HIV status and achieving fertility desires: Implications for HIV prevention and t

艾滋病毒状况和实现生育愿望：对艾滋病毒预防和治疗的影响

• 批准号: 7616871
• 负责人: Akinrinola Bankole
• 金额: $ 29.2万
• 依托单位: GUTTMACHER INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-05-01 至 2013-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7616871
• 关键词: AIDS prevention; Accounting; Address; Affect; Africa South of the Sahara; African; Age; Age-Years; Anti-Retroviral Agents; Attention; Attitude; Behavior; Biological Markers; Caring; Client; Communities; Contraceptive Agents; Contraceptive Usage; Contraceptive methods; Counseling; Country; Couples; Data; Data Collection; Data Set; Demographic and Health Surveys; Effectiveness; Epidemic; Face; Family Sizes; Federal Government; Fertility; Fertility Preferences; Fertility Rates; Future; Goals; Government; Government Agencies; HIV; HIV Infections; HIV Seropositivity; HIV diagnosis; Hand; Health Personnel; Health Services; Health Services Accessibility; Health care facility; Healthcare; High Prevalence; Human immunodeficiency virus test; Individual; Infection; Intention; International Agencies; Intervention; Interview; Joints; Laws; Measures; Multivariate Analysis; Nigeria; Patients; Perception; Pharmaceutical Preparations; Policies; Population; Pregnancy; Pregnant Women; Prevalence; Prevention; Protocols documentation; Provider; Public Health; Reproductive Behavior; Reproductive Health; Reproductive Health Services; Research; Resolution; Respondent; Risk; Role; Sampling; Services; Sex Behavior; Social support; Stigmata; Structure; Surveys; Technology; Termination of pregnancy; Test Result; Testing; Time; Vertical Disease Transmission; Visit; Woman; Zambia; abortion; base; behavioral/social science; child bearing; condoms; coping; design; experience; improved; meetings; men; preference; prevent; prevention service; programs; reproductive; social science research; social stigma; transmission process; trend; unintended pregnancy; willingness

DESCRIPTION (provided by applicant): The objective of this study is to help individuals and couples in African countries facing generalized HIV epidemics to achieve their family size goals and prevent unintended pregnancies while avoiding or coping with HIV infection. To do so, we propose to undertake new research that will improve provision of sexual and reproductive health services, including HIV- related care. Research on the influence of HIV status on childbearing intentions and contraceptive use in sub-Saharan Africa is very scarce. Existing studies have important limitations: most are small-scale and designed to assess the impact of interventions; most study HIV-positive people, sampled at health facilities, and most include women only, and lack the perspective of men, especially important in sub-Saharan Africa. To meet the study's objective, we propose three research efforts: (a) We will undertake new analyses of existing nationally representative survey data on men and women of reproductive age in 14 countries of sub-Saharan Africa, to provide a regional overview of the interrelationships between HIV status (based on biomarker testing, done in the surveys) and fertility desires and sexual and reproductive behaviors; bivariate and multivariate analyses will be done, as well as multilevel analyses for the 5 countries that also have information on availability of HIV-related services. (b) To provide deeper understanding of relationships between HIV status and attitudes regarding HIV-testing and services and the actions women and men are taking to achieve their fertility aspirations and prevent or cope with HIV infection, we will conduct a two-part study in one moderate-HIV-prevalence country (Nigeria) and one high prevalence country (Zambia): a quantitative survey of a community-based sample of 1300 men and women and a facility-based sample of 200 HIV positive people in each country; and in-depth interviews with 48 respondents systematically selected from the quantitative survey in each country. (c) We will conduct semi-structured interviews with about 80 health care providers in each country (Nigeria and Zambia) that provide sexual and reproductive health care, to improve understanding of the roles of providers in helping men and women meet their fertility aspirations and avoid or cope with HIV infection, with special attention to recent efforts to routinize and expand HIV testing. Project Narrative From the public health perspective, preventing the transmission of HIV and unintended pregnancy are very high priorities in sub-Saharan Africa, a region where HIV prevalence and unmet need for contraception are the highest in the world. Two recent trends} increased availability of HIV testing and of drug treatments for the HIV-positive} add to the urgency of the need for new research on the relationships between HIV prevention, HIV-related care, and prevention of unintended pregnancy. The proposed research will guide providers who face difficult choices and decisions in meeting these dual needs.

描述（由申请人提供）：本研究的目的是帮助面临艾滋病毒流行的非洲国家的个人和夫妇实现其家庭规模目标并防止意外怀孕，同时避免或应对艾滋病毒感染。为此，我们建议开展新的研究，以改善性健康和生殖健康服务的提供，包括艾滋病毒相关护理。关于撒哈拉以南非洲地区艾滋病毒状况对生育意愿和避孕药具使用影响的研究非常缺乏。现有研究存在重要局限性：大多数研究规模较小，旨在评估干预措施的影响；大多数研究都是在卫生设施中对艾滋病毒呈阳性的人进行采样，并且大多数只包括女性，缺乏男性的视角，这在撒哈拉以南非洲地区尤其重要。为了实现该研究的目标，我们提出三项研究工作： (a) 我们将对撒哈拉以南非洲 14 个国家的育龄男女现有的具有全国代表性的调查数据进行新的分析，以提供艾滋病毒状况（基于调查中进行的生物标志物测试）与生育愿望以及性行为和生殖行为之间相互关系的区域概况；将进行双变量和多变量分析，以及对也掌握艾滋病毒相关服务可用性信息的 5 个国家进行多层次分析。 (b) 为了更深入地了解艾滋病毒状况、对艾滋病毒检测和服务的态度以及妇女和男子为实现生育愿望以及预防或应对艾滋病毒感染而采取的行动之间的关系，我们将在一个艾滋病毒中度流行国家（尼日利亚）和一个高流行国家（赞比亚）开展一项由两部分组成的研究：对 1 300 名男子和妇女的社区样本和 200 名艾滋病毒阳性者的设施样本进行定量调查 各个国家的人民；并对每个国家的定量调查中系统选取的 48 名受访者进行深度访谈。 (c) 我们将与每个国家（尼日利亚和赞比亚）提供性健康和生殖健康护理的约 80 名医疗服务提供者进行半结构化访谈，以提高对服务提供者在帮助男性和女性实现生育愿望以及避免或应对艾滋病毒感染方面的作用的了解，特别关注最近为常规化和扩大艾滋病毒检测所做的努力。项目叙述 从公共卫生的角度来看，预防艾滋病毒传播和意外怀孕是撒哈拉以南非洲地区的高度优先事项，该地区艾滋病毒感染率和未满足的避孕需求是世界上最高的。最近的两个趋势}艾滋病毒检测和艾滋病毒阳性者药物治疗的可用性的增加}增加了对艾滋病毒预防、艾滋病毒相关护理和预防意外怀孕之间关系进行新研究的紧迫性。拟议的研究将指导那些在满足这些双重需求时面临困难选择和决策的提供者。