Integrating spatial and non-spatial data to examine multilevel drivers of HIV risk among adolescent mothers in sub-Saharan Africa

整合空间和非空间数据来研究撒哈拉以南非洲地区青少年母亲艾滋病毒风险的多层次驱动因素

• 批准号: 10700436
• 负责人: Luwam T Gebrekristos
• 金额: $ 4.13万
• 依托单位: DREXEL UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-06-01 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10700436
• 关键词: 19 year old; AIDS prevention; Address; Adolescent; Adolescent HIV risk; Adult; Africa South of the Sahara; Applications Grants; Area; Behavioral; Characteristics; Communication; Country; Data; Data Analyses; Education; Epidemic; Epidemiologist; Fellowship; Female Adolescents; Funding; Future; Gender; Geography; Goals; HIV; HIV Infections; HIV Seronegativity; HIV diagnosis; HIV risk; HIV-infected adolescents; Health Priorities; Heterogeneity; Household; Individual; Inequity; Institution; Intervention; Knowledge; Laboratories; Laboratory Diagnosis; Lead; Link; Machine Learning; Maps; Masks; Measures; Mediation; Mentorship; Methodology; Methods; Modeling; Mothers; National Institute of Child Health and Human Development; Participant; Persons; Policies; Population; Populations at Risk; Poverty; Prevalence; Prevention Research; Prevention strategy; Public Health Schools; Research; Research Priority; Resources; Risk; Risk Factors; Safe Sex; Sample Size; Sampling; Sex Behavior; Source; Subgroup; Techniques; Training; Transact; Typology; United States National Institutes of Health; Universities; Unsafe Sex; Urbanicity; Urbanization; Vulnerable Populations; Writing; adolescent health; aged; career; cost efficient; design; girls; health care availability; health disparity; health equity; high risk; marginalization; motherhood; multidisciplinary; peer; population based; preventive intervention; programs; research data dissemination; sex; sexual relationship; skills; social; social epidemiology; spatial integration; structural determinants; teenage mother; transmission process; young woman; 19 year old; AIDS prevention; Address; Adolescent; Adolescent HIV risk; Adult; Africa South of the Sahara; Applications Grants; Area; Behavioral; Characteristics; Communication; Country; Data; Data Analyses; Education; Epidemic; Epidemiologist; Fellowship; Female Adolescents; Funding; Future; Gender; Geography; Goals; HIV; HIV Infections; HIV Seronegativity; HIV diagnosis; HIV risk; HIV-infected adolescents; Health Priorities; Heterogeneity; Household; Individual; Inequity; Institution; Intervention; Knowledge; Laboratories; Laboratory Diagnosis; Lead; Link; Machine Learning; Maps; Masks; Measures; Mediation; Mentorship; Methodology; Methods; Modeling; Mothers; National Institute of Child Health and Human Development; Participant; Persons; Policies; Population; Populations at Risk; Poverty; Prevalence; Prevention Research; Prevention strategy; Public Health Schools; Research; Research Priority; Resources; Risk; Risk Factors; Safe Sex; Sample Size; Sampling; Sex Behavior; Source; Subgroup; Techniques; Training; Transact; Typology; United States National Institutes of Health; Universities; Unsafe Sex; Urbanicity; Urbanization; Vulnerable Populations; Writing; adolescent health; aged; career; cost efficient; design; girls; health care availability; health disparity; health equity; high risk; marginalization; motherhood; multidisciplinary; peer; population based; preventive intervention; programs; research data dissemination; sex; sexual relationship; skills; social; social epidemiology; spatial integration; structural determinants; teenage mother; transmission process; young woman

PROJECT SUMMARY/ABSTRACT HIV transmission in sub-Saharan Africa (SSA) occurs predominantly among young people (aged 15-24 years old) and within micro-epidemics (high HIV prevalence areas). Among adolescents, girls account for 80% of all adolescent HIV infections (15-19 years old) and adolescent mothers (AMs) are at higher HIV risk than non-parenting girls. However, as AMs have been largely overlooked in HIV prevention research, gaps in knowledge regarding where micro-epidemics occur among AMs and how structural (e.g., urbanization) and relational HIV risk factors impact adolescent mothers’ HIV risk remain. Further, despite differences in AMs’ relationship configurations, no studies have examined how the co-occurrence of relational factors impact AMs’ vulnerability to HIV and unprotected sex using a typological approach. Moreover, most HIV studies on AMs in SSA use a single-level approach to describe HIV risk as opposed to a multilevel framework that incorporates spatial (i.e., structural factors) and non-spatial (i.e., relationship typologies, individual and familial factors) risk factors. This exploratory study will use a modified social ecological framework to identify micro-epidemics, and to characterize relationship typologies and multilevel factors that impact AMs’ HIV risk. The specific aims are to: 1) characterize HIV micro-epidemics among AMs in SSA, 2) identify typologies of AMs’ sexual relationships, and 3) assess whether multilevel factors are associated with HIV risk and unprotected sex among AMs. To address these aims, this study will use (1) secondary data from the Population-based HIV Impact Assessment (PHIA), which includes 2,879 AMs (aged 15-19 years old); and (2) publicly available structural-level data, from various sources which will be linked to PHIA cluster-level data. Multiple quantitative analytic approaches will be used to execute aims, including spatial and machine learning techniques (Aim 1), latent class analysis (Aim 2), and mixed effects modeling (Aim 3). Study findings may inform targeted HIV prevention interventions for AMs. This study aligns with the NICHD’s research priorities by examining structural risk factors of HIV in a high-risk setting and the UNAIDS 95-95-95 goal. The training plan developed by the PI, sponsor Dr. Félice Lê- Scherban, and co-sponsors Drs. Allison Groves and Alex Ezeh, supports the proposed research and the PI’s training goals, which are to: 1) gain expertise in theoretical frameworks of social epidemiological and adolescent health research, 2) develop methodological skills in machine learning and latent class analysis, and 3) refine research dissemination, communication, and scholarly writing skills. The PI will leverage resources at Drexel University Dornsife School of Public Health, a collaborative and multidisciplinary institution that prioritizes health disparities and global research. The proposed research, training, institution, and mentorship team will support the PI’s pursuit of becoming an independent social epidemiologist focusing on advancing health equity among marginalized adolescent populations.

项目摘要/摘要 撒哈拉以南非洲（SSA）的艾滋病毒传播主要发生在年轻人中（15-24岁 年龄）和微发育学（高艾滋病毒流行地区）。在青少年中，女孩占80％ 在所有青春期艾滋病毒感染（15-19岁）和青少年母亲（AMS）中，艾滋病毒风险高于 非父母的女孩。但是，正如AM在艾滋病毒预防研究中受到了很大的忽视，差距 关于AMS之间微发育的地方以及结构（例如城市化）和如何 关系艾滋病毒危险因素影响青少年母亲的艾滋病毒风险。此外，AMS的绝望差异 关系配置，没有研究研究关系因素的同时存在如何影响AMS 使用类型学方法对艾滋病毒和无保护性的脆弱性。此外，大多数HIV研究 SSA使用单层方法来描述HIV风险，而不是合并的多级框架 空间（即结构因素）和非空间（即关系类型，个人和家庭因素）风险 因素。这项探索性研究将使用经过改进的社会生态框架来识别微发育和 表征影响AMS艾滋病毒风险的关系类型和多层次因素。具体目的是 TO：1）在SSA中的AMS中表征HIV微发育，2）确定AMS性关系的类型， 3）评估AMS中多层因素是否与HIV风险和不受保护的性别有关。到 解决这些目的，本研究将使用（1）基于人群的HIV影响评估的辅助数据 （Phia），其中包括2,879 AM（15-19岁）； （2）从 各种来源将链接到PHIA群集级数据。多种定量分析方法将是 用于执行目标，包括空间和机器学习技术（AIM 1），潜在类别分析（AIM 2）， 和混合效应建模（AIM 3）。研究结果可能会为AMS的有针对性的HIV预防干预措施提供信息。 这项研究通过检查高危HIV的结构性风险因素与NICHD的研究优先级保持一致。 设置和UNAID 95-95-95目标。 PI制定的培训计划，赞助商FéliceLê-博士 Scherban和共同赞助商Drs。 Allison Groves和Alex Ezeh，支持拟议的研究和PI 培训目标，即：1）在社会流行病学和 青少年健康研究，2）在机器学习和潜在类别分析中发展方法学技能，以及 3）完善研究传播，沟通和科学写作技巧。 PI将利用资源 德雷克塞尔大学多恩斯夫公共卫生学院，这是一家合作和多学科机构 优先考虑健康差异和全球研究。拟议的研究，培训，机构和心态 团队将支持PI成为一名专注于前进的独立社会流行病学家的追求 边缘化青少年人群之间的健康公平。