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，艾滋病毒预防在女性而非男性中最为成功。例如，18-29 岁的南非年轻男性的艾滋病毒发病率仍然很高，经常吸毒，艾滋病毒检测率低，同时发生性行为。我们需要在如何、何时、何地让男性参与艾滋病毒预防方面进行创新。通过 R34 资金，我们成功地证明了让年轻人参与足球和职业培训的可行性。减少药物使用。将两个社区随机分为：干预（根据足球行为进行足球和职业培训）；或延迟交付对照社区。几乎所有符合条件的社区男性都被招募（95%；N=142），并在 6 个月时重新评估。在干预条件下，80% 的年轻人定期参加足球比赛，55% 的年轻人参加了职业训练。仅根据对男性、教练和家庭成员的定性访谈，与对照组男性相比，艾滋病毒检测结果并没有增加，尽管态度发生了转变，但该计划对改变男性在家庭和社区中的角色有好处。根据这些结果，建议进行一项随机对照试验 (RCT)，以测试随机分配社区中所有年轻男性接受以下活动的效果：1) 足球训练（8 个社区，针对 400 名男性）；职业培训（8 个社区，400 名男性）；或 3）控制条件（8 个社区，400 名男性）主要结果是减少药物使用（通过快速诊断测试 [RDT] 进行测试），增加重复艾滋病毒检测（连锁、艾滋病毒感染者的保留和遵守医疗护理）、没有同时存在的伙伴关系、增加安全套的使用以及没有暴力/逮捕。斯泰伦博斯大学面试官将在招聘时、6、15 和 15 日进行评估。 24 个月（使用手机）。教练将实施生活技能手册，并将认知行为技能融入到比赛/练习中出现的问题情况中，并通过手机实时报告所有干预联系人和内容。将与教练和年轻人一起进行（n=30，每 6 个月一次）如果 RCT 成功，国际足球协会联合会 (FIFA) 可能会在南非政府的国家资助下进行全球计划推广。 NEET（非教育、就业或培训）职业培训计划，其年度资金通常不足。