Can Church Schools Reduce Risk of HIV Infection for Orphan Girls in Zimbabwe?

说明（由申请人提供）：艾滋病流行病已导致数百万成年人患病和死亡，并造成数百万孤儿。本研究考察了津巴布韦一个特别弱势群体——青春期孤女的学校教育和初次性行为的背景。这项研究采用了严格的随机对照试验设计，以检验适度的支持是否能使孤儿女孩在过渡到高中期间留在学校，以及宗教教育是否比世俗教育对艾滋病毒风险行为提供了更大的保护。卫理公会为津巴布韦的教育和孤儿服务提供了重要的基础设施。这项研究特别关注年轻的女孤儿，因为她们感染艾滋病毒的可能性更大，辍学的可能性更大，并且由于失去父母的保护而更容易受到性虐待。本研究的具体目的是：1)通过实验检验适度的援助是否可以帮助孤儿女孩在学校度过高中阶段，以及参加教会开办的高中是否比参加世俗学校更能预防艾滋病毒风险行为；2)比较教会和世俗中学所教授的性和艾滋病相关信息的内容和一致性；3)对比世俗中学和教会中学，研究女孤儿对艾滋病信息的理解，并探讨女孩做出性行为决定的背景。对于目标1，方法包括使用实验设计和自我管理的调查，由津巴布韦曼尼兰省的孤儿少女完成。对于目标2和目标3，概念映射技术用于收集和分析来自成年人（教会人员，教师和管理人员）和孤儿少女的信息。研究活动将由美国和津巴布韦的合作者共同进行。这项研究解决了一个具有最高公共卫生意义的问题。津巴布韦的艾滋病毒感染率是世界上最高的，艾滋病孤儿的比例也是如此。这项研究将有助于建立以下方面的知识库：宗教组织参与艾滋病毒相关活动的程度和性质、联合卫理公会及其学校影响孤儿风险和保护因素的机制，以及津巴布韦年轻妇女作出性决定的背景。

DESCRIPTION (provided by applicant): The AIDS pandemic has led to the illness and death of millions of adults, and has also resulted in millions of orphans. This study examines the context of schooling and sexual debut among a particularly vulnerable group, adolescent orphan girls in Zimbabwe. The study uses a rigorous randomized controlled trial design to test whether modest support can retain orphan girls in school through the transition to high school and whether religious schooling adds greater protection than secular schooling for HIV risk behaviors. The Methodist Church provides an important infrastructure for education, as well as services for orphans, in Zimbabwe. The study specifically focuses on young female orphans because of their greater likelihood of HIV infection, greater likelihood of school dropout, and greater vulnerability to sexual abuse due to loss of parental protection. Specific aims for the proposed study are: 1) To test experimentally whether modest assistance can help orphan girls stay in school through the transition to high school, and whether attending a church-run high school is more protective against HIV risk behaviors than attending a secular school; 2) To compare the content and consistency of sex and HIV-related messages taught through church-sponsored versus secular secondary schools; and 3) To examine how female orphans perceive HIV messages from church-sponsored compared to secular secondary schools, and to explore the context in which the girls make decisions about sexual behavior. For Aim 1, methods include use of an experimental design and self- administered surveys completed by orphan adolescent girls in Manicaland Province, Zimbabwe. For Aims 2 and 3, concept mapping techniques are used to gather and analyze information from adults (church personnel, teachers and administrators) and orphan teen girls. Research activities will be jointly conducted by U.S. and Zimbabwean collaborators. The research addresses a problem of the highest public health significance. HIV prevalence in Zimbabwe is among the highest in the world, as is the proportion of AIDS orphans. The study will contribute to the knowledge base concerning the extent and nature of religious organizations' involvement in HIV-related activities, mechanisms by which the United Methodist Church and its schools influence orphan risk and protective factors, and the context in which young Zimbabwean women make decisions about sex.