Community Influences on Young People's HIV/AIDS Knowledge, Attitudes & Practices

说明（由申请人提供）：背景：以年轻人为目标是战胜全球艾滋病毒/艾滋病流行病的关键，尽管对影响年轻人的知识、态度和性行为的个人和家庭因素给予了很多关注，但对社区结构因素的作用仍然知之甚少。目标：我们将在布基纳法索、加纳和赞比亚这三个国家估计社区环境的几个方面对青年人对艾滋病毒/艾滋病的知识、对其他艾滋病毒/艾滋病患者的态度和最近的性行为的影响。数据和方法：分析样本为来自布基纳法索（2003年）、加纳（2003年）和赞比亚（2001- 2002年）最新人口与健康调查的男性和女性（15-24岁）。将审查代表经济繁荣、性别规范和不平等、保健基础设施和知识、社区态度和行为的社区一级变量。将采用多层次建模策略来确定社区层面特征在年轻人对艾滋病毒/艾滋病的认识、他们对其他艾滋病毒/艾滋病患者的态度以及他们最近的性行为方面的作用。意义：以往对年轻人的知识、态度和行为的研究只考察了社区中单一元素的作用；这项研究的创新之处在于其对社区整体观点的概念化，研究了经济、社会和规范社区特征在决定年轻人的知识、态度和行为方面的作用。这项研究将提供关于社区的物质、行为、社会和规范环境特征与年轻人的知识、态度和行为之间关系的新信息。除了加强社区对健康的影响这一科学领域外，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，并将导致更大的动机来改进社区一级数据的收集。社区的创新方法和概念化可用于审查国内和国际环境中的其他健康结果。这项研究还将确定可用于制定公共卫生干预措施的社区特点，加强公共卫生做法，以改进旨在减少艾滋病毒在年轻人中传播的方案和政策。

DESCRIPTION (provided by applicant): Background: Targeting young people is essential in defeating the global HIV/AIDS epidemic and although much attention has been given to the individual and familial factors that influence the knowledge, attitudes and sexual behavior of young people, the role of structural elements of the community remains poorly understood. Objectives: We will estimate the influence of several dimensions of the community environment on a young person's knowledge of HIV/AIDS, attitudes towards others with HIV/AIDS and recent sexual behaviors in three countries: Burkina Faso, Ghana and Zambia. Data and Method: The analysis samples are males and females (15-24) from the latest Demographic and Health Surveys from Burkina Faso (2003), Ghana (2003) and Zambia (2001-02). Community level variables representing economic prosperity, gender norms and inequalities, the health care infrastructure and knowledge, attitudes and behaviors in the community will be examined. A multilevel modeling strategy will be applied to identify the role of community level characteristics in young people's knowledge of HIV/AIDS, their attitudes to others with HIV/AIDS, and their recent sexual behaviors. Significance: Previous studies of young people's knowledge, attitudes and behaviors have examined only the role of single elements of the community; this research is innovative in its conceptualization of a holistic view of the community, examining the role of economic, social and normative community characteristics in determining young people's knowledge, attitudes and behaviors. This research will provide new information on the associations between characteristics of a community's physical, behavioral, social and normative environment and young people's knowledge, attitudes and behaviors. 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 HIV transmission among young people.