Positive Outcomes for Orphans (POFO): HIV Risk as Young Adults

艾滋病是非洲青少年的主要死因，也是第二大死因。 在全球青少年中，15-19奥尔兹的所有新艾滋病毒感染者中有三分之二发生在 青春期女孩孤儿和失散儿童感染艾滋病毒的风险特别高 感染了“孤儿的积极结果：年轻人感染艾滋病毒的风险”将评估各种因素， 与青春期艾滋病毒风险、艾滋病毒检测和艾滋病毒治疗参与和保留相关 和年轻的成年人。2006年至2008年，艾滋病毒/艾滋病与孤儿护理：孤儿的积极成果 （POFO）研究采用随机抽样调查方法，招募了3，057名6-12岁的家庭OSC（N= 1，562） 和机构护理环境（N= 1，495），代表5个文化、经济和 政治上不同的国家：埃塞俄比亚、肯尼亚、坦桑尼亚、柬埔寨和印度。经过10年的随访，POFO 是OSC唯一的多国纵向研究，其结果直接影响了政策， 对OSC的干预。感染艾滋病毒的所有青少年中有一半在6个国家，其中4个国家被列入本报告。 study.到目前为止，9%的POFO参与者（现在年龄在16-22岁）已经检测或怀疑是HIV阳性， 远高于全国平均水平。该补助金的第一个目的是跟踪POFO OSC队列，因为他们 从青春期过渡到青年期，以确定与艾滋病毒风险的关联， 相关行为。通过另外三轮数据收集，将可获得长达14年的数据， 每名OSC参与者（研究完成时年龄为21-27岁）。艾滋病毒检测将在每一轮和每一个障碍提供 并将评估治疗参与和保留的促进因素。第二个目标是建立长期的- 艾滋病毒相关结果的长期预测模型，该模型在幼儿期识别那些处于 艾滋病毒感染的最高风险是年轻人。所有14年的数据将用于开发模型，以支持 开发筛查工具，在生命早期识别高风险OSC。为了得到权重， 估计代表今天的OSC，我们将比较原始POFO样本与新的OSC样本， 相同的领域：我们将增加一个新的横截面样本，250名6-16岁的OSC（以匹配POFO I和II）， 参与本研究的四个研究中心（N= 1，000）均遵循原始POFO I采样程序。 第三个目标是确定艾滋病毒相关预防方案的地点和性别偏好。 定量调查，包括以离散选择的形式在系统变化的小插曲之间进行选择 与所有参与的OSC及其护理人员进行的实验，将得出相对可接受的 在当地采取多种预防干预措施。该R 01具有改变模式的巨大潜力 设计和实施针对艾滋病毒风险和治疗参与的干预措施 在这个最危险的人群中。

AIDS is the leading cause of death among adolescents in Africa, and the 2nd leading cause of death among adolescents globally, with two-thirds of all new HIV infections amongst 15-19 year olds occurring in adolescent girls. Orphaned and separated children (OSC) are at especially high risk of becoming HIV infected. “Positive Outcomes for Orphans (POFO): HIV Risk as Young Adults” will evaluate factors associated with HIV risk, HIV testing, and HIV treatment engagement and retention during adolescence and young adulthood. Between 2006-8, the HIV/AIDS and Orphan Care: Positive Outcomes for Orphans (POFO) study used random sampling survey methods to enroll 3,057 OSC ages 6-12 living in families (N=1,562) and institutional care settings (N=1,495) representative of the OSC populations in 5 culturally, economically, and politically distinct countries: Ethiopia, Kenya, Tanzania, Cambodia and India. With 10 years of follow-up, POFO is the only multi-country longitudinal study of OSC and its findings have directly impacted policies and interventions for OSC. Half of all adolescents living with HIV are in 6 countries, 4 of which were included in this study. To date, 9% of POFO participants (now ages 16-22) have tested, or are suspected to be, HIV positive, a rate well above national averages. The first aim of this grant is to follow the POFO OSC cohort as they transition through adolescence and into young adulthood to identify associations with HIV risk and related behaviors. With three additional rounds of data collection, up to 14 years of data will be available for each OSC participant (ages 21-27 at study completion). HIV testing will be offered at each round and barriers and facilitators of treatment engagement and retention will be assessed. The second aim is to create long- term predictive models of HIV-relevant outcomes that identify in early childhood those OSC who are at highest risk for HIV as young adults. All 14 years of data will be used to develop models to support the development of screening tools that identify high-risk OSC early in life. In order to derive weights that allow estimates to represent today’s OSC, we will compare the original POFO sample with a new sample of OSC from the same areas: we will add a new cross-sectional sample of 250 OSC ages 6-16 (to match POFO I and II) at each of the four sites participating in this study (N=1,000) following the original POFO I sampling procedures. The third aim is to identify site- and gender-specific preferences for HIV related prevention programs. Quantitative surveys, including choices between systematically varied vignettes in the form of a discrete choice experiment conducted with all participating OSC and their caregivers, will elicit the relative acceptability of diverse prevention interventions in the local context. This R01 has significant potential to shift paradigms for the design and implementation of interventions that target the HIV risk and treatment engagement among this most at risk population.