Economic Opportunity for Zimbabwean Adolescent Orphans

津巴布韦青少年孤儿的经济机会

• 批准号: 7110979
• 负责人: Nancy S. Padian
• 金额: $ 91.45万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-09-26 至 2008-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7110979
• 关键词: AIDS education /prevention; Africa; HIV infections; Herpes simplex disease; adolescence (12-20); age at pregnancy; behavior therapy; behavioral /social science research tag; clinical research; disease /disorder proneness /risk; education evaluation /planning; female; health disparity; health education; high risk behavior /lifestyle; human subject; peer group; prostitution; role model; safe sex /sex abstinence; sex behavior; sexually transmitted diseases; socioeconomics; therapy compliance; training; urban poverty area

DESCRIPTION (provided by applicant): The overall aim of this project is to determine, using a randomized controlled design, whether an innovative economic and life-skills intervention designed to increase control over sexual interactions prevents the adverse consequences of unprotected sex among out-of-school female orphans aged 16-19 in Zimbabwe. The intervention, which builds on our recently completed study that assessed the feasibility of such a program, will be evaluated for its effect on the acquisition of sexually transmitted infections, including HIV, as well as unintended pregnancy. The intervention consists of an integrated micro-credit program, including entrepreneurial training, loan provision, practical business education, mentorship, and peer support groups. This will be combined with a previously-tested fife-skills education curriculum that delivers HIV/reproductive health education through the use of role plays, drawing exercises, and other techniques, to help participants negotiate the terms of their sexual relationships. In order to assess the effects of this combined intervention over and above life-skills alone, the control group will receive the fife-skills education curriculum, a "placebo" health and nutrition training, and on-going peer support groups. Although there is great potential for such combined economic and life-skills programs to improve the reproductive health of female adolescent orphans, no research to date has assessed the effect of such interventions on sexual risk behaviors, STI/HIV or pregnancy outcomes in this or any other at-risk group. Our intervention is guided by a causal model in which the provision of economic alternatives and opportunities (through the micro-credit intervention) and sexual negotiation skills (through the life-skills intervention) are the driving forces in increasing control over sexual interactions, and thus reducing high-risk behaviors and adverse biological outcomes. The specific aims of this project are: 1) To assess the effectiveness of a combined micro-credit and life-skills education intervention in reducing the incidence of our primary outcomes: Herpes simplex virus type 2 (HSV2) and unintended pregnancy; 2) To assess the effectiveness of a combined micro-credit and life-skills education intervention in reducing our secondary outcomes: high-risk risk behaviors (e.g., unprotected sex, number of partners, transactional sex, early sexual debut, sexual coercion and violence); 3) To examine the intermediary effects of increased economic opportunity and improved sexual negotiation skills in enhancing participants' control over sexual interactions, and 4) To evaluate whether characteristics related to participation, i.e., factors related to participant adherence, satisfaction, and understanding of the intervention mediate observed effects.

描述（由申请人提供）：该项目的总体目的是使用随机控制的设计来确定旨在增加对性相互作用的控制的创新经济和生命技能干预措施是否会阻止Zimbabwe 16-19岁的校外女性孤儿对性行为的不利后果。该干预措施是基于我们最近完成的研究，该研究评估了该计划的可行性，将评估其对收购包括HIV在内的性传播感染以及意外怀孕的影响。干预措施包括一个综合的微观学计划，包括企业家培训，贷款提供，实践商业教育，指导和同伴支持小组。这将结合以前经过测试的Fife技能教育课程，该课程通过使用角色扮演，绘画练习和其他技术来提供艾滋病毒/生殖健康教育，以帮助参与者谈判其性关系的条款。为了单独评估这种综合干预措施的影响，对照组将获得Fife技能教育课程，“安慰剂”健康和营养培训以及正在进行的同伴支持小组。尽管这种合并的经济和生命技能计划有很大的潜力可以改善女性青少年孤儿的生殖健康，但迄今为止，尚无研究评估此类干预措施对性风险行为，性病/HIV或怀孕结果对此或任何其他高危人群的影响。我们的干预措施以因果模型为指导，在该因果模型中，提供经济替代方案和机会（通过微学分干预）和性谈判技巧（通过生命技能干预）是增加对性互动的控制，从而减少高风险行为和不良生物学局势的驱动力。该项目的具体目的是：1）评估合并的微观学分和生命技能教育干预措施在减少我们主要结果的发生率方面的有效性：单纯疱疹病毒2型（HSV2）和意外怀孕； 2）评估合并的微观学分和生命技能教育干预措施在减少我们的次要结果方面的有效性：高风险的风险行为（例如，无保护的性别，伴侣的数量，交易性行为，早期性行为，性行为，性胁迫和暴力）； 3）研究增加经济机会和提高性谈判技巧在增强参与者对性互动的控制方面的中介效应，以及4）评估与参与的特征，即与参与者依从性，满意度和对干预措施的理解有关的因素是否介绍了观察到的影响。