRH），包括艾滋病毒测试和 在青春期友好的空间中进行治疗。该计划建立了强大的社会支持 通过同行指导以及社交网络和青少年友好的临床的使用 将艾滋病毒与性和生殖保健服务（SRH）融合在一起的服务。这 为GRS为青少年女孩开发的“ Skillz计划”产生了对所有人的需求 年轻妇女的艾滋病毒级联阶段。这是一种基于运动的学校干预， 增加艾滋病毒和SRH服务的使用并改善社会心理健康， 包括自尊，授权和自给自足。确保不间断 连续护理，我们将Skillz与Cidrz Teen Services进行了整合以创建 “ Skillz Plus”，这是赞比亚青少年的90-90-90途径。而不是 专注于改变年轻女性对自己风险的态度，使用医疗 模型，我们利用足球，当地同伴导师和女性生活教练的力量 在年轻妇女和服务之间建造桥梁，通常被认为是无法访问，遥远的 或无关紧要。 我们的具体目的是1.研究Skillz的增量成本效益 卢萨卡中学的青少年女孩接受艾滋病毒测试的女孩 准实验影响评估。 2。评估Skillz Plus的影响 在6个月时在6个月时抑制病毒载荷（AIM 2A）两年，12个月，12 通过个体级随机对照的月零24个月（AIM 2B） 对于那些测试阳性和3的人的试验。确定调解人，预测因素和障碍 Skillz Plus的吸收（测试，保留和抑制病毒负荷）都定量 通过调解和适度分析和定性通过焦点小组 与教练和女孩的讨论（FGD）。