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中艾滋病毒的行为风险。有许多有希望的战略，但从中选择的证据基础仍然有限。我们提出了一项混合方法的调查，将焦点小组讨论(FGD)和深度访谈(IDI)与对加纳东南部三个社区的年轻人及其父母的纵向队列研究(LCS)相结合，以确定性别父母养育做法、同龄人群体规范和其他因素与个人发展过程和当地流行病学情况相互作用的方式，以塑造这些社区年轻人新出现的性行为模式。最初的FGD将被用来描述父母对青少年的性行为的性别理想，以及这些社区青少年同龄人群体中盛行的性行为和浪漫行为的性别规范，并将为LCS的工具设计提供参考。LCS将包括较年轻的一组(第一波年龄为13至14岁，第三波为16至17岁，N=900)和较年长的一组(第一波年龄为18至19岁，第三波为21至22岁，N=900)，他们及其父母/照顾者将每隔18个月接受三次访问。女孩和男孩将被同等比例包括在内。LCS访谈将包括有关育儿实践、同伴影响、宗教和宗教信仰、性别人格特征、性别角色态度、人生历程期望和性行为的模块。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。将利用低风险和高风险的LCS参与者进行后续注射，以进一步了解青春期女孩和男孩用来驾驭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局部艾滋病毒流行率的巨大差异，使我们能够评估流行病学环境如何影响青少年的性行为。该项目建立在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现有合作的基础上，将有助于这两个机构在撒哈拉以南非洲对青少年进行纵向人口研究的能力。结果将传播给几个科学和健康促进受众，我们将把我们的发现转化为适当的概念，以便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的干预措施。 公共卫生相关性：需要有效的干预措施来降低撒哈拉以南非洲青少年中艾滋病毒的行为风险，尽管有许多有希望的战略，但在这些战略中进行选择的证据基础仍然有限。我们提出了一项混合方法的调查，将焦点小组讨论和深入访谈与对加纳东南部三个社区的青年及其父母的三波纵向队列研究相结合。我们的目标是确定按性别划分的育儿做法、同龄人群体规范和其他因素与个人发展过程和当地流行病学情况相互作用的方式，以塑造这些社区年轻人正在出现的性行为模式，并将我们的发现转化为适合在这些人群中设计有效干预措施的概念。

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.