Preventing HIV Risk Among Adolescent Orphans in Kenya

预防肯尼亚青少年孤儿的艾滋病毒风险

• 批准号: 7752851
• 负责人: DENISE Dion HALLFORS
• 金额: $ 22.35万
• 依托单位: PACIFIC INSTITUTE FOR RES AND EVALUATION
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-01-08 至 2011-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7752851
• 关键词: AIDS prevention; AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; Adolescent; Adult; Affect; Africa South of the Sahara; African; Age; Area; Attitude; Award; Behavior; Behavior Control; Biological; Budgets; Cessation of life; Child; Coitus; Communities; Complex; Computer Assisted; Contracts; Control Groups; Country; Critiques; Data; Data Collection; Development; Devices; Disease; Dose; Education; Elderly; Electronics; Elements; Enrollment; Ethnic Origin; Ethnic group; Evaluation; Experimental Designs; Family; Female Adolescents; Food; Foundations; Funding; Future; Goals; Grant; HIV; Hand functions; Healthcare; High Prevalence; Human Rights; Infection; Intervention; Interview; Kenya; Knowledge; Language; Learning; Letters; Life; Link; Longitudinal Surveys; Manuals; Manuscripts; Measures; Modeling; National Institute of Child Health and Human Development; North Carolina; Orphan; Outcome; Parents; Phase; Pilot Projects; Population Study; Prevalence; Prevention; Principal Investigator; Process; Province; Puberty; Published Comment; Randomized; Recommendation; Research; Research Activity; Research Personnel; Resources; Risk; Risk Behaviors; School Enrollments; Schools; Self Administration; Self-Administered; Shelter facility; Site; Social Controls; Structure; Students; Suggestion; Supervision; Surveys; Technology; Teenagers; Testing; Time; Translating; Travel; UNICEF; USAID; Variant; Visit; Water; Work; Writing; Youth; Zimbabwe; aged; avoidance of risky sexual behavior; base; cost; delay sexual debut; experience; group intervention; high risk sexual behavior; high school; informant; insight; meetings; pandemic disease; prevent; programs; sex; sex risk; sexually active; skills; teacher; theories; university student

DESCRIPTION (provided by applicant): The AIDS pandemic has led to the illness and deaths of millions of adults in severely-affected countries, and has also led to millions of orphans. Worldwide, the number of children under age 18 who have lost one or both parents to AIDS stands at more than 15 million, and estimates are that this number will surpass 25 million by 2010. The vast majority - 11 million-of these children live in sub-Saharan Africa. As orphans reach puberty, they are more likely to become sexually active, placing them at risk of contracting HIV/AIDS themselves through sexual contact. This study will extend a comprehensive intervention ("Reach Out") to a neighboring community and test whether structural support for young adolescent orphans to continue school prevents HIV risk behaviors, over and above the provision of food, safe water, and health care. The study population is the Luo ethnic group in Nyanza Province, Kenya. The prevalence of HIV/AIDS among the Luo is 22%, 3 times higher than in Kenya as a whole. Specific aims for the proposed study are as follows: 1) To extend the Reach Out intervention to a neighboring community and test whether the school support elements delay sexual debut and prevent sexual risk behaviors, using an experimental design; and 2) To conduct a process evaluation of the extension of Reach Out and prepare a manual for further testing and replication. In order to test the effects of the school component on HIV prevention, 100 orphans, aged 13-14, will be randomized to intervention and control groups. The intervention group will receive the full Reach Out model; the control group will receive food and other basic needs, but not school support. Students will respond to a self administered longitudinal survey (Aim 1); Reach Out staff and other community informants will respond to qualitative interviews (Aim 2). Research activities will be jointly conducted by U.S. and Kenyan collaborators. The pilot study will provide a strong foundation for a larger replication and experimental testing of the Reach Out model for the prevention of HIV among orphans in other areas of Kenya and sub-Saharan Africa.

描述(申请人提供)：艾滋病大流行在受严重影响的国家已导致数百万成年人患病和死亡，还导致数百万孤儿。在世界范围内，因艾滋病失去单亲或双亲的18岁以下儿童人数超过1500万，估计到2010年这一数字将超过2500万。这些儿童中的绝大多数--1100万--生活在撒哈拉以南非洲。随着孤儿进入青春期，他们更有可能变得性生活活跃，从而使他们自己面临通过性接触感染艾滋病毒/艾滋病的风险。这项研究将把一项全面的干预扩展到邻近的社区，并测试对青少年孤儿继续上学的结构性支持是否能够防止艾滋病毒危险行为，而不仅仅是提供食物、安全水和医疗保健。研究人群为肯尼亚尼扬萨省的罗族人。Luo人的艾滋病毒/艾滋病流行率为22%，是肯尼亚整体的3倍。这项研究的具体目标如下：1)利用实验设计，将触达干预扩展到邻近社区，并测试学校支持要素是否延迟性首发期和防止性危险行为；以及2)对触达干预的扩展进行过程评估，并准备一份手册，以便进一步测试和复制。为了测试学校在预防艾滋病毒方面的效果，100名年龄在13-14岁的孤儿将被随机分为干预组和对照组。干预组将接受全面接触模式；控制组将获得食物和其他基本需求，但不会得到学校支持。学生将回答自我管理的纵向调查(目标1)；外展工作人员和其他社区线人将回答定性访谈(目标2)。研究活动将由美国和肯尼亚的合作者联合进行。试点研究将为在肯尼亚和撒哈拉以南非洲其他地区的孤儿中预防艾滋病毒的REACH OUT模式进行更大范围的复制和实验测试提供坚实的基础。

项目成果

Process and outcome evaluation of a community intervention for orphan adolescents in western Kenya.

• DOI: 10.1007/s10900-012-9548-x
• 发表时间: 2012-10
• 期刊: JOURNAL OF COMMUNITY HEALTH
• 影响因子: 5.9
• 作者: Hallfors, Denise D.;Cho, Hyunsan;Mbai, Isabella;Milimo, Benson;Itindi, Janet
• 通讯作者: Itindi, Janet