Protecting Women from Economic shocks to fight HIV in Africa (POWER)

保护非洲妇女免受经济冲击，抗击艾滋病毒 (POWER)

• 批准号: MR/Y003837/1
• 负责人: Aurelia Lepine
• 金额: $ 75.72万
• 依托单位: University College London
• 依托单位国家: 英国
• 项目类别: Fellowship
• 财政年份: 2024
• 资助国家: 英国
• 起止时间: 2024 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FY003837%2F1
• 关键词: Protecting; Women; Economic; shocks; fight

HIV/AIDS is one of the leading cause of mortality globally and the leading cause among women aged 15-44 years. African women aged 15-24 are twice more likely to be infected with HIV than their male counterparts. In Cameroon, one of the countries with the highest gender disparity in HIV globally, adolescent girls are five times more likely to be infected with HIV than boys of the same age. There is a growing number of studies showing that risks taken during transactional sex and commercial sex -in addition to biological susceptibility- are responsible for gender inequalities in HIV/AIDS. However, there is superficial understanding of the main causes driving risky sexual behaviours of women who engage in those practises in Africa. Recent studies have shown that women mainly adopt risky sexual behaviours in order to cope with negative income shocks (e.g. agricultural and climatic shocks, illness or death of family members) and suggest that economic shocks are a substantial piece of the HIV puzzle in Africa. If women adopt risky sexual behaviours to cope with negative income shocks, hence providing women formal risk-coping strategies could be a very promising approach to prevent HIV. However, there are still important gaps in knowledge, mainly because no previous study has been designed to specifically answer this research question. The goal of this research is to fill these gaps in knowledge in order to inform the design of novel public health interventions to tackle sexually transmitted infections (STIs) and HIV. Specifically, the study aims (1) to estimate the effect of economic shocks affecting households on sexual behaviours and STI and HIV acquisition of young women, (2) to identify the channels through which economic shocks affect STIs and HIV, (3) to estimate the effectiveness of an intervention that protects women from economic shocks to prevent STI and HIV and (4) to measure the cost-effectiveness of an intervention that protects women from economic shocks to prevent HIV in the general population. The proposed study will use data from a new cohort of women in Cameroon. The study has recruited 1,500 unmarried women engaging in transactional sex or commercial sex, including three biobehavioural and socioeconomic surveys. A randomised controlled trial was embedded to the cohort study and has provided women allocated to the treatment group with a formal risk-coping strategy (a family health insurance). This research is of immediate necessity to address a vital public health challenge of our time and has the strong potential to have a long lasting impact on shaping the research agenda on HIV/AIDS.

艾滋病毒/艾滋病是全球死亡的主要原因之一，也是 15-44 岁女性的首要原因。 15-24 岁的非洲女性感染艾滋病毒的可能性是男性的两倍。喀麦隆是全球艾滋病毒性别差异最大的国家之一，青春期女孩感染艾滋病毒的可能性是同龄男孩的五倍。越来越多的研究表明，除了生物易感性之外，性交易和商业性行为中所承担的风险也是造成艾滋病毒/艾滋病性别不平等的原因。然而，对于非洲妇女从事危险性行为的主要原因，人们的了解还很肤浅。最近的研究表明，妇女主要采取危险的性行为来应对负面的收入冲击（例如农业和气候冲击、家庭成员的疾病或死亡），并表明经济冲击是非洲艾滋病毒难题的一个重要组成部分。如果女性采取危险的性行为来应对负面的收入冲击，那么为女性提供正式的风险应对策略可能是预防艾滋病毒的一种非常有前途的方法。然而，知识上仍然存在重要差距，主要是因为之前没有研究专门回答这个研究问题。这项研究的目标是填补这些知识空白，以便为解决性传播感染 (STI) 和艾滋病毒的新型公共卫生干预措施的设计提供信息。具体来说，该研究的目的是 (1) 评估影响家庭的经济冲击对年轻女性的性行为以及性传播感染和艾滋病毒感染的影响，(2) 确定经济冲击影响性传播感染和艾滋病毒的渠道，(3) 估计保护妇女免受经济冲击以预防性传播感染和艾滋病毒的干预措施的有效性；(4) 衡量保护妇女免受经济冲击以预防普通人群艾滋病毒的干预措施的成本效益。拟议的研究将使用喀麦隆新一批女性的数据。该研究招募了 1,500 名从事性交易或商业性行为的未婚女性，其中包括三项生物行为和社会经济调查。队列研究中嵌入了一项随机对照试验，并为分配到治疗组的女性提供了正式的风险应对策略（家庭健康保险）。这项研究对于解决我们这个时代的一项重大公共卫生挑战至关重要，并且具有对制定艾滋病毒/艾滋病研究议程产生长期持久影响的强大潜力。