HIV Prevention for Batswana Youth: Adaptation of an Evidence-Based Intervention

博茨瓦纳青年的艾滋病毒预防：采用循证干预措施

• 批准号: 8217072
• 负责人: JANET S ST LAWRENCE
• 金额: $ 16.82万
• 依托单位: MISSISSIPPI STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-01-28 至 2013-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8217072
• 关键词: 19 year old; AIDS prevention; AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; Adolescent; Adult; Advisory Committees; Age; Alcohol consumption; Alcohols; Attention; Behavior; Behavior Therapy; Behavioral; Biological; Botswana; Caring; Cognitive; Collaborations; Communication; Communities; Country; Development; Educational Curriculum; Effectiveness; Evidence based intervention; Evidence based program; Feasibility Studies; Focus Groups; Future; Gender; Gender Role; HIV; Health education; Household; Incidence; Infection; Intervention; Interview; Life; Life Expectancy; Male Circumcision; Measurement; Measures; Mississippi; Monitor; Parents; Participant; Personal Communication; Play; Predatory Behavior; Preparation; Prevalence; Prevention; Prevention program; Primary Prevention; Property; Protocols documentation; Psychometrics; Randomized Controlled Trials; Research; Risk; Risk Factors; Role; Secondary Schools; Sex Characteristics; Sexuality; Stigmata; Strategic Planning; Teenagers; Testing; Training; Translating; Universities; Vertical Disease Transmission; Work; Youth; Zidovudine; age group; base; case finding; combat; conflict resolution; disorder prevention; evidence base; informant; interpersonal conflict; intimate partner violence; pandemic disease; parental monitoring; pregnancy prevention; programs; public health relevance; response; satisfaction; skills; social; social stigma; sugar; trend

DESCRIPTION (provided by applicant): Botswana has the 2nd highest HIV prevalence in the world, peaking at 40.2% in 30-34 year olds. Botswana also has been the world's leader in providing universal free access to AZT, prevention of mother to child transmission, an extensive network of VCT centers, and a nationwide male circumcision program. However, this emphasis on biomedical strategies for case finding, care, and treatment has not been paralleled by primary prevention programs. The new national strategic plan to be issued in 2010 now places importation and adaptation of evidence-based behavioral prevention as the highest strategic priority for the immediate future. It is in response to the new strategic plan that this collaborative R34 proposal to adapt and pilot an evidence-based program, the Becoming a Responsible Teen (BART) intervention, for Batswana youth is submitted. Guided by a teen advisory committee and a community advisory board, we will conduct focus groups with youth and in-depth interviews with key informants in the first year to inform adaptation of the measurement protocol and intervention for youths 14-19 in Gabarone secondary schools. In the 2nd year, measures will be pilot tested to establish their psychometric properties and to compare responses by gender. Role play vignettes will be drafted, their social and ecological validity assessed, and the BART intervention will be adapted for Batswana adolescents. New culturally appropriate modules addressing alcohol as a risk factor, conflict resolution to reduce intimate partner violence, and stigma reduction will be added. In addition, a new 3-session intervention for parents and a separate 3-session program for household caretakers will be added, addressing HIV/AIDS information, communicating with youth on sensitive topics, and monitoring, In the 3rd year, a pilot feasibility study will assess recruitment, retention, interventionists' fidelity, and youth and parents/caretakers' response to their respective interventions, and whether the results suggest that the Botswana version of BART provides value added when compared against the existing Life Skills curriculum in the secondary schools. This developmental application is the first step in a programmatic sequence developed in collaboration between the University of Botswana, governmental agencies and NGOs in Gaborone, and Mississippi State University. If the feasibility trial documents positive changes in behavior, it will inform a R01 application for a larger randomized controlled trial with cognitive, behavioral and biological endpoints. If the RCT provides strong evidence of effectiveness, we will work with the Ministries of Education, Health, and Youth and Culture to disseminate the intervention throughout Botswana's secondary schools and train staff in each community to deliver the program with fidelity. PUBLIC HEALTH RELEVANCE: Botswana is one of the two countries hardest hit by AIDS anywhere in the world with adult prevalence that peaks at 40.2% in 30-34 year olds. As a result, life expectancy is reduced from 70 to 33 years. An estimated 37-39% of Botswana's adults between the ages of 15-49 are HIV-infected in contrast to the sub-Saharan average of 5.0%. Despite extensive efforts by Botswana governmental and non- governmental organization s (NGOs) to combat the pandemic through testing, universal treatment, and male circumcision, these biomedical strategies have not been paralleled by attention to effective behavioral interventions. A new national strategic plan to be released in 2010 identifies behavioral primary prevention for youth based on evidence-based programs as the highest priority for the next three years. This proposal to adapt BART, an evidence-based HIV prevention program of proven effectiveness, for Botswana youth is timely, responding to the new national priorities that refocus attention to primary prevention in order to reduce the incidence of new infections, especially among youth.

描述（由申请人提供）：博茨瓦纳（Botswana）拥有世界第二高的HIV患病率，在30-34岁的孩子中达到40.2％。博茨瓦纳（Botswana）也一直是全球领导者，可以为AZT提供普遍的自由访问，预防母亲传播的母亲，广泛的VCT中心网络以及全国性的男性包皮环切术计划。但是，这种强调病例发现，护理和治疗的生物医学策略尚未与初级预防计划平行。现在将于2010年发布的新的国家战略计划现在将进口和基于证据的行为预防的适应作为不久的将来的最高战略优先事项。为了应对新的战略计划，这项合作R34提议适应和试行以证据为基础的计划，成为负责任的青少年（BART）干预措施，以提交Batswana青年。在一个青少年咨询委员会和社区顾问委员会的指导下，我们将在第一年与青年人进行焦点小组，并与主要线人进行深入的访谈，以告知适应Gabarone中学14-19岁的年轻人的测量协议和干预。在第二年，将对措施进行试验，以确定其心理测量特性并通过性别比较反应。角色扮演小插曲将被起草，评估他们的社会和生态有效性，而巴特干预将适用于巴茨瓦纳青少年。将增加针对酒精作为危险因素的新文化适当的模块，减少亲密伴侣暴力的冲突解决方案以及减少污名。 In addition, a new 3-session intervention for parents and a separate 3-session program for household caretakers will be added, addressing HIV/AIDS information, communicating with youth on sensitive topics, and monitoring, In the 3rd year, a pilot feasibility study will assess recruitment, retention, interventionists' fidelity, and youth and parents/caretakers' response to their respective interventions, and whether the results suggest that the Botswana version of BART provides与中学现有生活技能课程相比，增值。该开发应用是博茨瓦纳大学，政府机构和加博隆的非政府组织与密西西比州立大学合作开发的程序序列的第一步。如果可行性试验记录了行为的积极变化，它将为R01应用程序提供较大的随机对照试验，并具有认知，行为和生物学终点。如果RCT提供了有效性的有力证据，我们将与教育，健康，青年和文化部合作，在博茨瓦纳的中学中传播干预措施，并在每个社区中培训每个社区的员工，以忠实的态度进行该计划。 公共卫生相关性：博茨瓦纳（Botswana）是世界上任何地方受艾滋病袭击最严重的国家之一，成人患病率在30-34岁的年轻人中达到40.2％。结果，预期寿命从70年降低到33年。与撒哈拉以下平均水平为5.0％相比，估计有37-39％的博茨瓦纳成年人在15-49岁之间感染了HIV。尽管博茨瓦纳政府和非政府组织（NGOS）通过测试，普遍治疗和男性包皮环切术作斗争大流行，但这些生物医学策略并未与对有效行为干预的关注相似。一项新的国家战略计划将于2010年发布，该计划将基于循证计划的年轻人的行为主要预防确定为未来三年的最高优先事项。这项改编Bart的提议是一项基于证据的艾滋病毒预防效果，对博茨瓦纳青年来说是及时的，对新的国家优先事项做出了回应，以重新关注主要预防，以减少新的感染的发生率，尤其是在青年中。