Community factors shaping the sexual behavior of males

描述（由申请人提供）：背景：针对男性是阻止艾滋病毒的异性传播的关键，尽管人们对影响男性性行为的个人和家庭因素给予了很大的关注，但社区因素在塑造男性性行为中的作用仍然知之甚少。目的：我们将评估加纳、尼日利亚、赞比亚和津巴布韦四个国家的社区环境的几个方面对异性恋男性性行为的影响。数据和方法：分析样本是来自加纳（2003年）、尼日利亚（2003年）、赞比亚（2001- 2002年）和津巴布韦（1999年）最近人口和健康调查的性活跃男性（15-54岁）。社区层面的变量代表经济繁荣，性别规范，流行的人口和性行为，并在社区中的医疗保健信息的曝光将进行检查。一个多层次的建模策略将被应用到确定的作用，社区层面的特点，在塑造男性性行为。重要性：以往的男性性行为研究只考察了社会中单一因素的作用，本研究创新地提出了社会整体观的概念，考察了经济、社会和规范性社会特征在决定男性性行为中的作用。这项研究将提供关于社区的物理、行为、社会和规范环境的特征与男性性行为之间的关联的信息，并将展示通过个人特征介导社区因素以塑造个人性行为的方式，提供将直接影响针对异性恋男性的健康干预措施的发展的新信息。除了加强社区对健康影响的科学领域外，这项研究还将引起人们对审查社区对其他健康结果的影响的兴趣，并将导致更大的动力来改善社区一级数据的收集。创新的方法和社区的概念化可以用来检查在国内和国际环境中的其他健康成果。该研究还将确定可用于制定公共卫生干预措施的社区特征，加强公共卫生实践，以改善旨在减少异性恋艾滋病毒传播的计划和政策。

DESCRIPTION (provided by applicant): Background: Targeting men is essential in stemming the heterosexual transmission of HIV and although much attention has been given to the individual and familial factors that influence male sexual behavior, the role of community factors in shaping male sexual behavior remains poorly understood. Objectives: We will estimate the influence of several dimensions of the community environment on the sexual behavior of heterosexual males in four countries: Ghana, Nigeria, Zambia and Zimbabwe. Data and Method: The analysis samples are sexually active males (15-54) from the latest Demographic and Health Surveys from Ghana (2003), Nigeria (2003) and Zambia (2001-02) and Zimbabwe (1999). Community level variables representing economic prosperity, gender norms, prevailing demographic and sexual behaviors, and exposure to health care messages in the community will be examined. A multilevel modeling strategy will be applied to identify the role of community level characteristics in shaping male sexual behavior. Significance: Previous studies of male sexual behavior have examined only the role of single elements of the community; this research is innovative in it's conceptualization of a holistic view of the community, examining the role of economic, social and normative community characteristics in determining male sexual behavior. This research will provide information on the associations between characteristics of a community's physical, behavioral, social and normative environment and male sexual behavior, and will demonstrate ways in which community factors are mediated by individual characteristics to shape individual sexual behavior, providing new information that will directly influence the development of health interventions aimed at heterosexual males. In addition to strengthening the scientific field of community influences on health, the research will generate interest in examining community influences on other health outcomes, and will lead to a greater motivation to improve the collection of community level data. The innovative methodology and conceptualization of the community can be employed to examine other health outcomes in both domestic and international settings. The research will also identify community characteristics that can be harnessed in the development of public health interventions, strengthening public health practice for the improvement of program and policy aimed at reducing heterosexual HIV transmission.