Sexual behaviors, sexual networks and reproductive health in Malawi

马拉维的性行为、性网络和生殖健康

基本信息

批准号：
8435326
负责人：
Stephane Helleringer
金额：
$ 7.59万
依托单位：
COLUMBIA UNIVERSITY HEALTH SCIENCES
依托单位国家：
美国
项目类别：
财政年份：
2012
资助国家：
美国
起止时间：
2012-03-01 至 2014-06-28
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8435326
关键词：
Address Affect African Age Agreement Behavior Calibration Cessation of life Characteristics Clinic Coitus Country Data Data Set Disease Disease Outbreaks Educational Status Enrollment Event Health Individual Infection Injection of therapeutic agent Interview Island Life Cycle Stages Link Low income Malawi Male Circumcision Maps Marriage Measures Medical Outcome Participant Patient Self-Report Pattern Population Population Study Positioning Attribute Preventive Intervention Recording of previous events Relative (related person)Reporting Reproductive Health Research Research Support Respondent Risk Risk Behaviors Risk Factors Schools Sex Behavior Sexual Health Sexual Partners Sexually Transmitted Diseases Structure Surveys Symptoms Testing Time Unplanned pregnancy Unsafe Sex Woman base child bearing condoms follow-up mathematical model member mortality movie sexual relationship

项目摘要

DESCRIPTION (provided by applicant): According to the WHO, unsafe sex is responsible for 1.7 million deaths in low income countries and is the leading risk factor for mortality in African women. An increasing number of sexual behavior surveys are conducted in sub-Saharan countries to understand and address the key determinants of poor sexual/reproductive health, but such surveys present major limitations. They are often affected by non-negligible levels of non-response and only provide self-reported, highly unreliable data on individual behaviors. Virtually all surveys have also been "egocentric", i.e., they are limited to eliciting the sexual partnerships of a respondent without providing information on the sexual networks of a respondent's partner(s) that indirectly put the respondent at risk. These indirect connections are a major determinant of disease dynamics in populations. In 2005, we initiated a unique study of population-level sexual networks on Likoma Island (Malawi) that integrated partner tracing. Using these data (also known as "sociocentric"), we were able to reconstruct "maps" of the sexual connections that link inhabitants of the island directly and indirectly. We have also documented large biases in self-reported data on sexual partnerships. In 2007, we conducted a follow-up of that study, yielding the first longitudinal dataset on the global sexual networks of a sub-Saharan population. The main aim of this application is to document previously unobserved longitudinal dynamics of the sexual networks that make sex unsafe in Likoma (a small island of Northern Malawi). During this project, we will 1) use multiple reports of sexual partnerships obtained during the survey to measure the extent of non-response, attrition and misreporting biases in self-reported sexual network data, 2) describe, for the first time in a sub-Saharan setting, changes in the global structure of sexual networks and changes and individual trajectories within these networks and 3) determine whether sexual and reproductive health outcomes are associated with the observed network structures. This will provide new information on sexual networking that could inform preventive interventions in sub-Saharan countries. It will also provide empirical estimates of parameters that will permit the appropriate calibration of mathematical models of disease spread.

描述（由申请人提供）：据世界卫生组织称，不安全性行为导致低收入国家 170 万人死亡，并且是非洲妇女死亡的主要风险因素。撒哈拉以南国家进行了越来越多的性行为调查，以了解和解决性健康/生殖健康不佳的关键决定因素，但此类调查存在重大局限性。他们常常受到不可忽视的不答复的影响，并且只提供自我报告的、非常不可靠的个人行为数据。事实上，所有调查都是“以自我为中心”的，即，它们仅限于引出受访者的性伙伴关系，而不提供受访者伴侣的性网络信息，从而间接使受访者面临风险。这些间接联系是人群疾病动态的主要决定因素。 2005 年，我们对利科马岛（马拉维）人口层面的性网络进行了一项独特的研究，其中整合了伴侣追踪。利用这些数据（也称为“社会中心”），我们能够重建直接和间接连接岛上居民的性关系“地图”。我们还记录了有关性伙伴关系的自我报告数据中存在巨大偏差。 2007 年，我们对该研究进行了后续研究，产生了第一个关于撒哈拉以南人口全球性网络的纵向数据集。该应用程序的主要目的是记录以前未观察到的性网络的纵向动态，这些动态使利科马（马拉维北部的一个小岛）的性行为变得不安全。在这个项目中，我们将 1) 使用调查期间获得的多份性伙伴关系报告来衡量自我报告的性网络数据中不答复、自然流失和误报偏差的程度，2) 首次以子项目的形式描述-撒哈拉环境、性网络全球结构的变化以及这些网络内的变化和个体轨迹，3) 确定性健康和生殖健康结果是否与观察到的网络结构相关。这将提供有关性网络的新信息，为撒哈拉以南非洲国家的预防性干预措施提供信息。它还将提供参数的经验估计，以便对疾病传播的数学模型进行适当的校准。