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

项目概要/摘要 老年妇女是感染艾滋病毒的老年人（50岁以上）中最大的群体， 心理健康和生活质量都比老年人好。对于生活在美国的老年妇女来说， 艾滋病毒感染者，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 由于性别不平等加剧和对妇女的污名化， 在非洲，丧偶妇女与艾滋病毒相关的健康结果较差， 已婚妇女感染艾滋病毒。这项研究将比较交叉污名（艾滋病毒，老龄化， 在感染艾滋病毒的老年丧偶和已婚妇女中， 影响他们的心理健康和生活质量，以及他们对干预措施的想法， 并改善他们的生活质量。本研究还将评估经验丰富的交叉学科 污名与心理健康和生活质量，以及这些可能如何在丧偶妇女和已婚妇女之间的差异 年龄在50岁以上的艾滋病毒感染者。 项目负责人Odhiambo女士是Maseno大学的博士候选人，亲兄弟 艾滋病毒健康可持续发展（SD 4 H）培训计划。SD 4 H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 在临床研究证书在加州大学旧金山弗朗西斯科（UCSF），并正在做实地工作，她 博士项目在肯尼亚。她即将发表的研究表明，多部门干预未能 解决感染艾滋病毒的寡妇遭受羞辱的经历，需要进一步研究 艾滋病毒感染妇女的污名化问题以及解决污名化问题的干预措施。Odhiambo女士的作品 根据污名化理论，这是人口健康差异的根本原因。耻辱感造成了 社会和经济资源、日益严重的粮食不安全、贫困和健康状况不佳。 优势和创新：这项补充研究是第一个评估 非洲感染艾滋病毒的老年妇女经历了交叉的耻辱和生活质量。其次我们 将采用日常歧视量表（EDS），这是在美国背景下开发的另一种量表，并将其用于 肯尼亚当地的情况来衡量经历过的交叉污名。EDS的设计具有适应性， 可以衡量不同形式的耻辱。第三，我们将从一个 基于人群的健康和人口统计学监测系统，确保研究参与者具有代表性 50岁以上感染艾滋病毒的妇女总人口样本。这一行政 补助金将支持Odhiambo女士从博士过渡到博士后研究，同时仍接受 来自母公司的团队指导授予多个主要调查员。这项研究还将产生一些想法 Odhiambo女士可以在未来进一步发展和测试的干预措施， 格兰特. Odhiambo女士正在成为下一代跨学科的艾滋病毒研究人员。 在公共卫生，艾滋病毒健康和发展科学的专业知识，这一补充申请将支持 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.