Rakai Orphans in Communities

ROC摘要/摘要 失去父母中的一方或双方会对儿童、青少年、 大家庭、社区和国家。最近，艾滋病毒治疗和治疗的改进 预防导致孤儿人数急剧下降。这似乎是由于 综合预防艾滋病毒(CHP)，特别是扩大获得高效的机会 抗逆转录病毒疗法(ART)和成人中艾滋病毒相关死亡率的下降 通常是父母。与艾滋病毒有关的孤儿人数的减少为儿童提供了实质性的好处 以及年轻人、家庭和他们的社区。关于孤儿院的死亡率如何下降，我们知之甚少 可能对影响艾滋病毒风险的社会和经济因素产生了影响 孤儿进入青春期和青壮年(Aya)。 社区中的Rakai孤儿(ROC)研究将探索影响、测量和 孤儿的政策问题，Aya中的艾滋病毒风险，青少年社会 过渡，以及家庭和社会背景。影响包括艾滋病毒风险以及社会和经济 后果。孤儿年龄的测量将是这项提议的关键组成部分。 在几项研究中，孤儿年龄越早似乎与更不利的后果有关。 因此，关键问题是评估孤儿对艾滋病毒的社会和行为风险的影响。 以及这种影响可能会根据孤儿的年龄而发生变化。未被充分开发的组件 我们将研究的是热电联产的经济效益与成本的权衡。使用 丰富的Rakai社区队列研究(RCCS)资源，我们将探索两者的关系 艾滋病病毒治疗和预防、孤儿和新的艾滋病病毒感染之间的关系。 记录卫生防护方案对艾滋病毒相关孤儿的影响和艾滋病毒风险的下降将指导 未来在艾滋病毒治疗和预防方案以及卫生和社会政策方面的投资 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.