Gendered Social Context of Adolescent HIV Risk Behavior in Ghana

描述（由申请人提供）：需要有效的干预措施来降低撒哈拉以南非洲青少年感染艾滋病毒的行为风险。有许多有希望的战略，但选择这些战略的证据基础仍然有限。我们提出了一种混合方法的调查，将焦点小组讨论（FGD）和深入访谈（IDI）与加纳东南部三个社区的青年及其父母的纵向队列研究（LCS）相结合，以确定性别育儿实践，同龄人群体规范，以及其他因素与个体发育过程和当地流行病学环境相互作用，形成新的性行为模式这些社区的年轻人。最初的FGD将被用来描述父母为青少年所持有的性行为的性别化理想，以及这些社区中青少年同龄人群体中普遍存在的性和浪漫行为的性别化规范，并将为LCS的仪器设计提供信息。LCS将包括一个较年轻的队列（第1波时年龄为13 - 14岁，第3波时年龄为16 - 17岁，N = 900）和一个较年长的队列（第1波时年龄为18 - 19岁，第3波时年龄为21 - 22岁，N = 900），他们将与父母/护理人员一起沿着，每隔18个月接受3次访谈。女孩和男孩将按同等比例参加。LCS访谈将包括育儿实践，同伴影响，宗教和宗教信仰，性别人格特征，性别角色态度，生命历程期望和性行为等模块。分析策略包括广义验证性因素分析、增长曲线建模、生存分析、倾向分层和潜在类建模，以回答特定的研究问题。低风险和高风险LCS参与者的后续IDIs将用于进一步了解青春期女孩和男孩用于导航父母和同伴影响以及艾滋病毒威胁的策略。这三个研究社区的特点是当地艾滋病毒流行率的巨大变化，使我们能够评估流行病学的情况如何影响青少年的性行为。该项目以宾夕法尼亚州立大学人口研究所和加纳大学区域人口研究所之间的现有合作为基础，将有助于提高这两个机构对撒哈拉以南非洲青少年进行纵向人口研究的能力。研究结果将分发给一些科学和健康促进受众，我们将把我们的研究结果转化为适合于为加纳和撒哈拉以南非洲其他地区的青少年人口设计有效干预措施的概念。 公共卫生相关性：需要采取有效的干预措施，以减少撒哈拉以南非洲青少年感染艾滋病毒的行为风险，尽管存在许多有希望的战略，但在这些战略中进行选择的证据基础仍然有限。我们提出了一种混合方法的调查，整合焦点小组讨论和深入访谈的三波纵向队列研究的青年和他们的父母在加纳东南部的三个社区。我们的目标是确定的方式，性别养育的做法，同龄人群体的规范，和其他因素与个人的发展过程和当地流行病学的情况下，塑造新兴的模式，在这些社区的青年之间的性行为，并将我们的研究结果转化为概念，适合于设计有效的干预措施，在这些人群。

DESCRIPTION (provided by applicant): Effective interventions are needed to reduce behavioral risk for HIV among adolescents in sub-Saharan Africa. Numerous promising strategies exist, but the evidentiary basis for choosing among them remains limited. We propose a mixed-methods investigation that integrates focus group discussions (FGDs) and in-depth interviews (IDIs) with a longitudinal cohort study (LCS) of youth and their parents in three communities in southeastern Ghana to identify the ways in which gendered parenting practices, peer group norms, and other factors interact with individual developmental processes and local epidemiological circumstances to shape emerging patterns of sexual behavior among youth in these communities. Initial FGDs will be used to characterize the gendered ideals of sexual behavior that parents hold for their adolescents and the gendered norms of sexual and romantic behavior that prevail among adolescent peer groups in these communities, and will inform the design of instrumentation for the LCS. The LCS will include a younger cohort (aged 13 to 14 years at Wave 1 and 16 to 17 years by Wave 3, N = 900) and an older cohort (aged 18 to 19 years at Wave 1 and 21 to 22 years by Wave 3, N = 900) who, along with their parents/caregivers, will be interviewed three times at 18-month intervals. Girls and boys will be included in equal proportions. LCS interviews will include modules on parenting practices, peer influences, religion and religiosity, gendered personality traits, gender role attitudes, life course expectations, and sexual behaviors. Analytic strategies include generalized confirmatory factor analysis, growth curve modeling, survival analysis, propensity stratification, and latent class modeling to answer specific research questions. Follow-up IDIs with low-risk and high-risk LCS participants will be used to gain further insight into the strategies that adolescent girls and boys use to navigate parental and peer influences and the threat of HIV. The three study communities are characterized by dramatic variations in localized HIV prevalence, allowing us to assess how epidemiological circumstances impinge upon adolescent sexual behavior. The project builds upon an existing collaboration between the Population Research Institute at Penn State University and the Regional Institute for Population Studies at the University of Ghana, and will contribute to the capacity of both institutions to conduct longitudinal demographic research with adolescents in sub-Saharan Africa. Results will be disseminated to several scientific and health promotion audiences, and we will translate our findings into concepts appropriate for the design of effective interventions for adolescent populations in Ghana and elsewhere in sub-Saharan Africa. PUBLIC HEALTH RELEVANCE: Effective interventions are needed to reduce behavioral risk for HIV among adolescents in sub-Saharan Africa, and although numerous promising strategies exist, the evidentiary basis for choosing among these strategies remains limited. We propose a mixed-methods investigation that integrates focus group discussions and in-depth interviews with a three-wave longitudinal cohort study of youth and their parents in three communities in southeastern Ghana. Our goals are to identify the ways in which gendered parenting practices, peer group norms, and other factors interact with individual developmental processes and local epidemiological circumstances to shape emerging patterns of sexual behavior among youth in these communities, and to translate our findings into concepts appropriate for the design of effective interventions in these populations.