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

项目摘要/摘要 尽管取得了相当大的进展，但许多国家仍在努力实现 艾滋病规划署90-90-90目标。这些目标尤其具有挑战性，在 青春期女孩，据报告吸收、滞留和病毒抑制较差3-6 草根足球(GRS)和赞比亚传染病研究中心 (CIDRZ)合作开发了一套全面的青少年套餐 提供性健康和生殖健康服务，包括艾滋病毒检测和 治疗，在青少年友好的空间。这项计划建立在强大的社会支持之上。 通过同伴指导，使用社交网络和青少年友好的临床 将艾滋病毒与性健康和生殖健康服务(SRH)相结合的服务。这个 GRS为青春期女孩开发的SKILLZ方案产生了对所有人的需求 在年轻女性中，艾滋病病毒层出不穷。这是一项以体育为基础的学校干预， 增加艾滋病毒和性生殖健康服务的使用，改善心理社会福利， 包括自尊、赋权和自给自足。为了确保不间断地 持续的关怀，我们将SKILLZ与CIDRZ青少年服务相结合，以创建 ‘SKILLZ Plus’，赞比亚青少年无缝的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 作为模特，我们利用足球、当地同伴导师和女性生活教练的力量 在年轻女性和通常被视为难以接近、疏远的服务之间架起桥梁 或者无关紧要。 我们的具体目标是：1.检验SKILLZ的增量成本效益 卢萨卡一名女孩在中学青春期女孩中进行艾滋病毒检测 准实验影响评价。2.评估SKILLZ Plus的影响 两年病毒载量抑制(目标2a)，6个月和6个月，12 月和24个月(目标2b)，通过个人水平的随机对照 对那些检测呈阳性的人进行试验和3.确定调解人、预测者和障碍 SKILLZ Plus的摄取(测试、保留和病毒载量抑制)都是定量的 通过调解和协调分析，并通过焦点小组定性地 与教练和女孩讨论(FGD)。

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.