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/艾滋病是全球死亡率的主要原因之一，也是15-44岁妇女的主要原因。 15-24岁的非洲妇女感染HIV的可能性是男性的两倍。在喀麦隆，在全球艾滋病毒中性别差异最高的国家之一，青春期女孩感染艾滋病毒的可能性是同一年龄的男孩的五倍。越来越多的研究表明，在交易性行为和商业性行为期间采取的风险是生物易感性 - 造成艾滋病毒/艾滋病的性别不平等。但是，人们对推动非洲从事这些做法的妇女有风险的性行为的主要原因有透明的理解。最近的研究表明，妇女主要采取危险的性行为来应对负收入冲击（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重要部分。如果妇女采取有风险的性行为来应对负收入冲击，那么提供妇女正式的风险推动策略可能是预防艾滋病毒的一种非常有前途的方法。但是，知识仍然存在重要的差距，主要是因为以前没有设计任何研究来专门回答这一研究问题。这项研究的目的是在知识中填补这些空白，以便为新的公共卫生干预措施设计以解决性传播感染（STIS）和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普通人群。拟议的研究将使用喀麦隆一组新女性队列的数据。这项研究已招募了1,500名未婚妇女进行交易性行为或商业性行为，包括三项生物行为和社会经济调查。一项随机对照试验嵌入了队列研究中，并为分配给治疗组的妇女提供了正式的风险培训策略（家庭健康保险）。这项研究是应对我们这个时代至关重要的公共卫生挑战的必要条件，并具有对塑造研究议程艾滋病毒/艾滋病的持久影响的强大潜力。