Effects of Family Environment on HIV Risk Behavior in Ugandan Females, ages 15-19

家庭环境对 15-19 岁乌干达女性艾滋病毒危险行为的影响

• 批准号: 7811383
• 负责人: Nanlesta Autumn Pilgrim
• 金额: $ 4.14万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-01-20 至 2011-06-19
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7811383
• 关键词: AIDS prevention; Address; Adolescent; Affect; Africa South of the Sahara; Age; Belief; Cessation of life; Characteristics; Cohort Studies; Communities; Data; Data Analyses; Development; Dimensions; Disadvantaged; Education; Effectiveness; Environment; Equation; Family; Female; Female Adolescents; HIV; HIV Infections; Health Sciences; Home environment; Household and Family; Male Adolescents; Measures; Mediating; Modeling; Multiple Partners; Multivariate Analysis; Pathway interactions; Personal Satisfaction; Play; Policies; Population Study; Prevention; Public Health; Publishing; Research; Risk; Risk Behaviors; Role; Rural; Sexual Partners; Socioeconomic Status; Structure; Surveys; Survival Analysis; Time; Uganda; base; cohort; condoms; epidemiological model; experience; family influence; programs; sex; sex risk; sexual coercion; sexual debut; therapy design

DESCRIPTION (provided by applicant): Prevention of HIV infection in adolescent females is a continuing public health problem globally, especially in sub-Saharan Africa, where adolescent females are three times more likely to be HIV-infected than adolescent males. Recent studies have shown that adolescent females who are sexually vulnerable are at greater risk of HIV than those who are not sexually vulnerable. Based on published data from Rakai, sexual vulnerability is defined as early sexual debut, experiencing sexual coercion and engaging in cross- generational sex. Despite such advances, few studies have examined the factors that make adolescent females sexually vulnerable in sub-Saharan Africa. The proposed study theorizes that the family environment plays an integral role in adolescent females' sexual vulnerability as well as sexual risk behaviors. Studies have not longitudinally explored the influence of family environment on sexual vulnerability internationally nor have studies investigated the pathways through which family environment might affect HIV sexual risk behavior in female adolescents. Using 15 years of longitudinal data from the Rakai Health Sciences Program community cohort study (RCCS) in rural southwestern Uganda, the proposed study will use secondary data analysis to examine the influence of family environment on sexual risk behavior among females, ages 15 to 19. The specific aims of this study are to: 1) examine the effects of family environment on female adolescents' sexual vulnerability and 2) examine whether the pathway in which family environment affects female adolescent's HIV sexual risk is direct or is mediated by the adolescent sexual vulnerability status. The study populations are females who were a part of the RCCS during their adolescent years between 2002 and 2008. Using answers from the annual survey administered to the cohort, HIV-sexual risk behaviors will be measured as use of condoms and having multiple sexual partners and family environment will be operationalized in terms of eight dimensions, such as structure, size and presence of HIV in the home. Study aims will be addressed using generalized estimation equation analyses, survival analyses, structural equation models and epidemiological models. Findings will inform efforts to protect female adolescents from sexually vulnerable situations and to reduce HIV prevention efforts among adolescents, especially in developing settings. It will add to research on how families and households affect adolescent well-being and development. The results can enhance the effectiveness of HIV intervention designs that employ multiple levels of influence in similar settings as well as inform policies and create programs that incorporate the family into their initiatives.

描述（由申请人提供）：预防青少年女性感染艾滋病毒是全球持续存在的公共卫生问题，特别是在撒哈拉以南非洲，那里的青少年女性感染艾滋病毒的可能性是青少年男性的三倍。最近的研究表明，性脆弱的少女感染艾滋病毒的风险比性脆弱的少女更大。根据Rakai公布的数据，性脆弱性被定义为过早的性行为，经历性强迫和从事跨代性行为。尽管取得了这些进展，但很少有研究调查撒哈拉以南非洲地区的少女易受性侵害的因素。本研究认为，家庭环境在青春期女性的性脆弱性和性风险行为中起着不可或缺的作用。国际上尚未有研究纵向探讨家庭环境对性脆弱性的影响，也没有研究调查家庭环境可能影响女性青少年艾滋病毒性风险行为的途径。利用乌干达西南部农村Rakai健康科学项目社区队列研究（RCCS） 15年的纵向数据，这项拟议的研究将使用二次数据分析来检查家庭环境对15至19岁女性性风险行为的影响。本研究的具体目的是：1)检验家庭环境对女性青少年性脆弱性的影响；2)检验家庭环境对女性青少年HIV性风险的影响途径是直接的还是由青少年性脆弱性状况介导的。研究对象是2002年至2008年青少年时期参与RCCS计划的女性。使用对队列进行的年度调查的答案，艾滋病毒性风险行为将被衡量为使用避孕套，拥有多个性伴侣和家庭环境将在八个方面进行操作，例如家庭结构，规模和艾滋病毒的存在。研究目的将使用广义估计方程分析、生存分析、结构方程模型和流行病学模型来解决。研究结果将为保护女性青少年免受性脆弱处境的努力提供信息，并减少青少年，特别是发展中国家青少年的艾滋病毒预防工作。它将增加对家庭和家庭如何影响青少年福祉和发展的研究。研究结果可以提高在类似环境中运用多层次影响的艾滋病毒干预设计的有效性，并为政策提供信息，并制定将家庭纳入其倡议的方案。