A Mixed-Methods Study of Socio-Ecological Resilience Among Young ACE-Exposed Women in South Africa

南非暴露于 ACE 的年轻女性社会生态复原力的混合方法研究

• 批准号: 10254665
• 负责人: Deborah Baron
• 金额: $ 3.63万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-05-03 至 2024-01-02
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10254665
• 关键词: AIDS prevention; Acquired Immunodeficiency Syndrome; Address; Adolescence; Adult; Affect; Age; Ally; Area; Behavior; Behavioral; Buffers; Caring; Characteristics; Communities; Complex; Contraceptive Agents; Coupled; Data; Development; Environment; Exposure to; Family; Fellowship; Goals; HIV; HIV Infections; HIV risk; Health; Health Promotion; Health Services; Health behavior; High Prevalence; Human; Incidence; Individual; Intervention; Knowledge; Life; Link; Literature; Logistic Regressions; Manuscripts; Measures; Mediation; Methods; Modeling; National Institute of Mental Health; Outcome; Pathway interactions; Phase; Population; Prevention Research; Prevention program; Process; Qualitative Research; Reporting; Research; Research Methodology; Research Personnel; Research Priority; Resources; Risk; Risk Behaviors; Services; Sex Behavior; Sexual Partners; Sexual abuse; Sexually Transmitted Diseases; Social Network; Social support; Source; South Africa; South African; Statistical Models; Strategic Planning; Stressful Event; Structure; Training; Trauma; United States National Institutes of Health; Unsafe Sex; Woman; Women' s Health; Youth; adverse childhood events; base; behavioral/social science; coping; data management; emotional abuse; experience; global health; health service use; high risk sexual behavior; improved; insight; intimate partner violence; pediatric trauma; physical abuse; pre-exposure prophylaxis; prevention service; preventive intervention; psychologic; resilience; response; sex; sexual risk behavior; skills; social; social structure; tenure track; therapy design; trait; traumatic event; young woman

ABSTRACT Young South African (SA) women, a population disproportionately impacted by HIV, commonly suffer adverse childhood experiences (ACEs). These childhood traumas are positively associated with HIV risk behaviors. Studies show that ACEs co-occur in youth and create life trajectories of cumulative risk exposures. Despite the pervasiveness of ACEs among SA women, there is limited data examining the effects of ACEs broadly and how they impact SA women’s HIV prevention behaviors. Socio-ecological resilience—conceptualized as re- sources at the individual, interpersonal and community levels that facilitate positive adaptation in response to trauma—offers a strengths-based approach to examine how these protective determinants buffer the negative impacts of ACEs that worsen young women’s sexual risk behaviors and engagement with HIV prevention pro- grams that impact HIV incidence. This research aligns with the NIH’s Strategic Plan for HIV and HIV-Related Research priority area to use behavioral and social science to gain insights about individuals’ behaviors and their contexts that influence HIV and HIV prevention interventions. The study will apply a social ecological framework to explore protective resilience factors that counter the negative cumulative effects of ACEs on HIV prevention behaviors among young SA women as they transition from adolescence to adulthood. The pro- posed mixed methods research will use data from the co-sponsor’s NIMH R01, Multilevel Mechanisms of HIV Acquisition in Young SA Women. The specific aims of this study are to: 1) Determine the effects of socio-eco- logical resilience in young SA women who have experienced ACEs on their transactional sex behaviors, and utilization of HIV prevention and contraceptive health services; 2) Contextualize how young SA women ex- posed to ACEs understand and experience resilience across multiple socio-ecological levels to navigate and negotiate sexual partnerships, and utilization of contraceptive and HIV prevention services, by using Pho- tovoice, a participatory qualitative research methodology; and 3) Explore convergent and divergent findings with the goal of developing trauma-informed resilience interventions to reinforce combination HIV prevention programs by integrating data from Aims 1 and 2. The proposed fellowship will build on the applicant’s prior re- search experience by supporting their training as a mixed methods global health researcher. The specific train- ing goals of this fellowship are to: 1) Develop the applicant’s theoretical grounding in socio-ecological resilience and trauma-informed care as applied to young ACE-exposed women; 2) Increase the applicant’s quantitative skills to manage data, and analyze, interpret, and present results of statistical models; 3) Deepen the appli- cant’s expertise in qualitative and participatory research skills; 4) Expand the applicant’s capacity to integrate quantitative and qualitative data and present mixed methods research findings; and 5) Advance the applicant’s skills in manuscript development and grantsmanship. These activities will support the applicant’s goal of be- coming a tenure-track HIV prevention mixed methods investigator specializing in adolescent women’s health.

摘要