Rakai Orphans in Communities

拉凯社区孤儿

• 批准号: 10760957
• 负责人: JOHN S. SANTELLI
• 金额: $ 80.34万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-21 至 2028-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10760957
• 关键词: AIDS prevention; Acquired Immunodeficiency Syndrome; Address; Adolescence; Adolescent; Adolescent HIV risk; Adolescent and Young Adult; Adult; Africa; Africa South of the Sahara; Age; Area; Attention; Behavioral; Child; Child Health; Cohort Studies; Communities; Cost-Benefit Analysis; Data; Distal; Economic Factors; Economics; Education; Educational Status; Epidemic; Event; Extended Family; Family; Family health status; Funding; Future; HIV; HIV Infections; HIV risk; Health; Health Policy; Household; Incidence; Individual; Information Systems; Interview; Investments; Male Circumcision; Marriage; Measurement; Measures; Mediating; Medical; Mental Health; Methods; Occupations; Orphan; Parents; Perinatal; Policies; Population; Poverty; Prevention; Prevention program; Reporting; Resource-limited setting; Resources; Risk; Risk Behaviors; Risk Factors; Role; Route; Secondary Schools; Social Environment; Social Impacts; Social Policies; Social outcome; Socioeconomic Status; South Africa; Time; Uganda; United States National Institutes of Health; Vulnerable Populations; Work; Youth; adverse outcome; antiretroviral therapy; burden of illness; cost; economic impact; improved; infection risk; innovation; life history; male; mortality; prevent; programs; sex; social; social factors; social health determinants; transmission process; treatment program

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.

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。与艾滋病毒有关的死亡率下降给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孤儿社区研究（ROC）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，较早的孤儿年龄似乎与更不利的结果有关。 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。