Fifteen years of epidemic HIV: Novel risk behavior in South African teens in 2010

艾滋病毒流行十五年：2010 年南非青少年的新危险行为

基本信息

批准号：
8243516
负责人：
Christina Psaros
金额：
$ 7.51万
依托单位：
MASSACHUSETTS GENERAL HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-04-01 至 2014-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8243516
关键词：
16 year old AIDS prevention Adolescence Adolescent Affect African Age Alcohol consumption Alcohol or Other Drugs use Area Attention Attitude Behavior Behavior Therapy Behavioral Biological Caring Cessation of life Childhood Clinic Communities Data Development Drug usage Economics Epidemic Face Family Fatigue Fertility Future Generations Goals Government HIV HIV Infections HIV Seropositivity HIV-1 Health Personnel Health Services Accessibility Hospitals Hour Individual Infection Intervention Interview Investigation Learning Life Literature Measures Methodology Modeling Nature Parents Pattern Play Pregnancy Pregnancy Rate Pregnancy in Adolescence Pregnant Women Prevalence Prevention Research Prevention strategy Preventive Intervention Prophylactic treatment Province Qualitative Methods Risk Risk Behaviors Risk Factors Role Site Social Environment South Africa State Government Structure Techniques Teenagers Testing Unsafe Sex Vaccines Woman World Health Youth aged cohort condoms contextual factors critical period early childhood effective intervention experience high risk implantation informant male microbicide novel optimism pediatric trauma peer pregnant teen prevent psychological distress public health relevance sex risk sexual encounter social success transmission process young woman

项目摘要

DESCRIPTION (provided by applicant): Despite a decade of concerted prevention and research efforts, young women in South Africa remain at the epicenter of the global HIV epidemic. Young women in South African experience high rates of pregnancy and are twice as likely to be HIV infected as their same age male peers. At Prince Mshiyeni Memorial Hospital, a provincial government hospital and the proposed recruitment site for the current study, half of all antenatal clinic attendees are infected. Prevalence rises from 7% among 16 year olds to 54% among 22 year olds, suggesting that late adolescence represents a critical period during which large numbers of young women are becoming infected. Young South Africans becoming infected with HIV today grew up in an era where their parents and families were powerfully affected by HIV related illness, economic hardship, and death, but may also benefit from increased government and community attention to HIV. Systematic investigation into how growing up as the "second generation" of HIV-affected youth and its impact on current explosive rates of infection is lacking. Preliminary data from pregnant adolescents receiving care at PMMH suggest new patterns of behavior that likely contribute to high infection rates, but thus far remain undocumented in the scientific literature. Examples include participation in multiple, unprotected sexual encounters at 24-hour parties (known as nkwari) with concomitant alcohol and drug use and the desire to achieve pregnancy to preserve social relationships. A broader, ecological understanding of the evolving contextual factors that drive HIV risk behavior in this "second generation" is crucial in order to develop more effective and relevant behavioral interventions, and for successful implementation and roll-out of biological prevention measures. As estimates for a viable vaccine roll-out could be at least a decade away, effective interventions will need to respond to a dynamic and ever-changing epidemic for years to come. Project overview. The proposed study will use qualitative methods identify novel factors influencing HIV transmission risk in the "second generation" of young women in a South African HIV hyper-endemic setting. We will particularly explore (a) fertility desire, (b) increasing access to treatment and future biological prevention strategies; and (c) ART optimism, HIV prevention fatigue and HIV fatalism (d) and how these may be influenced by early childhood trauma and loss in being born into and raised in a community devastated by HIV. PUBLIC HEALTH RELEVANCE: Rates of HIV infection among young women in South Africa are among the highest in the world. Adolescent women in South Africa represent part of the "second generation" of HIV affected youth, a cohort that remains understudied. Adolescent women coming of age today likely have different experiences related to HIV than the generation before; we plan to explore how the experiences of these women may impact current HIV risk behavior with the ultimate goal of learning how to best intervene in order to reduce rates of HIV in the future.

描述（由申请人提供）：尽管进行了十年的一致预防和研究工作，但南非的年轻妇女仍处于全球艾滋病毒流行病的中心。南非的年轻妇女的怀孕率很高，艾滋病毒感染的可能性是男同龄人的两倍。在姆希耶尼亲王纪念医院，一家省政府医院和拟议的当前研究招聘现场，所有产前诊所参与者中有一半被感染。患病率从16岁的7％上升到22岁的54％，这表明青春期是一个关键时期，在此期间，大量年轻女性被感染。在这个时代，他们的父母和家人受到艾滋病毒相关疾病，经济困难和死亡的强大影响，但也可能受益于政府和社区对艾滋病毒的关注，从而受益于艾滋病毒相关的疾病，经济困难和死亡。系统的调查是，缺乏对受艾滋病毒影响的青年的“第二代”成长及其对当前爆炸性感染率的影响。来自PMMH接受护理的怀孕青少年的初步数据表明，可能导致高感染率的新行为模式，但迄今为止，科学文献中仍然没有记录。例子包括在24小时派对（称为NKWARI）中参与多种不受保护的性接触，并伴随着酒精和吸毒，并渴望获得怀孕以维护社会关系。在这种“第二代”中推动艾滋病毒风险行为的不断发展的上下文因素的更广泛的生态理解对于制定更有效和相关的行为干预措施以及成功实施和推出生物预防措施至关重要。由于对可行疫苗推出的估计至少可以至少十年之遥，因此有效的干预措施将需要对未来几年的动态和不断变化的流行作出反应。项目概述。拟议的研究将使用定性方法确定在南非艾滋病毒高流动性环境中年轻女性“第二代”中影响艾滋病毒传播风险的新因素。我们将特别探索（a）生育欲望，（b）增加获得治疗和未来的生物预防策略；（c）艺术乐观，艾滋病毒预防疲劳和艾滋病毒主义（d），以及在幼年时期的幼儿创伤和损失中如何影响这些疾病，并在艾滋病毒破坏的社区中出生和成长。公共卫生相关性：南非年轻女性的艾滋病毒感染率是世界上最高的。南非的青春期妇女代表了艾滋病毒受影响青年的“第二代”的一部分，这是一个尚未研究的同类。当今年龄的青春期妇女可能有与艾滋病毒有关的经历不同的经历。我们计划探索这些妇女的经历如何影响当前的艾滋病毒风险行为，以学习如何最好地干预以降低未来的艾滋病毒率。