Alcohol, Risky Behavior, and HIV/AIDS in Zimbabwe

描述（改编自申请人的摘要）：艾滋病毒正在撒哈拉以南非洲地区以高速度增长（联合国艾滋病规划署/世界卫生组织，2001年）。目前估计撒哈拉以南非洲有2850万成人和儿童感染艾滋病毒/艾滋病（联合国艾滋病规划署2002年a）。津巴布韦是艾滋病毒感染率最高的国家之一，估计有33.7%的15至49岁的成年人呈艾滋病毒阳性（联合国艾滋病规划署2002年）。在津巴布韦和撒哈拉以南非洲其他地区，艾滋病毒的主要传播方式已得到充分记录。虽然酒精使用似乎影响艾滋病毒风险行为，但对撒哈拉以南非洲同时使用酒精和艾滋病毒/艾滋病风险行为的原因和后果知之甚少。在撒哈拉以南非洲，人们对酒精对艾滋病毒/艾滋病疾病进展的影响了解得更少。拟议的研究将通过调查个人和环境因素如何影响津巴布韦农村地区酒精使用和危险行为的同时发生以及艾滋病毒感染和疾病进展来解决这些研究空白。这项研究将在两年的时间里研究以下因素对艾滋病毒感染风险的影响过程：典型的酒精使用；行为信念、态度、社会规范、保护因素和障碍以及在危险行为之前使用酒精的意图；酒精使用与危险行为同时发生；其他个人因素；特征的关系;以及津巴布韦农村地区的社区状况。该研究还将评估民意领袖社区一级干预模式对典型酒精使用、行为信念、社会规范、酒精和危险行为同时发生的保护因素和障碍以及两年期间艾滋病毒感染风险的影响。最后，该研究将调查在两年的时间里，典型的酒精使用、合并症（HBV、HCV）、其他个人因素、家庭支持、卫生保健使用和社区特征如何影响HIV/AIDS疾病的进展。拟议的项目将利用正在进行的ZiCHIRe研究创造的机会，在两年的时间里，从津巴布韦农村32个村庄的约5440人（18至30岁）的三个时间点收集额外的调查和生物数据。拟议的研究将更好地了解酒精使用如何影响资源贫乏国家的艾滋病毒感染风险和艾滋病毒/艾滋病疾病进展，可用于制定更有效的政策，以减少艾滋病毒/艾滋病在撒哈拉以南非洲的传播和影响。

DESCRIPTION (adapted from the applicant's abstract): HIV is increasing at high rates across sub-Saharan Africa (UNAIDS/WHO 2001). Current estimates are that 28.5 million adults and children are living with HIV/AIDS in sub-Saharan Africa (UNAIDS 2002a). Zimbabwe has one of the highest levels of HIV infection with an estimated 33.7% of adults 15 to 49 years old being HIV positive (UNAIDS 2002). The predominant mode of HIV transmission has been well documented in Zimbabwe and other parts of sub-Saharan Africa. While alcohol use appears to influence HIV risk behaviors, little is known about the causes and consequences of concurrent alcohol use and risky behavior for HIV/AIDS in sub-Saharan Africa. Even less is known about alcohol effects on HIV/AIDS disease progression in sub-Saharan Africa. The proposed study will address these research gaps by investigating how individual and environmental factors influence the concurrence of alcohol use and risky behavior, as well as HIV infection and disease progression, in rural Zimbabwe. The study will examine the process through which the risk of HIV infection is influenced over a two-year period by: typical alcohol use; behavioral beliefs, attitudes, social norms, protective factors and barriers, and intentions regarding the use of alcohol before risky behavior; concurrence of alcohol use and risky behavior; other individual factors; relationship characteristics; and, community conditions in rural Zimbabwe. The study also will evaluate the impact of a public opinion leader community-level intervention model on typical alcohol use, behavioral beliefs, social norms, and protective factors and barriers to concurrence of alcohol and risky behavior, and the risk of HIV infection over a two-year period. Finally, the study will investigate how HIV/AIDS disease progression is affected by typical alcohol use, co-morbidities (HBV, HCV), other individual factors, family support, health care use, and community characteristics over a two-year period. The proposed project will capitalize on an opportunity created by the ongoing ZiCHIRe study to collect additional survey and biological data at three time points over a two-year period from approximately 5,440 individuals (18 to 30 years old) across 32 villages in rural Zimbabwe. The proposed study will provide a better understanding of how alcohol use influences the risk of HIV infection and HIV/AIDS disease progression in resource-poor countries that can be used to develop more effective policies to reduce the spread and impact of HIV/AIDS in sub-Saharan Africa.