HIV acquisition and transmission: Multi-level longitudinal analysis, South Africa

摘要 艾滋病毒/艾滋病大流行对社会的影响是史无前例的。 人类历史。在全球，有4000万人感染艾滋病毒/艾滋病，其中绝大多数 在撒哈拉以南非洲。开发和实施的先决条件 预防干预是对谁处于危险之中以及为什么处于危险的理解。许多 个人、他们所在的社区以及感染本身的特征 有助于确定暴露和收购的风险以及多重因果关系 存在着将社会、人口、经济、文化和行为联系起来的途径 变量。虽然在理解病毒的传播方面已经取得了许多进展 从对不同人群中的个体风险因素的研究中获得的艾滋病毒，很多都是 仍然不知道为什么人群经历了不同的流行病，以及 将高风险的驱动因素与简单地与风险相关的变量进行比较。 该项目将使用一个多层次的框架来更好地理解因果关系 农村地区的艾滋病毒感染(包括感染的获得和传播) 以人口为基础的调查衡量艾滋病毒的南非环境 某些年龄段的患病率为50%。这项研究的目的是识别和量化 重要的环境、社区、家庭和个人层面的决定因素 艾滋病毒发病率和流行率，为干预策略提供信息。特别强调 被放在当地社区的层面上，这被视为对 了解疫情的传播情况并作出有效的预防工作。项目叙事 能够实施有效的干预措施，更好地了解 艾滋病毒流行具有复杂的多层次性质是必要的。拟议的研究 将有助于更好地了解艾滋病毒感染的致病途径 以及量化重要的环境、社区、家庭和个人层面 艾滋病毒感染的决定因素。这些信息可以用来指导有效的 预防工作。

Summary The impact of the HIV/AIDS pandemic on societies is without precedent in recorded human history. Globally, 40 million people are living with HIV/AIDS, the vast majority in sub-Saharan Africa. A prerequisite for the development and implementation of prevention interventions is an understanding of who is at risk and why. Many characteristics of the individual, the community they are from and the infection itself contribute to determining the risk of exposure and acquisition and multiple causal pathways exist linking social, demographic, economic, cultural and behavioural variables. Whilst many advances have been made in understanding the spread of HIV from studies of individual risk factors in a diverse range of populations, much is still unknown about why populations have experienced different epidemics, and what the drivers of high risk are compared with variables that simply correlate with risk. The project will use a multi-level framework to better understand the causal pathways of HIV infection (both in terms of acquisition and transmission of infection) in a rural South African setting where population-based surveys have measured HIV prevalence at >50% in some age-groups. The research aims to identify and quantify important environmental, community, household and individual-level determinants of HIV incidence and prevalence to inform intervention strategies. Particular emphasis is placed at the level of the local community which is seen as being vital both to understanding the spread of the epidemic and to effective prevention efforts. Project narrative To be able to implement effective interventions a greater understanding of the complex multi-level nature of the HIV epidemic is necessary. The proposed research will lead to a greater understanding of causal pathways of HIV infection by identifying and quantifying important environmental, community, household and individual-level determinants of HIV infection. This information can be used to guide effective prevention efforts.