Structural and Social Transitions Among Adolescents in Rakai (SSTAR)

拉凯青少年的结构和社会转型 (SSTAR)

基本信息

批准号：
10238089
负责人：
JOHN S. SANTELLI
金额：
$ 65.6万
依托单位：
COLUMBIA UNIVERSITY HEALTH SCIENCES
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-09-15 至 2023-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10238089
关键词：
AIDS prevention Acquired Immunodeficiency Syndrome Adolescence Adolescent Adolescent and Young Adult Adult Affect Africa South of the Sahara Age Architecture Behavior Behavior Therapy Biological Factors Characteristics Cohort Studies Coitus Communities Consequences of HIV Data Distal Education Epidemic Ethnography Face Future Gender Government HIV HIV Infections HIV risk Home Household Improve Access Incidence Individual Infection prevention Intervention Male Circumcision Marriage Mediating Mediation Mediator of activation protein Medical Methodology Methods Modeling Occupations Out-Migrations Outcome Pathway interactions Policies Prevention program Public Policy Qualitative Methods Qualitative Research Research Research Design Research Methodology Risk Risk Behaviors Risk Factors Role Rural Community School Enrollments Schools Sex Behavior Social Change Social Processes Social outcome Socioeconomic Status Structure Student Dropouts Techniques Time Time trend Uganda Work Youth case control child bearing data modeling experience infection risk innovation migration multilevel analysis next generation prevent programs reproductive outcome sexual debut social social determinants social structure tool trend young woman

项目摘要

Project Abstract Adolescents in sub-Saharan Africa make the transition to adulthood facing considerable risk of HIV infection; this risk is particularly high for young women. Understanding social processes that produce HIV risk and protect young people is critical to developing the next generation of youth HIV prevention programs. Looking beyond individual characteristics and behaviors, social structural factors (socioeconomic status, educational opportunities, gender, AIDS orphanhood, public policies) and timing of adolescent and young adult social role transitions (leaving school, initiation of sexual behaviors, migration and leaving home, marriage formation and dissolution) are critical drivers of youth HIV acquisition and other reproductive outcomes. Yet, these findings raise new questions: how do the interrelationships among social transitions and the timing, ordering and tempo of these transitions influence HIV risk behaviors, and, ultimately, HIV infection? How do social structural factors influence HIV infection? How do social transitions mediate HIV risk? To answer these questions, new research is needed which applies innovative quantitative and qualitative methods to high quality longitudinal data. Over the past six years, the Rakai Youth Project has used new qualitative data and existing quantitative and longitudinal data from the Rakai Community Cohort Study (RCCS) to successfully define a continuum of social and proximate determinants for HIV acquisition among youth ages 15–24 from 1994– 2013. Building on this work, Structural and Social Transitions among Adolescents and young adults in Rakai (SSTAR) will investigate the influence of social structural determinants on transitions from adolescence to adulthood using innovative statistical and qualitative research methodologies. SSTAR will define risk factors for and trends over time in key social transitions (sexual initiation, school leaving, marital formation and dissolution, migration, initiation of childbearing); interrelationships among transitions (ordering, timing, tempo); and consequences (HIV risk behaviors, acquisition) among adolescents and young adults using mixed methods. The proposed project will examine the influence on HIV acquisition of social structural determinants (access to schooling, SES, orphanhood, household structure, gender, government policy, HIV programs) directly and as mediated by social transitions, using the RCCS. Finally, SSTAR will explore the influence of social determinants and social transitions on HIV acquisition in: 1-high HIV incidence hotspot communities, 2- intermediate HIV incidence trading and transport hub communities, and 3- low HIV incidence settled, rural communities.

项目摘要撒哈拉以南非洲的青少年向成年过渡，面临着相当大的风险艾滋病毒感染；对于年轻女性而言，这种风险特别高。了解社会过程产生艾滋病毒风险和保护年轻人对于发展下一代青年至关重要艾滋病毒预防计划。超越个人特征和行为，社会结构性因素（社会经济地位，教育机会，性别，艾滋病，孤儿，公共政策）和青少年和年轻成人社会角色转变的时机（离开学校，开始性行为，移民和离开家，婚姻形成和解散）是青年艾滋病毒获取和其他生殖结果的关键驱动因素。但是，这些发现提出新问题：社会过渡和时机之间的相互关系如何这些过渡的订购和节奏会影响艾滋病毒的风险行为，并最终影响艾滋病毒感染？社会结构因素如何影响艾滋病毒感染？社会过渡如何调解艾滋病毒的风险？要回答这些问题，需要新的研究来应用创新高质量纵向数据的定量和定性方法。在过去的六年中， Rakai青年项目使用了新的定性数据以及现有的定量和纵向 Rakai社区队列研究（RCC）的数据成功定义了连续性从1994年的15-24岁青年中，社会和近端决定了艾滋病毒的收购 2013年。基于这项工作，青少年和年轻人的结构和社会过渡 Rakai（SSTAR）的成年人将调查社会结构决定者对使用创新的统计和定性研究，从青少年到成年的过渡方法。 SSTAR将在关键社会过渡中定义随着时间的流逝的风险因素和趋势（性启动，学校离开，婚姻形成和解散，移民，启动生育）；过渡之间的相互关系（订购，时机，节奏）；和后果（HIV风险行为，获取）使用混合方法中的青少年和年轻人。拟议的项目将研究对艾滋病毒收购社会结构的影响决定级（获得学校，SES，孤儿，家庭结构，性别，政府政策，艾滋病毒计划）直接使用RCC，并由社会过渡介导。最后， SSTAR将探索社会决定者和社会过渡对艾滋病毒收购的影响在：1高的HIV发病率热点社区，2个中级艾滋病毒发病率交易和运输中心社区和3个低艾滋病毒事件定居，农村社区。