Peer Intervention as Pedagogic Paradigm in Kinshasa SPH

描述（由申请人提供）：对非洲艾滋病毒预防/控制的有限支持将无法实现目前发达国家存在的昂贵项目。以个人为导向的方法可能不够。有效的战略必须以清楚了解非洲的情况为依据。在美国，同伴联系作为一种干预战略显然有效，因此最近在非洲，包括在刚果的金沙萨，出现了几个“示范”项目。然而，在非洲，对这种有吸引力/廉价的方法的有效性评价仍然很差。 为了促进行为科学、流行病学和研究方法的研究基础设施，金沙萨公共卫生学院（KSPH）提议与北卡罗来纳州大学和约翰霍普金斯大学（JHU）的公共卫生学院合作，以提高其行为科学、流行病学和研究方法的研究能力。 调查人员将首先建立一个KSPH研究单位作为KSPH MPH课程研究和研究培训的重点。 目前的ESTA/JHU共享Fogarty AITRP资金将使ESTA和JHU的ESTA/EPI/研究的中长期培训成为可能。作为一种教学模式，将进行2项随机对照干预研究，以评估同伴教育对降低包括艾滋病毒在内的性传播感染风险的有效性。KSPH/JHU/JHU将与金沙萨两个有效的一线社区非政府组织-青年十字路口和Matonge性病中心-合作，对最近感染艾滋病毒以外的性传播疾病的青少年和年轻女性性工作者进行同侪领导/网络研究。 实验条件为同伴外展教育条件，平等注意控制条件为个体关注的社会认知条件。这两项研究将包括400名指数参与者（TA或CSW，近期有HIV以外的性传播感染），随机分配到两种条件之一（200/条件），每个指数随机选择2名同伴网络成员，总共1200名TA和1200名CSW。 每项试验的结果评估将包括在干预后3、6、12和18个月对400名指数参与者和800名同伴网络成员进行的测试前/测试后评估。主要的结果测量将是自我报告的性风险行为和STI/HIV发病率。 这项工作将为艾滋病毒预防政策提供信息，并加强KSPH的研究和培训

DESCRIPTION (provided by applicant): The limited support for HIV prevention/control in Africa will not enable expensive programs of the type now present in developed countries. Individual-orientated approaches may not be sufficient. Effective strategies must be informed by a clear understanding of the African context. Based on the apparent efficacy of peer outreach as an intervention strategy in the USA, several "demonstration" projects have recently sprung up in Africa, including in Kinshasa, Democratic Republic of Congo. Yet the efficacy of this attractive/inexpensive approach remains poorly evaluated in Africa. To promote research infrastructure in behavioral science, epidemiology and research methodology (behav/epi/research), Kinshasa School of Public Health (KSPH) proposes to partner with the Schools of Public Health at the University of North Carolina (UNC) and Johns Hopkins University (JHU) to improve its behav/epi/research capacity. The investigators will first establish a KSPH Research Unit as a focus for research and research training in the KSPH MPH curriculum. Current UNC/JHU shared Fogarty AITRP funds will then enable medium and long term training in behav/epi/research at UNC and JHU. As a pedagogic paradigm 2 randomized, controlled intervention studies to assess efficacy of peer education to decrease risk of sexually transmitted infections (STIs) including HIV will be performed. KSPH/UNC/JHU will partner with two effective front-line Kinshasa non-governmental community-based organizations, Carrefour des Jeunes (Crossroads for Youth) and Centre STD Matonge to conduct peer leader/network studies in teenagers (TAs) and young female sex workers (CSWs) with a recent STI other than HIV. The experimental condition is a peer outreach education condition and the equal attention control condition is an individually-focused social cognitive condition. Both studies will include 400 index participants (TAs or CSWs with a recent STI other than HIV) randomly assigned to one of the two conditions (200/condition) and 2 randomly chosen peer network members of each index, for a total of 1200 TAs and 1200 CSWs. Outcome evaluation in each trial will include pre-test/post-test assessments of 400 index participants and 800 of their peer network members at 3, 6, 12 and 18 months post intervention. Main outcome measures will be self reported sexual risk behaviors and STI/HIV incidence. The work will inform HIV prevention policy and strengthen research and training at KSPH