Adapting a Social Network-based Concurrency Intervention for Kenyan Adolescents

描述(由申请人提供)：国立卫生研究院艾滋病研究办公室优先考虑在不同的国际环境和人口中开发和评估文化上适当的干预措施。找到正确的预防工具来成功地与艾滋病毒作斗争是一项全球当务之急，因为新感染病例与治疗病例的比例为2：1。联合国艾滋病规划署估计，55%的新感染病例发生在25岁以下的人群中，并已发出全球行动呼吁，使儿童和青少年成为制定和实施新的艾滋病毒预防工作的核心。这项建议通过让青少年及其社区领导人参与“了解你的网络”(KYN)的改编来实现这一目标，KYN是一种艾滋病毒预防干预措施，旨在提高人们对同时(或重叠)的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很大差异。肯尼亚九个主要民族的艾滋病毒流行率从索马里人的不到1%到卢奥人的20%不等。年轻的罗族人感染艾滋病毒的高比例尤其令人担忧：最近的一项研究发现，艾滋病毒感染率从13-14岁女性的1.5%上升到15-19岁女性的8.6%，20-24岁女性的艾滋病毒感染率上升到33.7%。男性各年龄段的患病率增长较慢，从13-19岁男性的1%上升到20-24岁男性的10.4%，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，以解决他们社区中艾滋病毒流行的驱动因素，其中之一就是并发。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，以确定如何将基于社区的干预措施“了解你的网络”适当地调整为青少年人群的预防工具。本研究的目的是：1)描述罗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干预的影响；2)评估改编后的KYN干预在青少年中的可行性和可接受性。方法：利用Amornkul等人收集的现有调查数据，通过对近期科学文献的系统回顾和对罗族青少年并发情况的二次分析，实现目标1。目标2将通过分别与13-17岁的成年人和青少年进行有重点的小组讨论来实现。

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.