Intergenerational Intervention: Employing Youth to Promote Aging Healthy with HIV in Rural South Africa

代际干预：利用青年促进南非农村地区感染艾滋病毒的健康老龄化

• 批准号: 10619234
• 负责人: Nicole C Angotti
• 金额: $ 17.27万
• 依托单位: AMERICAN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-02-01 至 2025-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10619234
• 关键词: Acquired Immunodeficiency Syndrome; Address; Adult; Affect; Africa; Africa South of the Sahara; African; Age; Aging; Caring; Chronic; Chronic Disease; Communities; Cross-Sectional Studies; Data; Dimensions; Disease; Early Intervention; Elderly; Epidemic; Face; Family; Family Caregiver; Financial Contribution; Focus Groups; Funding; Gender; Generations; HIV; Health; Health Resources; Household; Household and Family; Human Resources; Interdisciplinary Study; Intervention; Interview; Labor Migrations; Leadership; Life; Life Cycle Stages; Link; Living Arrangement; Longitudinal Studies; Methods; Modeling; Older Population; Outcome; Parents; Pensions; Personal Satisfaction; Persons; Population; Province; Research; Resources; Respondent; Rural; Sampling; Services; Shapes; Site; Social isolation; Social support; South Africa; Spouses; Structure; Support System; Testing; Unemployment; United States National Institutes of Health; Viral; Youth; aged; aging in place; aging population; antiretroviral therapy; comorbidity; disability; evidence base; experience; improved; informant; innovation; intergenerational; longitudinal analysis; member; mortality; multiple chronic conditions; programs; randomized trial; response; rural South Africa; satisfaction; social capital; social determinants; success; therapy design; therapy development; trial design; young adult

PROJECT SUMMARY: South Africa’s rapidly growing population of older adults living with HIV (OPLHV) have suboptimal HIV-related outcomes, as they face a concomitant rise in levels of disability and chronic disease on top of a lack of HIV care and treatment interventions explicitly targeting older populations. With few alternatives to family-based care, most older Africans age in place, but with the “hollowed out” middle generation and high rates of labor migration, there is need to look elsewhere to seek the multi-dimensional support needed to age healthily. The proposed project aims to explore how an innovative intergenerational intervention could improve approaches to the management of HIV and related co-morbidities among OPLHV while offering opportunity to the younger generation in South Africa, where youth unemployment is a national concern, by employing youth to assist OPLHV in their communities. To shape early intervention development, the proposed formative and sequential mixed methods study aims to: 1) Identify the determinants of social support associated with aging healthy with HIV by gender and across the later life course—including ART management, management of multimorbidities, and life satisfaction—and how that support is moderated by household structure and composition, through longitudinal analysis of existing quantitative data from the NIH-funded study, Health and Aging in Africa: Longitudinal Studies of an INDEPTH Community; and 2) Elucidate how social support gaps can be strategically filled intergenerationally and inform a feasible intervention. This aim will be met using qualitative data with key intervention stakeholders, including a) in-depth interviews with older adults and their household member(s); b) semi-structured interviews with key informants from the community; and c) focus group discussions with youth. This project responds to the need to prepare for the growing population of adults aging with HIV and related co-morbidities while increasing the evidence base to support the design of interventions for OPLHV in diverse settings and subpopulations.

项目概要： 南非艾滋病毒感染者（OPLHV）老年人口数量迅速增长，其艾滋病毒相关结果并不理想，因为除了缺乏明确针对老年人群的艾滋病毒护理和治疗干预措施外，他们还面临着残疾和慢性病水平随之上升的问题。除了以家庭为基础的护理之外，大多数非洲老年人几乎没有其他选择，但随着中一代的“空心化”和高劳动力移民率，需要到其他地方寻求健康老龄化所需的多维支持。拟议项目旨在探索创新的代际干预措施如何改进艾滋病毒和 OPLHV 相关合并症的管理方法，同时为南非的年轻一代提供机会（青年失业是南非全国关注的问题），通过雇用年轻人协助社区中的 OPLHV。为了塑造早期干预措施的发展，拟议的形成性和序贯混合方法研究旨在：1）通过对 NIH 资助的非洲健康与老龄化研究的现有定量数据进行纵向分析，确定与艾滋病毒感染者健康老龄化相关的性别和整个生命历程的社会支持的决定因素，包括 ART 管理、多种疾病的管理和生活满意度，以及家庭结构和组成如何调节这种支持： INDEPTH 社区的纵向研究； 2) 阐明如何战略性地填补代际间的社会支持差距，并为可行的干预措施提供信息。这一目标将通过使用关键干预利益相关者的定性数据来实现，包括 a) 对老年人及其家庭成员的深入访谈； b) 对社区主要知情人进行半结构化访谈； c) 与青年进行焦点小组讨论。该项目满足了为日益增长的感染艾滋病毒和相关合并症的成年人口做好准备的需要，同时增加证据基础以支持在不同环境和亚人群中设计针对 OPLHV 的干预措施。