Building Capacity to Study the Intersection Between COVID-19 and HIV-Related Stigma among Adolescents in Western Kenya

项目摘要/摘要 肯尼亚是世界上艾滋病毒和艾滋病流行最严重的国家之一，约有160万艾滋病毒携带者和 2018年有2.5万人死于艾滋病。青少年，特别是女孩，特别容易感染艾滋病毒。在……里面 在肯尼亚西部，超过50%的青少年在18岁之前有过性行为；然而，年轻人在 15-19岁的人使用避孕套和艾滋病毒检测的比率很低。耻辱对艾滋病毒预防产生负面影响 行为，包括使用避孕套和艾滋病毒检测。在肯尼亚，社会资本、 宗教信仰和性别规范塑造了社会对被认为受感染的年轻人的歧视性态度 与艾滋病毒(即与艾滋病毒有关的耻辱)，这反过来又影响艾滋病毒的预防。我们的家长奖旨在研究 青少年中社会资本、宗教信仰、性别规范与HIV相关污名的关系 (15-19岁)及其对肯尼亚西部艾滋病毒预防的影响。 随着新冠肺炎疫情的到来，肯尼亚政府制定了缓解战略，包括 封锁。虽然这些政策对限制新冠肺炎的传播很重要，但它们有许多意想不到的 对青少年造成的后果，如艾滋病毒感染风险增加。此外，艾滋病毒携带者有 新冠肺炎带来的压力、孤立和耻辱增加了心理社会负担。这些 缺乏社会关系，特别是年轻人之间的社会关系，使结果变得更加复杂。因此，这 补充将使用混合方法来评估新冠肺炎缓解措施的影响 社会关系的变化(即社会资本、宗教信仰、性别规范)、污名和艾滋病毒预防 通过解决以下具体目标，在肯尼亚西部的青年中开展工作：(1)审查社会资本的趋势， 新冠肺炎封锁前后的宗教信仰、性别规范、污名与艾滋病预防行为 在肯尼亚西部的青少年中；(2)阐明社会关系变化的驱动因素， 西方新冠肺炎封锁期间的耻辱经历和艾滋病预防行为的变化 肯尼亚。在目标1中，我们将使用两项调查来探索以下人群的社会关系、耻辱和艾滋病毒预防 765名15-19岁的男孩和女孩。这两项调查将要求青年回忆他们的经历和 新冠肺炎大流行之前和期间的看法。在目标2中，我们将进行18个焦点小组讨论 与15-19岁的男孩和女孩一起，医疗保健提供者、父母、教师和宗教领袖 他们对新冠肺炎如何改变了年轻人，特别是艾滋病毒携带者的生活的看法。 本补编将阐明新冠肺炎疾病控制努力与以下方面相关的意外后果 肯尼亚青少年的艾滋病毒预防行为。此外，这项研究将扩大研究能力， 坦加扎大学学院和妇产科妇科医院周围的研究交叉口 在肯尼亚，新冠肺炎疾病控制努力、耻辱和艾滋病毒预防之间的关系。

Project Summary/Abstract Kenya has one of the world's largest HIV and AIDS epidemics, with about 1.6 million people living with HIV and 25,000 people dying from AIDS in 2018. Adolescents, especially girls, are particularly vulnerable to HIV. In western Kenya, over 50% of adolescents had sexual intercourse before the age of 18; however, youth between the ages of 15-19 have low rates of condom use and HIV testing. Stigma negatively affects HIV prevention behaviors, including condom use and HIV testing. In Kenya, complex interactions between social capital, religiosity, and gender norms shape societies’ discriminating attitudes towards youth perceived to be infected with HIV (i.e., HIV-related stigma), which, in turn, affects HIV prevention. Our parent award aims to study the relationship between social capital, religiosity, gender norms, and HIV-related stigma among adolescents (ages 15-19) and its impact on HIV prevention in western Kenya. With the advent of the COVID-19 pandemic, the Kenyan government enacted mitigation strategies, including lockdowns. Although these policies are important to limit the spread of COVID-19, they have many unintended consequences among adolescents, such as increased risk of HIV. Additionally, people living with HIV have increased psychosocial burdens emanating from stress, isolation, and stigma due to COVID-19. These outcomes are compounded by a lack of social relationships, especially among youth. Therefore, this supplement will use a mixed-methods approach to assess the effects of COVID-19 mitigation measures on changes in social relationships (i.e., social capital, religiosity, gender norms), stigma, and HIV prevention among youth in western Kenya by addressing the following specific aims: (1) Examine trends in social capital, religiosity, gender norms, stigma, and HIV preventive behaviors before and after the COVID-19 lockdown among adolescents in western Kenya; and (2) Elucidate the drivers of change in social relationships, the experience of stigma, and the changes in HIV preventive behaviors during the COVID-19 lockdown in western Kenya. In Aim 1, we will employ two surveys to explore social relationships, stigma, and HIV prevention among 765 boys and girls ages 15-19 years. The two surveys will ask youth to recall their experiences and perceptions before and during the COVID-19 pandemic. In Aim 2, we will conduct 18 focus groups discussions with boys and girls ages 15-19 years, healthcare providers, parents, teachers, and religious leaders to explore their perceptions of how COVID-19 has changed the lives of young people, especially youth living with HIV. This supplement will illuminate the unintended consequences of COVID-19 disease control efforts in relation to HIV preventive behaviors among adolescents in Kenya. Additionally, this study will extend research capacity at Tangaza University College and Gynocare Women’s and Fistulas Hospital around studying the intersection between COVID-19 disease control efforts, stigma, and HIV prevention in Kenya.