Diversity Supplement

项目摘要/摘要 青春期和青壮年是艾滋病毒和意外怀孕的高危时期 对南非的年轻女性来说。15岁至24岁的青春期女孩和年轻妇女占25% 南非新的艾滋病毒感染人数。此外，18%的AGYW妇女在18岁之前生育。艾滋病毒风险增加 在怀孕和产后显著增加，强调需要有效的艾滋病毒预防战略 对这群人来说。世界卫生组织指南建议妇女在以下情况下继续使用PrEP 她们怀孕了，仍然有感染艾滋病毒的风险。然而，南非还没有实施这些措施 将这些建议纳入其国家PrEP指南。这份为期两年的多样性补充文件旨在建立 基于妊娠AGYW中PrEP使用的证据，并与NICHD的战略计划保持一致，制定 传染病交叉主题下健康妊娠和终身健康的基础 疾病和全球健康。 具体目标是： 目标1：比较妊娠结局(例如流产、流产)和出生结局(例如， 胎龄、出生体重、出生身长、胎儿头围) 谁接受PrEP，谁不接受。 目标2：检查怀孕与PrEP依从性和持久性之间的关系 AGYW。 目的3：用行程图检查和描绘妊娠AGYW使用PrEP的经历。 目标4：定性地了解提供者对怀孕和使用AGYW的态度和信念 孕期准备和提供者关于孕期使用PrEP的临床建议。 在整个补充期内，被提名的候选人将从事各种研究和 专业发展活动，包括参加教学培训，继续制作 学术研究，并申请国家卫生研究所(NIH)的额外资金。活动 撰写本补充材料将为应聘者提供机会，以提高必要的技能 成为美国国立卫生研究院资助的独立研究人员。 初步研究数据将应用于未来的NIH R21提案，以制定干预措施，以改善 南非孕妇和产后AGYW的准备依从性和持久性。

PROJECT SUMMARY/ABSTRACT Adolescence and young adulthood are periods of high vulnerability to HIV and unintended pregnancies for young women in South Africa. Adolescent girls and young women (AGYW) aged 15 to 24 comprise 25% of new HIV infections in South Africa. Additionally, 18% of AGYW give birth by age 18. HIV risk increases significantly during pregnancy and postpartum, highlighting the need for efficacious HIV prevention strategies for this population. The World Health Organization guidelines recommend that women continue using PrEP if they become pregnant and remain at risk for HIV. However, South Africa has not yet implemented these recommendations into its national PrEP guidelines. This 2-year diversity supplement seeks to build the evidence base on PrEP use among pregnant AGYW and aligns with NICHD's Strategic Plan, Setting the Foundation for Healthy Pregnancies and Lifelong Wellness under the cross-cutting topics of infectious disease and global health. The Specific Aims are: Aim 1: Compare pregnancy outcomes (e.g., termination, miscarriage) and birth outcomes (e.g., gestational age, birth weight, birth length, fetal head circumference) between pregnant AGYW who uptake PrEP and those who do not. Aim 2: Examine the association between pregnancy and PrEP adherence and persistence among AGYW. Aim 3: Use journey mapping to examine and depict pregnant AGYW's experience using PrEP. Aim 4: Qualitatively explore provider attitudes and beliefs toward AGYW who are pregnant and use PrEP and providers clinical recommendations regarding PrEP use during pregnancy. Throughout the supplement period, the proposed candidate will engage in a variety of research and professional development activities, including participating in didactic trainings, continuing to produce scholarly research, and applying for additional National Institute of Health (NIH) funding. The activities comprising this supplement will provide the candidate with opportunities to enhance the necessary skills to become an independent NIH-funded researcher. Preliminary study data will be applied to a future NIH R21 proposal to develop an intervention to improve PrEP adherence and persistence among pregnant and postpartum AGYW in South Africa.