Building Capacity to Reduce HIV-Related Stigma among Adolescents in Western Kenya

建设能力以减少肯尼亚西部青少年与艾滋病毒相关的耻辱

• 批准号: 10055160
• 负责人: Nema Aluku
• 金额: $ 21.61万
• 依托单位: UNIVERSITY OF IOWA
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-01 至 2022-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10055160
• 关键词: AIDS prevention; Acquired Immunodeficiency Syndrome; Address; Adolescent; Affect; Africa South of the Sahara; Age; Assessment tool; Attitude; Behavior; Belief; Cause of Death; Coitus; Complex; County; Diagnosis; Disclosure; Discrimination; Disease; Epidemic; Face; Fistula; Frequencies; Gender; Goals; HIV; Health; Health Personnel; High Prevalence; Hospitals; Human immunodeficiency virus test; Individual; Institution; Intervention; Interview; Iowa; Kenya; Measures; Mediating; Methods; Parents; Pathway interactions; Perception; Persons; Population; Prevention strategy; Preventive; Property; Psychometrics; Qualitative Methods; Regression Analysis; Religion and Spirituality; Religious Belief; Reporting; Research; Resources; Role; Sampling; Schools; Shapes; Social Network; Social support; Societies; Sports; Surveys; Techniques; Universities; Unmarried; Unsafe Sex; Woman; Youth; base; biological sex; boys; care seeking; cognitive interview; college; condoms; design; effective intervention; experience; girls; instrument; men; negative affect; sex; sexual encounter; social capital; social culture; social relationships; social stigma; teacher

Project Summary/Abstract Kenya has one of the world's largest HIV and AIDS epidemics, with about 1.6 million people living with HIV and 25,000 people dying from AIDS in 2018. Adolescents, especially girls, are particularly vulnerable to HIV. In western Kenya, over 50% of adolescents had sexual intercourse before the age of 18; however, youth between the ages of 15-19 have low rates of condom use and HIV testing. Stigma negatively affects HIV prevention behaviors, including condom use and HIV testing. In Kenya, complex interactions between social capital, religiosity, and biological sex shape societies' discriminating attitudes towards youth perceived to be infected with HIV (i.e., social stigma), which, in turn, affects HIV prevention. The University of Iowa is partnering with Tangaza University College (Nairobi) and Gynocare Women's and Fistula Hospital (Eldoret) to elucidate the complex relationship between social capital, religiosity, sex, and HIV-related stigma among adolescents (ages 15-19) and its impact on HIV prevention in western Kenya. Focusing on three counties in western Kenya, this two-year, mixed-methods project will develop contextualized measures of social capital, religiosity, and HIV-related stigma (Aim 1); determine the relationship between social capital, religiosity, sex, HIV-related stigma, and HIV-preventive behaviors using quantitative methods (Aim 2); and explicate the relationships between social capital, religiosity, sex, and HIV-related stigma using qualitative methods (Aim 3). For Aim 1, cognitive interviewing techniques will be used with a purposive sample of 12 girls and 12 boys to contextualize and validate a 13-item social capital instrument, a 10-item religiosity scale, and a 27-item instrument to assess social stigma related to HIV. The psychometric properties of these contextualized measures will be assessed through a pilot survey administered to a sample of 100 adolescents. For Aim 2, a survey that includes the validated measures developed in Aim 1 will be administered to 765 randomly selected unmarried girls and boys (ages 15-19) from in western Kenya. Multiple regression analysis will be used to examine the association between (1) social capital and HIV-preventive behaviors (i.e., condom use and HIV testing), and the potential mediating role of social stigma; and (2) social capital and social stigma, and the potential moderating role of religiosity and sex. For Aim 3, 36 in-depth interviews will be conducted with adolescents (ages 15-19), parents, religious leaders, teachers, and health care providers to better understand the complex relationships identified in Aim 2. Led by an experienced Executive Committee and Advisory Board, this study will develop three new scales and identify potential pathways to reduce HIV-related stigma and increase HIV-preventive behaviors among adolescents in western Kenya. This project will also increase the research capacity of two Kenyan institutions to examine HIV-related stigma and its consequences. Ultimately, this partnership will allow us to design effective interventions to address stigma and promote young people's health throughout Kenya.

项目总结/摘要 肯尼亚是世界上艾滋病毒和艾滋病流行最严重的国家之一，约有160万艾滋病毒感染者， 2018年有2.5万人死于艾滋病。青少年，特别是女孩，特别容易感染艾滋病毒。在 在肯尼亚西部，超过50%的青少年在18岁之前发生性行为;然而， 15-19岁年龄段的避孕套使用率和艾滋病毒检测率较低。污名化对艾滋病毒预防产生负面影响 行为，包括使用避孕套和艾滋病毒检测。在肯尼亚，社会资本、 宗教信仰和生理性别塑造了社会对被认为受感染的青年的歧视态度 HIV（即，社会耻辱），这反过来又影响到艾滋病毒的预防。爱荷华州大学与 Tangaza大学学院（内罗毕）和Gynocare妇女和瘘管病医院（埃尔多雷特）， 社会资本、宗教信仰、性别与青少年艾滋病相关污名之间的复杂关系 15-19）及其对肯尼亚西部艾滋病毒预防的影响。 这个为期两年的混合方法项目将以肯尼亚西部的三个县为重点， 社会资本，宗教信仰和艾滋病毒相关的耻辱（目标1）的措施;确定之间的关系 社会资本、宗教信仰、性别、艾滋病相关污名和艾滋病预防行为 (Aim 2）;并阐明社会资本，宗教信仰，性别和艾滋病相关的耻辱之间的关系，使用 定性方法（目标3）。对于目标1，认知访谈技术将用于有目的的样本 12名女孩和12名男孩的背景和验证13项社会资本工具，10项宗教信仰， 量表，以及一个27项工具，以评估与艾滋病毒有关的社会耻辱。这些的心理测量特性 将通过对100名青少年进行抽样调查，评估因地制宜的措施。 就目标2而言，将对765名儿童进行一项调查，其中包括目标1中制定的经验证的措施 从肯尼亚西部随机挑选未婚女孩和男孩（15-19岁）。多元回归分析 将被用来检查（1）社会资本和艾滋病毒预防行为（即，避孕套 使用和艾滋病毒检测），以及社会耻辱感的潜在中介作用;（2）社会资本和社会耻辱感， 以及宗教信仰和性的潜在调节作用。就目标3而言，将进行36次深入访谈 与青少年（15-19岁），父母，宗教领袖，教师和卫生保健提供者，以更好地 理解目标2中确定的复杂关系。 在经验丰富的执行委员会和咨询委员会的领导下，这项研究将制定三个新的量表， 确定减少艾滋病毒相关污名和增加艾滋病毒预防行为的潜在途径， 肯尼亚西部的青少年。该项目还将提高肯尼亚两个机构的研究能力 研究与艾滋病毒有关的污名及其后果。最终，这种伙伴关系将使我们能够设计 在肯尼亚各地采取有效的干预措施，解决污名问题，促进青年人的健康。