Positive Outcomes for Orphans (POFO): HIV Risk as Young Adults

孤儿的积极成果 (POFO)：年轻人的艾滋病毒风险

• 批准号: 9410634
• 负责人: Jan Ostermann
• 金额: $ 63.93万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-09 至 2022-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9410634
• 关键词: 19 year old; AIDS prevention; AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Adolescence; Adolescent; Africa; Age; Alcohol or Other Drugs use; Area; Behavior; Cambodia; Caregivers; Caring; Cause of Death; Characteristics; Child; Child Care; Childhood; Cognitive Therapy; Communities; Continuing Education; Country; Data; Data Collection; Development; Education; Emotional; Employment; Enrollment; Ensure; Ethiopia; Event; Family; Female; Female Adolescents; Future; Gender; Generations; Geography; Grant; HIV; HIV Infections; HIV Seropositivity; HIV risk; Home environment; Human immunodeficiency virus test; Immunoglobulin A; Income; India; Influentials; Intervention; Interview; Kenya; Life; Life Cycle Stages; Link; Longitudinal Studies; Manuscripts; Methods; Modeling; Nature; Orphan; Outcome; Parents; Participant; Policies; Politics; Population; Populations at Risk; Positioning Attribute; Pregnancy in Adolescence; Prevalence; Prevention program; Preventive Intervention; Procedures; Recording of previous events; Research; Risk Behaviors; Sampling; Site; Social support; Survey Methodology; Surveys; Tanzania; Target Populations; Testing; Trauma; United States National Institutes of Health; Vulnerable Populations; Weight; Work; Youth; age group; aged; child protection; cohort; design; early childhood; experimental study; follow-up; gender difference; high risk; improved; insight; interest; intimate partner violence; low and middle-income countries; low income country; male; next generation; novel; orphaned adolescents; physical conditioning; predictive modeling; preference; programs; resilience; retention rate; screening; sex; social stigma; tool; young adult

AIDS is the leading cause of death among adolescents in Africa, and the 2nd leading cause of death among adolescents globally, with two-thirds of all new HIV infections amongst 15-19 year olds occurring in adolescent girls. Orphaned and separated children (OSC) are at especially high risk of becoming HIV infected. “Positive Outcomes for Orphans (POFO): HIV Risk as Young Adults” will evaluate factors associated with HIV risk, HIV testing, and HIV treatment engagement and retention during adolescence and young adulthood. Between 2006-8, the HIV/AIDS and Orphan Care: Positive Outcomes for Orphans (POFO) study used random sampling survey methods to enroll 3,057 OSC ages 6-12 living in families (N=1,562) and institutional care settings (N=1,495) representative of the OSC populations in 5 culturally, economically, and politically distinct countries: Ethiopia, Kenya, Tanzania, Cambodia and India. With 10 years of follow-up, POFO is the only multi-country longitudinal study of OSC and its findings have directly impacted policies and interventions for OSC. Half of all adolescents living with HIV are in 6 countries, 4 of which were included in this study. To date, 9% of POFO participants (now ages 16-22) have tested, or are suspected to be, HIV positive, a rate well above national averages. The first aim of this grant is to follow the POFO OSC cohort as they transition through adolescence and into young adulthood to identify associations with HIV risk and related behaviors. With three additional rounds of data collection, up to 14 years of data will be available for each OSC participant (ages 21-27 at study completion). HIV testing will be offered at each round and barriers and facilitators of treatment engagement and retention will be assessed. The second aim is to create long- term predictive models of HIV-relevant outcomes that identify in early childhood those OSC who are at highest risk for HIV as young adults. All 14 years of data will be used to develop models to support the development of screening tools that identify high-risk OSC early in life. In order to derive weights that allow estimates to represent today’s OSC, we will compare the original POFO sample with a new sample of OSC from the same areas: we will add a new cross-sectional sample of 250 OSC ages 6-16 (to match POFO I and II) at each of the four sites participating in this study (N=1,000) following the original POFO I sampling procedures. The third aim is to identify site- and gender-specific preferences for HIV related prevention programs. Quantitative surveys, including choices between systematically varied vignettes in the form of a discrete choice experiment conducted with all participating OSC and their caregivers, will elicit the relative acceptability of diverse prevention interventions in the local context. This R01 has significant potential to shift paradigms for the design and implementation of interventions that target the HIV risk and treatment engagement among this most at risk population.

艾滋病是非洲青少年死亡的主要原因，也是第二大死亡原因 在全球青少年中，有15-19岁的年轻人中有三分之二的新艾滋病毒感染 青春期女孩。孤儿和分居的儿童（OSC）尤其高的风险 已感染。 “孤儿的积极结果（POFO）：年轻人的艾滋病毒风险”将评估因素 与青少年期间的HIV风险，HIV测试以及HIV治疗的参与和保留有关 和年轻的成年。在2006 - 8年之间，艾滋病毒/艾滋病和孤儿护理：孤儿的积极成果 （POFO）研究使用随机抽样调查方法招募3,057个OSC 6-12岁的家庭（n = 1,562） 和机构护理环境（n = 1,495），代表5个文化，经济上的OSC人群 政治不同的国家：埃塞俄比亚，肯尼亚，坦桑尼亚，柬埔寨和印度。随访10年，pofo 是OSC的唯一多国纵向研究及其发现直接影响了政策和 OSC的干预措施。所有艾滋病毒感染的青少年中有一半在6个国家，其中4个包括在其中 学习。迄今 评分远高于国家平均值。这笔赠款的第一个目的是跟随POFO OSC队列 通过青少年过渡到成年年轻人，以识别患有艾滋病毒风险和的关联 相关行为。另外三轮数据收集，最多可用于14年的数据 每个OSC参与者（研究完成时21-27岁）。每回合和障碍将提供艾滋病毒测试 将评估治疗参与和保留的促进者。第二个目的是创建长期 在幼儿期间识别的艾滋病毒相关结果的术语预测模型 年轻人艾滋病毒的最高风险。所有14年的数据都将用于开发模型以支持 开发筛选工具，这些工具在生命的早期识别高风险的OSC。为了得出允许的权重 估计代表当今的OSC，我们将将原始pofo样本与来自的新样本进行比较 相同的区域：我们将添加一个新的250个OSC年龄的新的横截面样本（以匹配pofo I和ii） 在原始pofo i抽样程序之后，四个站点中的每个站点中的每个站点（n = 1,000）。 第三个目的是确定针对艾滋病毒相关的预防计划的现场和性别特定的偏好。 定量调查，包括以离散选择形式的系统变化的小插图之间的选择 与所有参与的OSC及其护理人员进行的实验将引起相对的可接受性 在当地情况下的预防干预措施。该R01具有转移范式的巨大潜力 用于设计和实施针对艾滋病毒风险和治疗参与的干预措施 其中最有风险的人口。