Perceptions of Social Norms and Personal Propensity to Engage in HIV Testing: A Mixed Methods Study and Intervention in Rural Uganda

对社会规范和个人参与艾滋病毒检测倾向的看法：乌干达农村地区的混合方法研究和干预

• 批准号: 10001005
• 负责人: Jessica M Perkins
• 金额: $ 17.06万
• 依托单位: VANDERBILT UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-07 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10001005
• 关键词: AIDS prevention; AIDS/HIV problem; Adult; Affect; Africa South of the Sahara; Applications Grants; Area; Attitude; Award; Awareness; Behavior; Cohort Studies; Communication Methods; Communities; Community Health; Country; Couples; Data; Development; Doctor of Philosophy; Effectiveness; Epidemic; Evaluation; Focus Groups; Goals; HIV; HIV Seropositivity; Health Fairs; Health Professional; Human immunodeficiency virus test; Income; Intervention; Interview; Learning; Mentored Research Scientist Development Award; Mentors; Mentorship; Methods; Modeling; Outcome; Perception; Positioning Attribute; Prevalence; Public Health; Qualitative Research; Randomized; Research; Research Infrastructure; Research Methodology; Research Personnel; Research Priority; Resources; Risk Behaviors; Rural; Same-sex; Social Perception; Statistical Methods; Subgroup; Surveys; Testing; Time; Training; Uganda; United States National Institutes of Health; Vulnerable Populations; Woman; Work; aged; base; behavior test; career; cognitive interview; design; experience; experimental study; improved; innovation; men; population based; primary outcome; secondary outcome; skills; social; social epidemiology; social group; social norm; social stigma; therapy design; therapy development; uptake

PROJECT SUMMARY/ABSTRACT In Uganda, only one-fifth of HIV-positive adults are aware of their serostatus, far short of the UNAIDS 90% target for ending the epidemic. Perceived social norms, defined as one’s perceptions about which attitudes and behaviors are held and engaged in by majority of a social group, are understudied as potential drivers of HIV testing. The preliminary data from my dissertation fieldwork in rural Uganda showed that most people thought that most people in their village had never been tested for HIV even though most had actually been tested, and that men who (mistakenly) perceived HIV testing as uncommon were 3 times more likely to have never been tested themselves. My long-term career goal is to become an independent investigator with mixed-methods expertise in understanding how perceived social norms drive HIV testing, and to develop, test, and implement strategies to improve HIV testing. Although I have completed my PhD in social epidemiology, to achieve research independence I need additional mentorship and training in [1] qualitative research methods, [2] advanced statistical methods such as multilevel and longitudinal modeling, and [3] HIV-related intervention development in sub-Saharan Africa. The proposed training will enable me to achieve my scientific objective: to test the extent to which perceived social norms can affect one’s propensity to engage in HIV testing, and to develop a pilot intervention to increase testing in Uganda among men, women, and couples. My central hypothesis, based on my dissertation fieldwork, is that people misperceive HIV testing as uncommon within salient reference groups, and that these misperceptions greatly undermine their own propensity to undergo HIV testing. I further hypothesize that correcting these misperceptions will be a feasible and acceptable way to increase testing. I will test my central hypothesis by pursuing 3 specific aims: (1) Use qualitative research methods to design valid questions that elicit perceived social norms about HIV testing within different reference groups, including men-only, women-only, and couples-only subgroups of different backgrounds and experiences; (2) Estimate the extent to which social norms for HIV testing are misperceived and perceptions are associated with personal testing; and (3) Develop and test the feasibility, acceptability, and preliminary effectiveness of a pilot intervention to increase HIV testing among men, women, and couples. I am well- positioned to accomplish these aims given my strong preliminary data directly related to the content of the proposed K01 award and my mentors' combined expertise. My approach is innovative in its use of mixed methods to test theoretically-driven hypotheses about the extent to which perceived social norms about HIV testing within salient reference groups affect HIV testing behavior. The proposed research will have significant public health impact because it will lead to the development of a unique class of interventions to increase HIV testing in resource-limited settings, a necessity for ending the HIV epidemic in sub-Saharan Africa.

项目总结/摘要 在乌干达，只有五分之一的艾滋病毒阳性成年人知道自己的血清状况，远远低于联合国艾滋病规划署的90%。 结束这一流行病的目标。感知的社会规范，定义为一个人对哪些态度和 行为是由社会群体的大多数人持有和参与的，作为艾滋病毒的潜在驱动因素， 试验.我在乌干达农村进行的论文实地考察的初步数据显示，大多数人认为， 他们村里的大多数人从未接受过艾滋病毒检测，尽管大多数人实际上已经接受了检测， 那些（错误地）认为艾滋病毒检测不常见的男性从未接受过艾滋病毒检测的可能性是其他男性的3倍。 测试自己。我的长期职业目标是成为一名独立的调查员与混合方法 了解社会规范如何推动艾滋病毒检测的专业知识，并开发，测试和实施 改善艾滋病毒检测的战略。虽然我已经完成了社会流行病学博士学位， 研究独立性我需要额外的指导和培训[1]定性研究方法，[2] 先进的统计方法，如多层次和纵向建模，[3]艾滋病毒相关的干预 撒哈拉以南非洲的发展。建议的培训将使我能够实现我的科学目标： 测试社会规范在多大程度上影响一个人进行艾滋病毒检测的倾向， 制定试点干预措施，在乌干达的男子、妇女和夫妇中增加检测。我的中枢 假设，基于我的论文实地考察，是人们误解了艾滋病毒检测作为罕见的， 突出的参考群体，这些误解极大地破坏了他们自己的倾向， 艾滋病毒检测。我进一步假设，纠正这些误解将是一个可行的和可接受的方式， 增加测试。我将通过追求三个具体目标来检验我的中心假设：（1）使用定性研究 设计有效问题的方法，在不同的参考文献中引出关于HIV检测的社会规范 团体，包括仅限男性、仅限女性和仅限夫妇的不同背景的亚组， （2）估计艾滋病毒检测的社会规范被误解的程度， 与个人测试有关;（3）开发和测试可行性，可接受性和初步 提高男子、妇女和夫妇中艾滋病毒检测的试点干预措施的有效性。我很好- 定位到实现这些目标，因为我的强有力的初步数据直接关系到的内容， K01奖和我的导师们的专业知识我的方法是创新的，它使用混合 方法来测试理论驱动的假设在多大程度上感知社会规范对艾滋病毒 在显著参照群体中进行检测会影响艾滋病毒检测行为。这项研究将具有重大意义。 公共卫生的影响，因为它将导致发展一种独特的干预措施，以增加艾滋病毒 在资源有限的情况下进行检测，这是结束撒哈拉以南非洲艾滋病毒流行的必要条件。