HIV & Drug Abuse Prevention for South African Men

艾滋病病毒

基本信息

批准号：
9049473
负责人：
Mary Jane Rotheram-Borus
金额：
$ 50.41万
依托单位：
UNIVERSITY OF CALIFORNIA LOS ANGELES
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：
2015-04-15 至 2020-02-29
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9049473
关键词：
AIDS prevention Adherence Africa Alcohol consumption Alcohol or Other Drugs use Area Behavior Behavioral California Car Phone Caring Cognitive Communities Data Diagnostic tests Diffuse Diffusion Drug usage Education Effectiveness Elements Employment Family Family member Frequencies Funding Future Gender Government Grant HIV Health Healthcare Home environment Human immunodeficiency virus test Incidence Income Intervention Interview Interviewer Life Los Angeles Manuals Manufactured football Medical Men&apos s Role Mental Health Minor Modeling Monitor Neighborhoods Occupations Outcome Patient Self-Report Perinatal Pharmaceutical Preparations Play Prevalence Prevention Prevention strategy Preventive Intervention Public Health Randomized Randomized Controlled Trials Recruitment Activity Reporting Research Infrastructure Risk Role playing therapy Schedule Services Site Soccer Social support South Africa South African Substance abuse problem Symptoms Testing Time Training Training Programs Unemployment Universities Violence Vocational Education Woman age group aged apprenticeship base condoms contingency management design drug abuse prevention drug testing efficacy testing expectation improved innovation men primary outcome programs reduced substance use response sex sex risk skills social norm time use uptake young man

项目摘要

DESCRIPTION: In Africa, HIV prevention has been most successful with women, not men. For example, young, South African men aged 18-29 years continue to have a high incidence of HIV, frequent drug use, low HIV testing rates, concurrent sexual partnerships, and low rates of HIV testing and utilization of medical care. Innovations are needed in how, when, and where we engage men in HIV prevention. With R34 funding, we successfully demonstrated the feasibility of engaging young men with soccer and vocational training to reduce drug use. We randomized two neighborhoods to either: an intervention (soccer and vocational training contingent on behaviors at soccer); or a delayed-delivery control neighborhood. Almost all eligible neighborhood men were recruited (95%; N=142) and 90% reassessed at 6 months. In the intervention condition, 80% of young men regularly attended soccer and 55% earned entry to vocational training. Intervention men completed drug tests at soccer (with uptake rising over time and drug use decreasing), and increased employment over six months, compared to control men. HIV testing did not increase, based only on self-reports. Qualitative interviews of men, coaches, and family members demonstrated the program's benefits in shifting men's role in their homes and communities, although attitudinal shifts towards women were minor. Based on these results, a randomized controlled trial (RCT) is proposed to test the efficacy of randomizing all young men in a neighborhood to receive: 1) soccer training (8 neighborhoods, 400 men); 2) soccer and vocational training (8 neighborhoods, 400 men); or 3) a control condition (8 neighborhoods, 400 men). The primary outcomes will be decreased substance use (tested with rapid diagnostic tests [RDT]), increased repeat HIV testing (linkage, retention, and adherence to medical care among HIV-infected men), no concurrent partnerships, increased condom use, and no violence/arrests. Stellenbosch University interviewers will conduct assessments at recruitment, 6, 15, and 24 months (using mobile phones). Coaches will implement a Life Skills manual, as well as integrating cognitive-behavioral skills into problem situations that arise at games/practices, and reporting in real time via mobile phones all intervention contacts and content. Qualitative interviews will be conducted with coaches and young men (n=30 at each 6 month interval). If the RCT is successful, global program diffusion is probable by the Fédération Internationale de Football Association (FIFA) with national funding by the South African government NEET (Not in Education, Employment or Training) vocational training program, whose annual funding is typically underspent.

描述：在非洲，预防艾滋病毒是女性而不是男性最成功的。例如，年龄在18-29岁之间的年轻，南非男性继续发生较高的艾滋病毒，频繁使用毒品，低艾滋病毒测试率，同时性伙伴关系以及艾滋病毒测试率低和医疗服务的利用率较低。需要在如何，何时和何处与男人进行预防艾滋病毒的方式进行创新。通过R34资金，我们成功证明了使年轻人接受足球和职业培训以减少吸毒的可行性。我们将两个社区随机分配到：干预措施（足球和职业培训取决于足球行为）；或延迟交付控制社区。招募了几乎所有合格的邻里男性（95％； n = 142），在6个月时重新评估了90％。在干预条件下，有80％的年轻人定期参加足球比赛，55％的年轻人获得了投票培训。与对照男子相比，干预男性在足球比赛中完成了药物测试（随着时间的推移随着时间的推移而增加，吸毒量减少），并且在六个月内增加了就业。仅基于自我报告，HIV测试并没有增加。对男性，教练和家庭成员的定性访谈表明，尽管对女性的态度转变很小，但该计划在转移男性在家里和社区中的作用方面的好处。基于这些结果，提出了一项随机对照试验（RCT），以测试将所有年轻人随机接收的有效性：1）足球训练（8个社区，400名男子）； 2）足球和职业培训（8个社区，400人）；或3）控制条件（8个社区，400人）。主要结果将减少药物使用（通过快速诊断测试[RDT]进行测试），增加了重复HIV测试（连锁，保留和遵守HIV感染的男性医疗保健），没有并发伙伴关系，避孕套的使用增加，也没有暴力/逮捕。 Stellenbosch大学访调员将在招聘，6、15和24个月（使用手机）进行评估。教练将实施生活技能手册，并将认知行为技能整合到游戏/实践中出现的问题情况下，并通过手机实时报告所有干预联系人和内容。定性访谈将与教练和年轻人进行（每6个月间隔n = 30）。如果RCT成功，全球计划的扩散是由FédérationInternationale de Football Association（FIFA）带来的，南非政府NEET（不在教育，就业或培训中）的职业培训计划的国家资助，其年度资金通常不承担。