Childbearing Dynamics in Setting of High HIV Prevalence and Massive ART rollout

HIV 高感染率和大规模 ART 推广背景下的生育动态

基本信息

批准号：
8529834
负责人：
VICTOR AGADJANIAN
金额：
$ 9.46万
依托单位：
ARIZONA STATE UNIVERSITY-TEMPE CAMPUS
依托单位国家：
美国
项目类别：
财政年份：
2008
资助国家：
美国
起止时间：
2008-05-15 至 2013-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8529834
关键词：
AIDS/HIV problem Adherence Affect Africa South of the Sahara Area Attitude Behavior Characteristics Child Clinic Collection Communities Community Surveys Complement Contraceptive Agents Contraceptive Usage Counseling Country Data Data Analyses Data Collection Demographic Transitions Development Economics Epidemic Epidemiology Ethnography Family Family Planning Family Relationship Fertility Fertility Preferences Fertility Study HIV HIV Infections HIV Seropositivity Health Health Services Accessibility Household Human immunodeficiency virus test Individual Interview Knowledge Marriage and Family Maternal and Child Health Mediating Mothers Mozambique Nature Office Nursing Outcome Perception Prevalence Prevention Prevention education Public Health Public Policy Recommendation Recording of previous events Regimen Research Respondent Rural Sampling Services Social Characteristics Social Environment Social Network Societies Structure Surveys System Testing Time Translating Vertical Disease Transmission Woman Women&apos s Role Work antiretroviral therapy authority base child bearing cost experience family structure follow-up longitudinal design population based population survey postnatal preference pregnant prenatal programs reproductive response scale up social socioeconomics theories transmission process trend

项目摘要

DESCRIPTION (provided by applicant): The massive rollout of antiretroviral therapy (ART) and of Prevention of Mother-to-Child Transmission (PMTCT) programs in many sub-Saharan countries is rapidly and radically changing the epidemiological and social meanings and implications of HIV/AIDS. The proposed study will focus on the intersections of childbearing with the scaling-up of HIV Voluntary Counseling and Testing (VCT) and treatment and resulting changes in individuals' knowledge and views about HIV infection and its consequences. It will combine different types of data collection and analysis to build upon the research team's previous work (R21HD048257, Agadjanian PI) in four contiguous rural districts of southern Mozambique, an area of precipitous erosion of traditional agrarian livelihoods, massive labor mobility, profound changes in marriage and family systems, high and growing HIV prevalence, and a vigorous expansion of VCT/ART/PMTCT. The scientific aims of the study are to examine in this changing context: how rural women's knowledge and perceptions of own HIV status affect their reproductive intentions, contraceptive choices, and fertility outcomes; how the characteristics of rural women's social environments influence the above relationships; how institutional characteristics and mechanisms of the Maternal and Child Health (MCH) clinics affect the ability of HIV+ and HIV- rural women to implement their reproductive intentions and contraceptive preferences. A separate aim of the project is to develop and disseminate practical recommendations on the basis of the analyses. To achieve these aims, the five-year project will use a longitudinal design that will involve two waves of population-based survey and of qualitative data collection. The two waves of survey will re-interview a representative sample of c. 1680 married rural women residing in 54 villages who were first interviewed for an earlier study in 2006. In parallel to the individual survey, in each village, a community survey will be carried out. In addition to the surveys, 72 of the survey respondents from eight of the sampled villages (nine per village), with whom semi-structured in-depth interviews were conducted in 2006, will participate in two waves of in- depth interviews. To complement the individual/household and community perspectives with an institutional one, in every year of the project, statistical data on MCH/VCT/PMTCT service provision and utilization will be collected from the districts' MCH clinics and in-depth interviews focusing on challenges and barriers involved will be carried out with the clinics' nurses. The results of the project will contribute to a better understanding of changes effected by the evolving HIV/AIDS landscape in reproductive intentions and behaviors and to the optimization of the integration of MTC with VCT/PMTCT services and improvement of rural women's access to these services. Project Narrative The project will examine how rural women's knowledge or perceptions of their HIV status affect their reproductive and contraceptive preferences, choices and outcomes in the context of rapidly increasing availability of HIV testing and treatment in Mozambique. It will build upon the research team's previous work in that country and will involve collection and analyses of longitudinal population survey, qualitative, and institutional data. The results of the project will advance the understanding of the relationships between HIV/AIDS and childbearing and will contribute to the optimization of rural maternal and child health and prevention of mother-to-child HIV transmission services.

描述（由申请人提供）：许多撒哈拉以南国家的抗逆转录病毒疗法（ART）的大规模推广和预防母亲到孩子传播（PMTCT）计划正在迅速而根本上改变了艾滋病毒的流行病学和社会意义和含义/艾滋病。拟议的研究将重点关注生育的交叉点，并扩大艾滋病毒自愿咨询和测试（VCT）以及治疗以及对艾滋病毒感染及其后果的知识和观点的变化。它将结合不同类型的数据收集和分析，以研究团队的先前工作（R21HD048257，Agadjanian PI）建立在莫桑比克南部的四个连续的农村地区，这是一个急剧侵蚀传统的农业生计的领域婚姻和家庭系统，艾滋病毒的流行率高，以及VCT/ART/PMTCT的大大扩展。该研究的科学目的是在这种不断变化的背景下研究：农村妇女对艾滋病毒地位的知识和看法如何影响其生殖意图，避孕选择和生育能力；农村妇女社会环境的特征如何影响上述关系；产妇和儿童健康（MCH）诊所的制度特征和机制如何影响艾滋病毒+和艾滋病毒妇女实施其生殖意图和避孕偏好的能力。该项目的另一种目的是根据分析制定和传播实用建议。为了实现这些目标，五年项目将使用纵向设计，该设计将涉及两次基于人群的调查和定性数据收集。两次调查将重新审视c的代表性样本。 1680年，居住在54个村庄中的乡村妇女于2006年首次接受采访。除了调查外，来自八个采样村庄（每个村庄的9个）的调查受访者中有72名受访者将于2006年与半结构化的深入访谈进行，将参加两次深度访谈。在项目的每一年中，将从该地区的MCH诊所和侧重于挑战中收集有关MCH/VCT/PMTCT服务提供和利用率的统计数据的统计数据，以补充个人/家庭和社区的观点。涉及的障碍将与诊所的护士一起进行。该项目的结果将有助于更好地理解生殖意图和行为中不断发展的艾滋病毒/艾滋病景观以及MTC与VCT/PMTCT服务的整合以及改善农村妇女对这些服务的访问的优化。项目叙述该项目将研究农村妇女对艾滋病毒状况的知识或看法如何影响她们的生殖和避孕偏好，选择和结果在莫桑比克迅速增加HIV测试和治疗的背景下。它将基于研究团队以前在该国的工作，并涉及纵向人口调查，定性和机构数据的收集和分析。该项目的结果将提高人们对艾滋病毒/艾滋病与生育之间关系的理解，并将有助于优化农村孕产妇和儿童健康以及预防母亲到孩子的艾滋病毒传播服务。