Encouraging Safe Dates: Reducing Intimate Partner Violence in South African Youth

鼓励安全约会：减少南非青少年的亲密伴侣暴力

• 批准号: 7581012
• 负责人: Pamela Kay Cupp
• 金额: $ 17.89万
• 依托单位: PACIFIC INSTITUTE FOR RES AND EVALUATION
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-03-06 至 2011-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7581012
• 关键词: Adolescence; Adolescent; Adopted; Affect; African; Age; Alcohols; Arts; Calculi; Communication; Conflict (Psychology); Data; Development; Drug abuse; Drug usage; Ethnography; Experimental Designs; Failure; Feasibility Studies; Female; Female Adolescents; Fibrinogen; Forcible intercourse; Foundations; Funding Mechanisms; Gender; Goals; HIV; Heavy Drinking; Heterosexuals; Inequality; Intervention; Knowledge; Language; Life; Link; Measures; Methodology; Modeling; Motivation; Outcome; Patient Self-Report; Personal Digital Assistant; Pilot Projects; Prevalence; Randomized Controlled Trials; Reporting; Research; Research Project Grants; Risk; Risk Behaviors; Schools; Sex Behavior; Sexual Partners; Social Environment; Social support; South Africa; Southeastern United States; Staging; Standardization; Stifle joint; Students; Surveys; Testing; Time; Training; Translating; Treatment Efficacy; Victimization; Violence; Vulnerable Populations; Woman; Youth; alcohol prevention; base; boys; child sexual assault; condoms; consistent condom use; design; early sex initiation; efficacy testing; experience; follow-up; girls; high risk; improved; innovation; intervention program; intimate partner violence; male; member; older women; peer; primary outcome; programs; reduced alcohol use; secondary outcome; sex; skills; social; teacher; transmission process

DESCRIPTION (provided by applicant): HIV prevalence rates in South Africa are among the highest in the world; transmission is largely heterosexual, and young people, especially young females, are disproportionately affected. It is increasingly understood that efforts to promote safer sexual practices in this vulnerable population may be undermined by high rates of intimate partner violence (IPV). Epidemiologic and ethnographic research among South African youth, much of it conducted by members of this research team, has provided data to support a model suggesting that ideologies of male superiority and cultural violence are manifested in gender inequality. In this setting, boys are encouraged to enforce the hierarchy, and to use violence to punish transgressions and stifle resultant conflicts. Girls receive little social support to protect them from such aggressive control. Alcohol and drug use are associated with higher levels of relationship conflict and a greater likelihood that violence will occur. High rates of rape and coerced sex are associated with early initiation of sex, failure to use condoms, and multiple, risky sexual partnerships, increasing risk of HIV transmission. Accordingly, it is proposed that an intervention be developed to reduce IPV among South African youth by: increasing social support for girls; questioning male norms of superiority, sexual entitlement, and control of girls; reducing alcohol and drug use; and improving communication to reduce the use of violence in resolving relationship conflicts. Efficacious interventions to delay sexual initiation, promote correct and consistent condom use, and discourage multiple risky sexual partnerships will also be integrated into the program. The intervention will be adapted from a school-based program, Safe Dates, which significantly reduced IPV among 8th and 9th grade students in the southeastern United States (Foshee, Bauman, Ennet, et al., 2004). It also will incorporate materials from two South African intervention programs, Our Times Our Choices (Drs. Zimmerman and Cupp) and Stepping Stones (Jewkes, Nduna & Jama 2002; Jewkes et al., 2007) which have shown significant effects on key outcomes. Specifically, we propose to: 1) Adapt Safe Dates for use as an intervention to reduce IPV among in- school South African adolescents and integrate interventions targeting HIV risk behavior; 2) Conduct a pilot study of the adapted Safe Dates program with in-school South African adolescents to: a) reduce IPV, the primary target of the intervention, and b) delay initiation of sex, increase condom use, decrease the number of sexual partners, and decrease risky sexual partnerships, the secondary targets of the intervention. The pilot study will employ an experimental design, a six-month follow-up period, and audio-enhanced personal digital assistants (APDAs) to optimize honest self-report. The primary goals of the proposed project are to demonstrate the feasibility of implementing the adapted Safe Dates program in South Africa and to provide estimates of effect sizes, so that a randomized control trial can be designed to assess its efficacy.

描述（由申请人提供）：南非的艾滋病毒流行率是世界上最高的;传播主要是异性恋，年轻人，特别是年轻女性，受到不成比例的影响。人们日益认识到，在这一弱势群体中促进安全性行为的努力可能会因亲密伴侣暴力的高发生率而受到破坏。在南非青年中进行的流行病学和人种学研究，其中大部分是由该研究小组的成员进行的，提供的数据支持了一个模型，该模型表明，男性优越的意识形态和文化暴力表现在两性不平等中。在这种情况下，男孩被鼓励执行等级制度，并使用暴力来惩罚违法行为和扼杀由此产生的冲突。女孩几乎得不到社会支持来保护她们免受这种侵略性控制。酒精和毒品的使用与更高程度的关系冲突和更大的可能性，暴力将发生。强奸和强迫性行为的高发生率与过早开始性行为、不使用避孕套以及多个危险的性伙伴关系有关，增加了艾滋病毒传播的风险。因此，建议制定干预措施，通过以下方式减少南非青年的IPV：增加对女孩的社会支持;质疑男性的优越性、性权利和对女孩的控制;减少酗酒和吸毒;改善沟通，减少在解决关系冲突时使用暴力。有效的干预措施，以推迟性行为的开始，促进正确和一致的使用避孕套，并劝阻多个危险的性伙伴关系也将纳入该计划。该干预措施将改编自一项以学校为基础的计划，即安全约会，该计划显着降低了美国东南部8年级和9年级学生的IPV（Foshee，Bauman，Ennet等人，2004年）。它还将纳入两个南非干预方案的材料，我们的时代我们的选择（齐默尔曼博士和Cupp）和踏脚石（Jewkes，Nduna和Jama 2002; Jewkes等人，2007年），对关键成果产生了重大影响。具体而言，我们建议：（1）调整安全约会，将其作为一种干预措施，以减少南非在校青少年的IPV，并整合针对艾滋病毒风险行为的干预措施;（2）对南非在校青少年进行经调整的安全约会方案的试点研究，以便：a）减少IPV，这是干预的主要目标，和B）延迟性行为的开始，增加安全套的使用，减少性伴侣的数量，减少危险的性伙伴关系，这是干预的次要目标。该试点研究将采用实验设计，为期六个月的随访期，以及音频增强的个人数字助理（APDA），以优化诚实的自我报告。拟议项目的主要目标是证明在南非实施适应安全日期计划的可行性，并提供效应量的估计，以便设计随机对照试验来评估其疗效。