The Problem With Male Sexual/Repro Health:Qualitative/Quantitative Study, Uganda

男性性/生殖健康问题：定性/定量研究，乌干达

• 批准号: 8507491
• 负责人: Maria J Wawer
• 金额: $ 42.67万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-09 至 2015-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8507491
• 关键词: Adolescent; Adoption; Adult; Africa; Africa South of the Sahara; African; Attitude; Behavior; Behavioral; Belief; Caring; Censuses; Characteristics; Charge; Clinic; Cohort Studies; Communities; Consent; Contraceptive methods; Couples; Data; Data Collection; Databases; Development; Effectiveness; Elderly; Enrollment; Family; Family Planning; Fathers; Female Contraceptive Agents; Fertility Rates; Focus Groups; Funding; Future; Gatekeeping; Gender Role; General Population; HIV; HIV/STD; Health; Health Personnel; Health Sciences; Health Services; Health behavior; Household; Influentials; Information Services; Intervention; Intervention Studies; Interview; Knowledge; Male Circumcision; Methods; Mothers; Outcome; Parents; Participant; Peer Pressure; Perception; Persons; Planned Pregnancy; Play; Policy Research; Population; Prevention; Preventive Health Services; Provider; Qualitative Methods; Qualitative Research; Reproductive Health; Reproductive Health Services; Research; Risk; Risk Behaviors; Risk Reduction; Role; Services; Sexual Health; Site; Social Health Services; Social Work; Son; Spouses; Structure; Suggestion; Surveys; System; Testing; Uganda; Wife; Woman; aged; antiretroviral therapy; base; behavior influence; community setting; condoms; consistent condom use; cost; design; experience; health care service utilization; improved; male; member; men; peer; programs; role model; service utilization; social; social stigma; therapy outcome; transmission process; uptake

DESCRIPTION (provided by applicant): Men play a pivotal role in the adoption of currently proven methods of sexual HIV/STI risk reduction, including consistent condom use and male circumcision (MC). Men also influence partners' use of contraception. However, males have fewer entry points to sexual and reproductive health (SRH) information and services, since most family planning and pregnancy-related programs are woman-centered. Finally, men tend to utilize many health care services less than women; in the case of HIV, these results in delayed treatment, poorer antiretroviral therapy (ART) outcomes, and potentially more HIV transmission. The Rakai Health Sciences Program (RHSP), Uganda, has documented many challenges related to male use of SRH services in the general population of the ongoing Rakai Community Cohort Study (RCCS) - a longitudinal behavioral and HIV study of 50 villages - despite the fact that the RHSP offers services free of charge through PEPFAR. In this RO1, we propose to conduct mixed method qualitative and quantitative research on personal, social and structural facilitators and barriers to the acceptance and use of key SRH-associated services by adolescent and adult men, and to explore attitudes regarding potential approaches to increase SRH use. Qualitative research, conducted among male users and non-users of services, family (e.g., spouses, parents) and community members (e.g., influential peers, service providers), will include focus groups to examine community norms; and in-depth interviews to explore personal factors, social influences and perceived structural barriers (such as quality of services) which influence use of SRH. We will also conduct structured observations in service provision sites to identify venue-related obstacles and in other community settings to examine if selected services may be provided there. The qualitative research will be embedded within the RCCS, providing a unique opportunity to purposively enroll male participants on the basis of risk behaviors and service use/nonuse, and to explore social and familial contexts of and influences on male SRH behaviors. On the basis of FGD and IDI data, we will also design and incorporate a module on male SRH into the annual RCCS survey of ~14,000 adults, in order to examine the generalizability of the qualitative findings in the Rakai population and to determine the distribution of key attitudes, perceptions and behaviors. This RO1 will provide the most comprehensive information to date on barriers to and potential motivators of male SRH service acceptance/use in an African setting, and will inform the design of future intervention studies of community and clinic-based strategies to improve male uptake of services such as condoms, MC, family planning, and for HIV+ men, ART. Findings, which will be disseminated in the African region, will also have implications for improving male use of other health and preventive services.

描述（由申请人提供）：男性在采用当前证明的性HIV/STI风险降低方法中起着关键作用，包括一致的避孕套使用和男性包皮环切术（MC）。男人还影响伴侣对避孕的使用。但是，男性的性和生殖健康（SRH）信息和服务的入口更少，因为大多数计划生育和与妊娠有关的计划都是以女性为中心的。最后，男性倾向于利用许多医疗服务少于女性。在HIV的情况下，这些导致延迟治疗，较差的抗逆转录病毒疗法（ART）结局以及潜在的HIV传播。乌干达的Rakai Health Sciences计划（RHSP）记录了与男性使用SRH服务有关的许多挑战，尽管这是50个村庄的纵向行为和HIV研究，尽管RHSP可以通过PEPFAR提供免费的服务。 在此RO1中，我们建议对个人，社会和结构促进者进行定性和定量研究，以及对青少年和成年男性接受和使用与SRH相关的关键服务的障碍，并探索对增加SRH使用的潜在方法的态度。定性研究，在男性用户和非用户服务，家庭（例如配偶，父母）和社区成员（例如有影响力的同伴，服务提供者）中进行的定性研究将包括检查社区规范的焦点小组；以及探索影响使用SRH使用的个人因素，社会影响和感知的结构性障碍（例如服务质量）的深入访谈。我们还将在服务提供站点中进行结构化的观察，以确定与场地相关的障碍和其他社区环境，以检查是否可以在那里提供选定的服务。定性研究将嵌入RCC中，为男性参与者提供独特的机会，以风险行为和服务使用/不使用，并探索对男性SRH行为的社会和家族背景。在FGD和IDI数据的基础上，我们还将设计并将男性SRH的模块纳入对约14,000名成年人的年度RCC调查中，以检查Rakai人群中定性发现的普遍性，并确定关键态度，感知和行为的分布。 该RO1将提供迄今为止在非洲环境中男性SRH服务接受/使用的障碍和潜在动机的最全面的信息，并将为基于社区和诊所的未来干预研究设计，以改善男性吸收，例如避孕套，MC，MC，计划生育和HIV+男性，艺术，艺术。将在非洲地区传播的发现也将对改善男性对其他健康和预防服务的使用有影响。