HIV status and achieving fertility desires: Implications for HIV prevention and t

艾滋病毒状况和实现生育愿望：对艾滋病毒预防和治疗的影响

基本信息

批准号：
7616871
负责人：
Akinrinola Bankole
金额：
$ 29.2万
依托单位：
GUTTMACHER INSTITUTE
依托单位国家：
美国
项目类别：
财政年份：
2008
资助国家：
美国
起止时间：
2008-05-01 至 2013-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7616871
关键词：
AIDS prevention Accounting Address Affect Africa South of the Sahara African Age Age-Years Anti-Retroviral Agents Attention Attitude Behavior Biological Markers Caring Client Communities Contraceptive Agents Contraceptive Usage Contraceptive methods Counseling Country Couples Data Data Collection Data Set Demographic and Health Surveys Effectiveness Epidemic Face Family Sizes Federal Government Fertility Fertility Preferences Fertility Rates Future Goals Government Government Agencies HIV HIV Infections HIV Seropositivity HIV diagnosis Hand Health Personnel Health Services Health Services Accessibility Health care facility Healthcare High Prevalence Human immunodeficiency virus test Individual Infection Intention International Agencies Intervention Interview Joints Laws Measures Multivariate Analysis Nigeria Patients Perception Pharmaceutical Preparations Policies Population Pregnancy Pregnant Women Prevalence Prevention Protocols documentation Provider Public Health Reproductive Behavior Reproductive Health Reproductive Health Services Research Resolution Respondent Risk Role Sampling Services Sex Behavior Social support Stigmata Structure Surveys Technology Termination of pregnancy Test Result Testing Time Vertical Disease Transmission Visit Woman Zambia abortion base behavioral/social science child bearing condoms coping design experience improved meetings men preference prevent prevention service programs reproductive social science research social stigma transmission process trend unintended pregnancy willingness

项目摘要

DESCRIPTION (provided by applicant): The objective of this study is to help individuals and couples in African countries facing generalized HIV epidemics to achieve their family size goals and prevent unintended pregnancies while avoiding or coping with HIV infection. To do so, we propose to undertake new research that will improve provision of sexual and reproductive health services, including HIV- related care. Research on the influence of HIV status on childbearing intentions and contraceptive use in sub-Saharan Africa is very scarce. Existing studies have important limitations: most are small-scale and designed to assess the impact of interventions; most study HIV-positive people, sampled at health facilities, and most include women only, and lack the perspective of men, especially important in sub-Saharan Africa. To meet the study's objective, we propose three research efforts: (a) We will undertake new analyses of existing nationally representative survey data on men and women of reproductive age in 14 countries of sub-Saharan Africa, to provide a regional overview of the interrelationships between HIV status (based on biomarker testing, done in the surveys) and fertility desires and sexual and reproductive behaviors; bivariate and multivariate analyses will be done, as well as multilevel analyses for the 5 countries that also have information on availability of HIV-related services. (b) To provide deeper understanding of relationships between HIV status and attitudes regarding HIV-testing and services and the actions women and men are taking to achieve their fertility aspirations and prevent or cope with HIV infection, we will conduct a two-part study in one moderate-HIV-prevalence country (Nigeria) and one high prevalence country (Zambia): a quantitative survey of a community-based sample of 1300 men and women and a facility-based sample of 200 HIV positive people in each country; and in-depth interviews with 48 respondents systematically selected from the quantitative survey in each country. (c) We will conduct semi-structured interviews with about 80 health care providers in each country (Nigeria and Zambia) that provide sexual and reproductive health care, to improve understanding of the roles of providers in helping men and women meet their fertility aspirations and avoid or cope with HIV infection, with special attention to recent efforts to routinize and expand HIV testing. Project Narrative From the public health perspective, preventing the transmission of HIV and unintended pregnancy are very high priorities in sub-Saharan Africa, a region where HIV prevalence and unmet need for contraception are the highest in the world. Two recent trends} increased availability of HIV testing and of drug treatments for the HIV-positive} add to the urgency of the need for new research on the relationships between HIV prevention, HIV-related care, and prevention of unintended pregnancy. The proposed research will guide providers who face difficult choices and decisions in meeting these dual needs.

描述（由申请人提供）：本研究的目的是帮助面临广义艾滋病毒流行病的非洲国家的个人和夫妇实现其家庭规模目标，并防止意外怀孕，同时避免或应对HIV感染。为此，我们建议进行新的研究，以改善包括HIV相关护理在内的性和生殖健康服务的提供。研究艾滋病毒状况对撒哈拉以南非洲的生育意图和避孕药的影响的研究非常稀缺。现有研究具有重要的局限性：大多数是小规模的，旨在评估干预措施的影响；大多数研究艾滋病毒阳性的人，在医疗机构中取样，大多数人仅包括女性，并且缺乏男性的观点，在撒哈拉以南非洲尤其重要。为了满足研究的目标，我们提出了三项研究工作：（a）我们将对撒哈拉以南非洲14个国家的现有国家代表性调查数据进行新的分析，以提供艾滋病毒状况之间的相互关系的区域概述（基于生物标记测试，在Surves和性行为和性行为和性行为）和性行为和性行为;将进行双变量和多变量分析，并对还具有有关HIV相关服务的信息的5个国家进行多层次分析。 (b) To provide deeper understanding of relationships between HIV status and attitudes regarding HIV-testing and services and the actions women and men are taking to achieve their fertility aspirations and prevent or cope with HIV infection, we will conduct a two-part study in one moderate-HIV-prevalence country (Nigeria) and one high prevalence country (Zambia): a quantitative survey of a community-based sample of 1300 men and women and a facility-based sample of 200 HIV positive每个国家的人；并对从每个国家进行定量调查的48位受访者进行了深入的访谈。（c）我们将对每个国家（尼日利亚和赞比亚）的大约80个医疗保健提供者进行半结构化访谈，这些提供者提供性和生殖医疗保健，以提高对提供者在帮助男性和女性遇到生育能力的作用，避免或应对HIV感染的人的理解，并特别注意最近努力进行例行和扩展HIV测试。从公共卫生的角度来看，项目叙述是防止艾滋病毒和意外怀孕的传播是撒哈拉以南非洲的很高优先事项，撒哈拉以南非洲是世界上最高的艾滋病毒患病率和未满足避孕的地区。最近的两种趋势}增加了HIV检测的可用性和对HIV阳性的药物治疗的可用性}增加了对预防HIV预防，与HIV相关的护理和预防意外怀孕之间关系的新研究的紧迫性。拟议的研究将指导提供者在满足这些双重需求时面临艰难的选择和决定。