The Effects of HIV/AIDS Stigma on Use of Services by Pregnant Women in Kenya

艾滋病毒/艾滋病耻辱对肯尼亚孕妇使用服务的影响

• 批准号: 7893174
• 负责人: Janet M Turan
• 金额: $ 16.79万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-08-11 至 2011-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7893174
• 关键词: AIDS prevention; AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; Adult; Adverse effects; Affect; Africa; Africa South of the Sahara; African; Award; Caring; Centers for Disease Control and Prevention (U.S.); Childbirth; Collaborations; Communities; Country; Data; Depreciation; Discrimination; Education; Family; Fright; Funding; Goals; HIV; HIV Infections; HIV Seropositivity; Health; Health Services; Health care facility; Human immunodeficiency virus test; Individual; Infant; Intervention; Interview; Kenya; Life; Light; Literature; Maternal Health; Measures; Medical Records; Medical Research; Mental Health; Mentored Research Scientist Development Award; Mentorship; Perception; Persons; Pilot Projects; Postpartum Period; Pregnancy; Pregnant Women; Prevention; Prospective Studies; Province; Public Health; Qualitative Research; Randomized; Reproductive Health; Research; Research Methodology; Research Personnel; Research Training; Resources; Risk; Role; Services; Social Sciences; Statistical Methods; Stigmata; Structure; Testing; Training Programs; Vertical Disease Transmission; Woman; Work; arm; base; care delivery; career; child bearing; design; effective intervention; experience; improved; mortality; pregnant; response; social stigma; therapy development; uptake

DESCRIPTION (provided by applicant): My career goal is to conduct research that contributes to improvements in maternal health in low-resource settings through reduction of the adverse effects of HIV/AIDS on the physical and mental health of pregnant and childbearing women. For this K01 Award, I am proposing research and training on the role of HIV/AIDS stigma as a barrier to utilization of essential maternity and HIV services by pregnant women in Africa. This award will facilitate my transition from a background in maternal and reproductive health, to an independent investigator focusing on HIV/AIDS stigma and its effects on maternal health in Africa. My goals are to gain expertise in social science approaches to the study of stigma, advanced statistical methods for analyzing longitudinal and clustered data, the cultural context of HIV/AIDS in Africa, and intervention development. I propose to conduct a prospective study in Kenya using structured interviews and data from medical records, as well as a qualitative study using in-depth interviews. The aims are: 1) to identify the effects of anticipated stigma and perceived community stigma on acceptance of HIV testing among pregnant women who use ANC services, 2) to prospectively investigate the effects of anticipated stigma and perceived community stigma on pregnant women's subsequent use of ANC, delivery, and postpartum services, 3) to investigate whether stigma can shed light on the mechanisms through which ANC and HIV service integration may affect HIV-positive pregnant women's use of maternity and HIV services, and 4) to use qualitative research methods to elucidate the role of HIV/AIDS stigma as a barrier to health service use among women in the community who do not use facility-based maternity services. My research will be conducted in conjunction with a CDC-funded study to be carried out by the Kenya Medical Research Insititute-UCSF Collaborative Group and will take advantage of the resources of that larger study. The proposed program of training and research will prepare me to design and test an intervention for reducing HIV/AIDS stigma and discrimination experienced by pregnant women in Kenya. This research will contribute to public health efforts to improve the health of pregnant women in low-resource settings. HIV/AIDS stigma may constitute an important barrier to pregnant women's use of health services and efforts to understand and reduce HIV/AIDS stigma will have important implications for HIV prevention and treatment, as well as for maternal health and mortality.

描述（由申请人提供）：我的职业目标是进行研究，通过减少艾滋病毒/艾滋病对孕妇和育龄妇女身心健康的不利影响，有助于改善低资源环境中的孕产妇健康。对于这个K 01奖，我建议研究和培训艾滋病毒/艾滋病耻辱感的作用，这是非洲孕妇利用基本孕产和艾滋病毒服务的障碍。这一奖项将有助于我从孕产妇和生殖健康的背景过渡到一个独立的调查员，专注于艾滋病毒/艾滋病的耻辱及其对非洲孕产妇健康的影响。我的目标是获得专业知识的社会科学方法来研究耻辱，先进的统计方法分析纵向和集群数据，艾滋病毒/艾滋病在非洲的文化背景，和干预发展。我建议在肯尼亚进行一项前瞻性研究，使用结构化访谈和医疗记录中的数据，以及使用深入访谈的定性研究。其目标是：1）确定预期耻辱和感知社区耻辱对使用ANC服务的孕妇接受HIV检测的影响，2）前瞻性调查预期耻辱和感知社区耻辱对孕妇随后使用ANC，分娩和产后服务的影响，3）调查污名化是否可以揭示产前护理和艾滋病毒服务一体化可能影响艾滋病毒阳性孕妇使用孕产和艾滋病毒服务的机制，以及4）使用定性研究方法来阐明艾滋病毒/艾滋病污名化作为社区中不使用基于设施的孕产妇服务的妇女使用卫生服务的障碍的作用。我的研究将与CDC资助的一项研究一起进行，该研究将由肯尼亚医学研究所-UCSF合作小组进行，并将利用该大型研究的资源。拟议的培训和研究计划将使我准备设计和测试一种干预措施，以减少肯尼亚孕妇遭受的艾滋病毒/艾滋病羞辱和歧视。这项研究将有助于公共卫生工作，以改善资源匮乏环境中孕妇的健康。艾滋病毒/艾滋病的耻辱感可能是孕妇利用保健服务的一个重要障碍，努力了解和减少艾滋病毒/艾滋病的耻辱感将对艾滋病毒的预防和治疗以及产妇保健和死亡率产生重要影响。