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

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.

项目概要/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（15-24 岁） 岁）和微流行病（艾滋病毒高发地区）内，青少年中，女孩占80%。 所有青少年艾滋病毒感染者（15-19 岁）和青少年母亲 (AM) 的艾滋病毒风险高于 然而，由于 AM 在艾滋病毒预防研究中基本上被忽视，因此在 有关 AM 中微流行病发生地点以及结构性（例如城市化）和如何发生的知识 此外，尽管 AM 存在差异，但相关的 HIV 风险因素仍然影响着青少年母亲的 HIV 风险。 关系配置，没有研究检验关系因素的共现如何影响 AM 的 此外，大多数针对 AM 的 HIV 研究都采用类型学方法。 SSA 使用单级方法来描述 HIV 风险，而不是包含以下因素的多级框架： 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 这项探索性研究将使用修改后的社会生态框架来识别微观流行病，以及 描述影响 AM 的 HIV 风险的关系类型和多层次因素。 目的：1) 描述 SSA 中 AM 中的 HIV 微流行病特征，2) 确定 AM 性关系的类型， 3) 评估多层次因素是否与 AM 中的 HIV 风险和无保护性行为相关。 为了实现这些目标，本研究将使用 (1) 来自基于人群的艾滋病毒影响评估的二手数据 (PHIA)，其中包括 2,879 名 AM（年龄 15-19 岁）和 (2) 公开的结构层面数据，来自 将与 PHIA 集群级数据相关联的各种来源将采用多种定量分析方法。 用于执行目标，包括空间和机器学习技术（目标 1）、潜在类别分析（目标 2）、 和混合效应模型（目标 3）。研究结果可为 AM 的针对性 HIV 预防干预措施提供信息。 这项研究通过检查高危人群中艾滋病毒的结构性危险因素，与 NICHD 的研究重点相一致。 培训计划由 PI、发起人 Félice Lê 博士制定。 Scherban 和共同发起人 Allison Groves 博士和 Alex Ezeh 支持拟议的研究和 PI 培训目标，包括： 1）获得社会流行病学和流行病学理论框架方面的专业知识 青少年健康研究，2) 培养机器学习和潜在类别分析的方法技能，以及 3) 完善研究传播、沟通和学术写作技能。 PI 将利用以下资源。 德雷克塞尔大学多恩西夫公共卫生学院是一所协作性多学科机构 优先考虑健康差异和全球研究 拟议的研究、培训、机构和指导。 团队将支持 PI 追求成为一名独立的社会流行病学家，专注于推进 公平青少年群体的健康。