Adapting a Social Network-based Concurrency Intervention for Kenyan Adolescents

描述（由申请人提供）：美国国立卫生研究院艾滋病研究办公室在不同的国际环境和人群中优先发展和评估文化上适当的干预措施。发现正确的预防工具以成功地防治艾滋病毒是一项全球当务之急，因为新感染病例比治疗病例多2:1。联合国艾滋病规划署估计，55%的新感染发生在25岁以下的人群中，并发出了一项全球行动呼吁，要求将儿童和青少年作为制定和实施新的艾滋病毒预防工作的中心。这项提案通过让青少年和他们的社区领袖参与“了解你的网络”（KYN）来实现这一目标。KYN是一项艾滋病毒预防干预措施，旨在提高人们对同时（或重叠）性伙伴关系在艾滋病毒传播中的作用的认识。据估计，肯尼亚全国艾滋病毒感染率为6.3%，艾滋病毒在各族裔群体中的分布存在显著差异。艾滋病病毒在肯尼亚九个主要民族中的流行率从索马里的不到1%到卢奥的20%不等。艾滋病毒感染在年轻的老挝的高流行率尤其令人震惊：最近的一项研究发现，艾滋病毒在13-14岁女性中的流行率从1.5%上升到15-19岁女性的8.6%，在20-24岁女性中上升到33.7%。男性在各年龄段的患病率增加较慢，从13-19岁男性的<1%，到20-24岁男性的10.4%，到25-29岁男性的30%。这些发现强调了对罗族青少年进行艾滋病毒预防干预的迫切需要，以解决其社区中艾滋病毒流行的驱动因素，其中之一是并发性。研究目的：了解罗族青少年的性伙伴关系模式及其形成的社会文化背景，以确定如何将“了解你的网络”这一基于社区的干预措施适当地用于该青少年群体的预防工具。本研究的目的是：1)描述洛族青少年的性伙伴关系模式及其形成的社会文化背景，并确定适应KYN干预的意义；2)评估适应KYN干预的可行性和可接受性。方法：目标1将通过整合近期科学文献的系统综述和利用Amornkul等人收集的现有调查数据对罗族青少年并发性行为的二次分析来完成。目标2将通过与13-17岁的成年人和青少年分别进行的重点小组讨论来实现。

DESCRIPTION (provided by applicant): The NIH Office of AIDS Research has prioritized the development and evaluation of culturally appropriate interventions in different international settings and populations. Discovering the right prevention tools to successfully combat HIV is a global imperative with new infections outpacing treated cases by a ratio of 2:1. UNAIDS estimates that 55% of new infections occur in persons younger than 25, and has issued a global call to action for making children and adolescents central to the development and implementation of new HIV prevention efforts. This proposal meets that goal by involving adolescents and their community leaders in the adaptation of "Know Your Network" (KYN), an HIV prevention intervention that raises awareness about the role of concurrent (or overlapping) sexual partnerships in the spread of HIV. Kenya has an estimated 6.3% national HIV prevalence and significant disparities in the distribution of HIV across ethnic groups. HIV prevalence among Kenya's nine major ethnic groups ranges from less than 1% in the Somali to 20% in the Luo. The high prevalence of HIV infection in young Luos is particularly alarming: a recent study found the prevalence of HIV increased from 1.5% in females aged 13-14 to 8.6% in females aged 15-19, and to 33.7% for women aged 20-24. Prevalence across age cohorts increased in males more slowly, from <1% in males aged 13-19, to 10.4% in males aged 20-24, and 30% in males aged 25-29. These findings underscore the critical need for HIV prevention interventions for Luo adolescents that address the drivers of the HIV epidemic in their communities, one of which is concurrency. Study Purpose: to gain understanding of Luo adolescents' sexual partnership patterns and the sociocultural context in which they form to determine how "Know Your Network," a community-based intervention, might be appropriately adapted for use as a prevention tool with this adolescent population. The study aims are to: 1) Describe Luo adolescents' sexual partnership patterns and the socio-cultural context in which they form, and identify implications for adaptations to the KYN intervention, 2) Assess the feasibility and acceptability of the adapted KYN intervention for youth. Methods: Aim 1 will be accomplished by integrating a systematic review of recent scientific literature with a secondary analysis of concurrency among Luo adolescents using existing survey data collected by Amornkul et al. Aim 2 will be accomplished using focused group discussions conducted separately with adults and adolescents aged 13-17. PUBLIC HEALTH RELEVANCE: HIV/AIDS is a leading cause of illness and premature death worldwide, and has reversed gains in human development. Some populations experience a disproportionate burden of HIV infection, and it is in these populations that HIV is spreading fastest. This project involves Kenyan adolescents, their families, and community in the adaptation of a new HIV prevention intervention for use adolescents at high risk of HIV infection.