Moving Beyond the Individual- A Data-driven Approach to Improving the Evidence on the Role of Community and Societal Determinants of HIV among Adolescent Girls and Young Women in Sub-Saharan Africa

超越个人——采用数据驱动的方法来改善关于艾滋病毒在撒哈拉以南非洲地区少女和年轻妇女中的社区和社会决定因素的作用的证据

• 批准号: 10619319
• 负责人: Domonique M Reed
• 金额: $ 4.47万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-03-01 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10619319
• 关键词: AIDS prevention; Acquired Immunodeficiency Syndrome; Address; Adolescent; Adolescent HIV risk; Advanced Development; Affect; Africa South of the Sahara; African American; Age; Algorithms; Area; Assessment tool; Attitude; Behavior; Behavioral Sciences; Biological; Cameroon; Censuses; Characteristics; Communities; Community Developments; Complex; Computing Methodologies; Country; Dangerousness; Data; Data Science; Data Set; Data Sources; Development; Disease Pathway; Disparate; Disparity; Education; Effectiveness; Environment; Epidemic; Epidemiology; Feedback; Female Adolescents; Fostering; Foundations; Future; Gender; Goals; HIV; HIV Infections; HIV Seropositivity; HIV disparities; HIV risk; Housing; Individual; Infection; Intervention; Knowledge; Laws; Malawi; Measurement; Mental Depression; Mentorship; Methodology; Mission; Modeling; National Institute of Mental Health; Pathway interactions; Pattern; Policies; Population; Prevention; Prevention Research; Prevention approach; Principal Investigator; Process; Psyche structure; Public Health; Recording of previous events; Research; Research Personnel; Research Priority; Risk; Risk Assessment; Risk Factors; Role; Rwanda; Science; Scientific Inquiry; Scientist; Sexually Transmitted Diseases; Social Processes; Societal Factors; Societies; Source; Structure; Techniques; Training; Transact; Uganda; Vulnerable Populations; aged; analytic epidemiology; analytical tool; big-data science; burden of illness; career; community-level factor; contextual factors; data integration; experience; health disparity; health seeking behavior; high risk; high risk sexual behavior; improved; innovation; interest; intervention effect; knowledge base; novel; population based; pre-exposure prophylaxis; preservation; preventive intervention; sex; structural determinants; therapy design; therapy development; trend; young woman

PROJECT SUMMARY/ABSTRACT Adolescent girls and young women (AGYW) in sub-Saharan Africa (SSA), the epicenter of the global HIV epidemic, have carried the primary burden of new HIV infections in this area for at least 30 years. Research has prioritized characterizing the individual predictors of HIV infection among AGYW by creating risk assessment tools that identify high-risk sub-populations for targeted HIV prevention efforts. Despite substantial efforts, there remains a disproportionate burden of disease among this vulnerable population, suggesting a need to identify and assess targets of intervention beyond the individual. The primary goals of this R36 dissertation proposal, Moving Beyond the Individual: A Data-driven Approach to Informing the Evidence on the Role of Community and Societal Determinants of HIV among Adolescent Girls and Young Women in Sub- Saharan Africa, are to create a comprehensive data source that will facilitate new ways of assessing HIV risk among AGYW, generating improved knowledge about individual, interpersonal, community, and societal risk factors; to characterize the interplay among these variables; and to assess the impact of interventions that target community and societal drivers of infection to inform improved prevention efforts. To achieve these goals, we propose three aims that will leverage publicly available, population-based data from five countries in SSA (Cameroon, Eswatini, Malawi, Rwanda, and Uganda) and apply advanced data science and epidemiologic methodologies. Aim 1 is to integrate publicly available data from the Population-based HIV Impact Assessment Project (individual, interpersonal, community), the Population and Housing Census (community), and UNAIDS Law and Policy Indicators (societal) to create a large, multi-level public health dataset. Aim 2 is to characterize and graphically depict the pathways among individual, interpersonal, community, and societal risk factors of HIV infection among AGYW using causal discovery algorithms to identify underlying disease pathways. Aim 3 is to estimate the impact of intervening on community and societal drivers of HIV infection among AGYW using parametric g-computation to model proposed intervention effects. To examine these aims, we will take a novel, intersectional approach to assess HIV behavioral science inquiries by leveraging causal discovery algorithms and g-computation. Findings from this research will advance the National Institute of Mental Health Division of AIDS Research’s priority to improve the knowledge base informing interventions, thereby advancing the development of interventions that go beyond the individual to reduce the burden of HIV among AGYW. The research and mentorship of this R36 proposal have been carefully crafted to optimize the ongoing doctoral training and research experience of the Principal Investigator of this study while fostering her development as an African American independent research scientist in the future.

项目摘要/摘要 撒哈拉以南非洲(SSA)的少女和年轻妇女(AGYW)，这是全球艾滋病毒的中心 至少30年来，这一流行病一直是这一地区新的艾滋病毒感染的主要负担。研究 通过制造风险，优先确定AGYW中艾滋病毒感染的个体预测因素的特征 为有针对性的艾滋病毒预防工作确定高危亚人群的评估工具。尽管有大量的 尽管作出了努力，但这一脆弱人群中的疾病负担仍然不成比例，这表明 需要确定和评估个人以外的干预目标。R36的主要目标是 论文提案，超越个体：一种数据驱动的方法来提供关于 青春期女孩和年轻妇女中HIV的社区和社会决定因素在亚裔中的作用 将创建一个全面的数据源，以促进评估艾滋病毒风险的新方法 在AGYW中，产生关于个人、人际、社区和社会风险的更好知识 因素；描述这些变量之间的相互作用；并评估干预措施的影响 以感染的社区和社会驱动因素为目标，为改进预防工作提供信息。要实现这些目标 目标，我们提出了三个目标，这三个目标将利用来自五个国家的公开可用、基于人口的数据 SSA(喀麦隆、Eswatini、马拉维、卢旺达和乌干达)，并应用先进的数据科学和 流行病学方法论。目标1是整合来自以人口为基础的艾滋病毒的公开数据 影响评估项目(个人、人际、社区)、人口和住房普查 (社区)和艾滋病规划署法律和政策指标(社会)，以创建一个大型、多层次的公共卫生 数据集。目标2是刻画和图形化地描绘个体、人际、 使用因果发现算法在AGYW中感染艾滋病毒的社区和社会风险因素 确定潜在的疾病途径。目标3是评估干预对社区和社会的影响 AGYW中HIV感染的驱动因素使用参数g计算来模拟拟议的干预效果。 为了检验这些目标，我们将采用一种新的、交叉的方法来评估艾滋病毒行为科学。 利用因果发现算法和g-计算进行查询。这项研究的发现将 推进国家精神卫生研究所艾滋病研究所艾滋病研究的重点提高认识 以告知干预措施为基础，从而推动超越个人的干预措施的发展 以减轻AGYW中艾滋病毒的负担。这项R36提案的研究和指导一直是 精心设计，以优化首席研究员正在进行的博士培训和研究经验 这项研究的同时促进了她作为一名非裔美国独立研究科学家在 未来。