Rakai Orphans in Communities

ROC总结/摘要 失去父母一方或双方可能对儿童、青少年、 大家庭、社区和国家。最近，艾滋病毒治疗和 预防措施导致文盲率急剧下降。这似乎是由于 联合艾滋病毒预防（CHP），特别是扩大获得高效 抗逆转录病毒疗法（ART）和降低成人中与艾滋病毒有关的死亡率- 往往是父母。与艾滋病毒相关的孤儿数量的减少为儿童带来了巨大的好处 以及青年、家庭和社区。人们对同性恋的衰落 可能影响到影响艾滋病毒风险的社会和经济因素， 孤儿进入青春期和青年期。 Rakai孤儿在社区（ROC）研究将探讨影响，测量， 政策问题的交叉点，艾滋病毒的风险AYA，青少年社会 过渡，家庭和社会背景。影响包括艾滋病毒风险以及社会和经济 后果衡量孤儿的年龄将是这项建议的一个关键组成部分。 在几项研究中，早期孤儿似乎与更多的不良后果有关。 因此，关键问题是估计艾滋病毒的社会和行为风险的影响 以及这种影响如何根据孤儿的年龄而变化。一个开发不足的组件 我们将研究的是热电联产的经济效益与成本的权衡。使用 Rakai社区队列研究（RCCS）的丰富资源，我们将探讨 艾滋病毒治疗和预防之间的关系，艾滋病和新的艾滋病毒感染AYA。 记录卫生防护中心对艾滋病毒相关疾病的影响和艾滋病毒风险的下降将指导 未来对艾滋病毒治疗和预防方案的投资以及 儿童和青年。

ROC Summary/Abstract Loss of one or both parents can have devastating consequences for children, adolescents, extended families, communities, and nations. Recently, improvements in HIV treatment and prevention have led to dramatic declines in orphanhood. This appears to be the result of combination HIV prevention (CHP), particularly expanded access to highly effective antiretroviral therapy (ART) and declining HIV-related mortality among adults – adults who are often parents. The declines in HIV-related orphanhood proffer substantial benefits to children and youth, families, and their communities. Little is known about how declines in orphanhood among youth may have impacted social and economic factors that influence HIV risk as orphans move into the adolescent and young adult (AYA) years. The Rakai Orphans in Communities (ROC) Study will explore impact, measurement, and policy issues at the intersection of orphanhood, HIV risk among AYA, adolescent social transitions, and family and social context. Impacts include HIV risk and social and economic consequences. Measurement of age at orphaning will be a critical component of this proposal. In several studies, earlier age at orphaning appears to be related to more adverse outcomes. Thus, key issues are estimating the impact of orphanhood on social and behavior risk for HIV and how that impact may change based on the age at orphaning. An under-explored component which we will examine is the economic benefits of CHP weighed against the costs. Using the rich resources of the Rakai Community Cohort Study (RCCS), we will explore the relationship between HIV treatment and prevention, orphanhood, and new HIV infection among AYA. Documenting the impact of CHP on HIV-related orphanhood and the decline HIV risk will guide future investments in HIV treatment and prevention programs and health and social policies for children and youth.