Sustainable Development for Improved HIV Health and Prevention in Kenya (SD4H-Kenya)

项目摘要/摘要 老年妇女是艾滋病毒携带者(OPLWH)中最大的老年群体(50岁)，她们遭受的痛苦更少 心理健康和生活质量高于老年男性。耻辱的经历对老年妇女来说是层层的 艾滋病毒，包括与艾滋病毒和老龄化有关的耻辱和性别歧视。丧偶妇女构成了 最大的妇幼保健员群体，由于性别不平等加剧和对女性的污名化 在非洲，寡妇与患有艾滋病毒的寡妇相比，报告的健康结果更差 携带艾滋病毒的已婚妇女。这项研究将比较交叉污名的经历(艾滋病毒，老龄化， 性别、贫困、寡妇)在感染艾滋病毒的老年寡妇和已婚妇女中，这是如何做到的 影响他们的心理健康和生活质量，以及他们对干预措施的看法，以减少跨部门 羞辱和提高他们的生活质量。这项研究还将评估有经验的跨部门 心理健康和生活质量的耻辱，以及寡妇和已婚妇女之间的差异 50岁的艾滋病毒携带者。 项目负责人Odhiambo女士是Maseno大学的博士生，也是家长中的博士生 资助艾滋病毒健康可持续发展(SD4H)培训计划。SD4H旨在提供培训和 为Maseno的研究生提供团队指导。Odhiambo女士完成了为期一年的高级培训 加州大学旧金山分校(UCSF)临床研究证书，正在为她做实地工作 在肯尼亚的博士项目。她即将发表的研究表明，多部门干预未能 解决携带艾滋病毒的寡妇中实施耻辱的经历，需要进一步研究 艾滋病毒携带者妇女中的耻辱和应对耻辱的干预措施。Odhiambo女士的作品是 关于污名是造成人口健康差距的根本原因的理论。耻辱造成一种损失 社会和经济资源，加剧了粮食不安全、贫困和健康状况不佳。 优势和创新：这项补充研究是第一批评估 在非洲感染艾滋病毒的老年妇女中经历了跨部门的耻辱和生活质量。其次，我们 我将改编日常鉴别量表(EDS)，这是在美国开发的另一种量表，并将其用于 衡量肯尼亚当地情况的人经历了跨部门的耻辱。EDS的设计具有较强的适应性和可扩展性 允许测量不同形式的柱头。第三，我们将从一个 以人口为基础的健康和人口监测系统，确保研究参与者具有代表性 艾滋病毒携带者和50岁妇女的总体人口样本。这项管理工作 补助金将支持Odhiambo女士从博士到博士后的过渡，同时仍在接受 来自家长的团队指导授予多名首席调查人员。这项研究还将产生一些想法 关于解决跨部门耻辱的干预措施，奥迪安博女士可以在未来进一步发展和测试 格兰特。Odhiambo女士正在成为跨学科的下一代艾滋病毒研究人员 公共卫生、艾滋病毒健康和发展科学方面的专业知识和本补充申请将支持 她的发展。

PROJECT SUMMARY/ABSTRACT Older women form the largest group of older people (50+ years) living with HIV (OPLWH) and suffer poorer mental health and quality of life than older men. The experiences of stigma are layered for older women living with HIV including HIV- and aging-related stigma and gender discrimination. Widowed women make up the largest group of OPLWH and due to heightened gender inequalities and the stigmatization of female widowhood in Africa, widowed women living with report poorer HIV-related health outcomes compared to married women living with HIV. This study will compare the experience of intersectional stigma (HIV, aging, gender, poverty, widowhood) among older widowed and married women living and aging with HIV, how this impacts their mental health and quality of life, and their ideas on interventions that can reduce intersectional stigma and improve their quality of life. This study will also assess the association of experienced intersectional stigma with mental health and quality of life, and how these may differ between widowed and married women with HIV aged 50+ years. The project lead, Ms. Odhiambo, is doctoral candidate at Maseno University and a Ph.D. fellow in the parent grant Sustainable Development for HIV Health (SD4H) training program. SD4H aimed to provide training and team mentorship to graduate students at Maseno. Ms. Odhiambo completed her year-long Advanced Training in Clinical Research certificate at University of California San Francisco (UCSF) and is doing field work for her PhD project in Kenya. Her soon to be published study showed that a multisectoral intervention failed to address experiences of enacted stigma among widows living with HIV, necessitating further research on stigma among women living with HIV and interventions to address the stigma. Ms. Odhiambo’s work is built upon the theory of stigma as a fundamental cause of population health disparities. Stigma creates a loss of social and economic resources, increasing food insecurity, poverty, and poor health. Strengths and innovation: This supplement study is among the first evaluating the association of experienced intersectional stigma and quality of life among older women living with HIV in Africa. Secondly, we will adapt the everyday discrimination scale (EDS), another scale developed in the USA context and use it in the local Kenyan context to measure experienced intersectional stigma. The design of EDS is adaptable and allows for measurement of different forms of stigma. Thirdly, we will sample study participants from a population-based health and demographic surveillance system ensuring study participants are a representative sample of the general population of women living with HIV and aged 50+ years. This administrative supplement will support Ms. Odhiambo’s transition from doctoral to post-doctoral studies while still receiving the team mentorship from the parent grant multiple principal investigators. The study will also generate ideas on interventions to address intersectional stigma that Ms. Odhiambo can further develop and test in future grant. Ms. Odhiambo is on a path to becoming the next generation of HIV researchers with transdisciplinary expertise in public health, HIV health, and development sciences and this supplement application will support her development.