Expanding HIV Testing and Prevention to Reach Vulnerable Young Women

扩大艾滋病毒检测和预防范围，惠及弱势年轻女性

基本信息

批准号：
8991043
负责人：
WENDEE M WECHSBERG
金额：
$ 39.75万
依托单位：
RESEARCH TRIANGLE INSTITUTE
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-09-01 至 2020-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8991043
关键词：
19 year old AIDS prevention AIDS/HIV problem Address Adolescent Africa Age-Years Alcohol or Other Drugs use Behavioral Belief Biological Caring Cities Cluster randomized trial Collaborations Communities Community Outreach Counseling Country Diagnosis Disadvantaged Drops Drug usage Ensure Evidence based intervention Female Female Adolescents Financial Support Focus Groups Fright Gender Goals Government HIV HIV Infections HIV/STD Health Health Care Seeking Behavior Health Services Human immunodeficiency virus test Improve Access Incidence Inequality Intervention Interview Knowledge Learning Letters Life Mentors Methods Monitor Neighborhoods Outcome Participant Pharmaceutical Preparations Population Pregnancy Pregnancy in Adolescence Prevalence Process Provider Public Health Randomized Recruitment Activity Rehabilitation therapy Relative (related person)Reproductive Health Risk Risk Behaviors Risk Factors Risk Reduction Schools Science Services Sex Characteristics Side Social Development South Africa Student Dropouts Substance abuse problem Target Populations Testing Training Treatment Efficacy USAID Unemployment Unplanned pregnancy Update Victimization Violence Visit Vulnerable Populations Woman Women&apos s Health Work aged alcohol and other drug base effective therapy efficacy testing empowered evidence base experience follow-up gang gang violence improved innovation men motherhood outreach peer post intervention primary outcome programs public health relevance reduced substance use response role model secondary outcome sex risk sexual violence sexually active skills social stigma substance abuse treatment substance using adolescents transmission process treatment adherence treatment program uptake vulnerable adolescent young woman

项目摘要

DESCRIPTION (provided by applicant): Vulnerable female adolescents in disadvantaged communities in Cape Town who use alcohol and other drugs (AOD) and have dropped out of school experience the greatest burden of new HIV infections in South Africa. The risk for acquiring HIV is perpetuated through intersecting factors of AOD use, gender inequality, sexual risk, victimization, unplanned pregnancy, and gang violence. Despite the pervasive ongoing transmission of HIV, this vulnerable population remains underserved by current HIV and drug treatment programs, with few providing HIV testing and counselling (HTC), antenatal care, or substance abuse rehabilitation, and none providing comprehensive HTC programs that address these intersecting risks for HIV among this population. Since 2001, we have adapted and conducted a comprehensive evidence-based intervention for women, the Women's Health CoOp (WHC), that addresses AOD use, sexual risk, and gender-based violence. The WHC was listed in the USAID Compendium of Gender Studies in Africa. The Young Women's CoOp (YWC) is an adaptation of the WHC that targets this vulnerable population of AOD using female adolescents. This proposed RFA project seeks to reach this hard-to-reach population and overcome barriers to improved health for female adolescents who have dropped out of school by increasing update of HTC through a comprehensive gender-focused HTC intervention with trained peer co-facilitators and outreach workers from each community. The study findings may provide knowledge that could be used to increase the uptake of services and improve treatment adherence among female adolescents through the use of peer-driven intervention methods. Specific Aims: Our specific aims including the following. In a cluster randomized trial conducted in 12 disadvantaged communities in Cape Town, South Africa, and with government collaboration, we propose: Aim 1. To train and evaluate adolescent peer role models to conduct community outreach with established outreach workers to recruit 500 out-of schools, substance-using female adolescents aged 15-19 for HTC, and to co-facilitate a gender-focused comprehensive HTC program. Aim 2. To test the efficacy of a young women's gender-focused comprehensive HTC program for reducing substance use, victimization, and sexual risk behavior (primary outcomes) and improving access to effective treatment and support services through linkages to care (substance abuse treatment, HIV, STIs, antenatal and reproductive health as secondary outcomes) relative to standard HTC for adolescent females. This study's collaboration with the Western Cape-Department of Social Development and the City of Cape Town will also empower peers trained to conduct outreach and co-facilitate the intervention within community centers will most likely ensure greater sustainability where it is needed most.

描述（由申请人提供）：南非开普敦弱势社区中使用酒精和其他药物 (AOD) 并已辍学的弱势女性青少年承受着新的艾滋病毒感染的最大负担，感染艾滋病毒的风险持续存在。尽管艾滋病毒正在普遍传播，但当前的艾滋病毒和毒品治疗计划仍然未能为这一弱势群体提供足够的服务。很少有机构提供艾滋病毒检测和咨询 (HTC)、产前护理或药物滥用康复服务，也没有机构提供全面的 HTC 计划来解决该人群中这些交叉的艾滋病毒风险。自 2001 年以来，我们针对该人群调整并实施了全面的循证干预措施。妇女健康合作社 (WHC)，致力于解决 AOD 使用、性风险和基于性别的暴力问题 WHC 被列入美国国际开发署非洲性别研究纲要。 (YWC) 是 WHC 的改编版，针对 AOD 的这一弱势群体，该 RFA 项目旨在覆盖这一难以接触到的群体，并克服障碍，改善辍学女性青少年的健康状况。通过与来自每个社区的训练有素的同伴共同协调员和外展工作人员进行全面的以性别为中心的 HTC 干预，增加 HTC 的更新。研究结果可能提供可用于增加女性青少年对服务的接受率和提高治疗依从性的知识。使用同行驱动具体目标：我们的具体目标包括以下内容：在南非开普敦 12 个弱势社区进行的一项整群随机试验中，我们建议：目标 1. 培训和评估青少年同伴榜样。与既定的外展工作人员一起开展社区外展活动，招募 500 名 15-19 岁的失学、吸毒女性青少年参与 HTC，并共同促进以性别为中心的综合 HTC 计划。目标 2. 测试效果。年轻女性以性别为中心的综合性 HTC 计划，旨在减少药物使用、受害和性危险行为（主要成果），并通过与护理（药物滥用治疗、艾滋病毒、性传播感染、产前和生殖）联系，改善获得有效治疗和支持服务的机会相对于针对青少年女性的标准 HTC，这项研究与西开普省社会发展部和开普敦市的合作还将授权受过培训的同伴在社区中心内开展外展活动并共同促进干预措施。将很可能在最需要的地方确保更大的可持续性。