A Mixed-Methods Study of Socio-Ecological Resilience Among Young ACE-Exposed Women in South Africa

南非暴露于 ACE 的年轻女性社会生态复原力的混合方法研究

基本信息

批准号：
10625409
负责人：
Deborah Baron
金额：
$ 3.18万
依托单位：
UNIV OF NORTH CAROLINA CHAPEL HILL
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-05-03 至 2024-01-02
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10625409
关键词：
AIDS prevention Acquired Immunodeficiency Syndrome Adolescence Adult Affect Age Area Behavior Behavioral Buffers Caring Characteristics Communities Complex Contraceptive Agents Coupled Data Development Disparity Environment Exposure to Family Fellowship Goals HIV HIV Infections HIV risk Health Health Promotion Health Services Health behavior High Prevalence Human Incidence Individual Inequity Intervention Knowledge Life Link Literature Logistic Regressions Manuscripts Measures Mediation Methods Modeling National Institute of Mental Health Outcome Pathway interactions Persons Phase Population Prevention Research Prevention program Process Qualitative Research Reporting Research Research Methodology Research Personnel Research Priority Resources Risk Risk Behaviors Services Sex Behavior Sexual Partners Sexual abuse Sexually Transmitted Diseases Social Network Social support South Africa South African Statistical Models Strategic Planning Stressful Event Training Transact Trauma United States National Institutes of Health Unsafe Sex Woman Women&apos s Health Youth adverse childhood events behavioral and social science coping data integration data management emotional abuse experience global health health service use high risk sexual behavior improved insight intimate partner violence pandemic disease pediatric trauma physical abuse pre-exposure prophylaxis prevention service preventive intervention psychologic resilience resilience factor response sex sexual risk behavior skills social social structure tenure track theories therapy design trait traumatic event young woman

项目摘要

ABSTRACT Young South African (SA) women, a population disproportionately impacted by HIV, commonly suffer adverse childhood experiences (ACEs). These childhood traumas are positively associated with HIV risk behaviors. Studies show that ACEs co-occur in youth and create life trajectories of cumulative risk exposures. Despite the pervasiveness of ACEs among SA women, there is limited data examining the effects of ACEs broadly and how they impact SA women’s HIV prevention behaviors. Socio-ecological resilience—conceptualized as re- sources at the individual, interpersonal and community levels that facilitate positive adaptation in response to trauma—offers a strengths-based approach to examine how these protective determinants buffer the negative impacts of ACEs that worsen young women’s sexual risk behaviors and engagement with HIV prevention pro- grams that impact HIV incidence. This research aligns with the NIH’s Strategic Plan for HIV and HIV-Related Research priority area to use behavioral and social science to gain insights about individuals’ behaviors and their contexts that influence HIV and HIV prevention interventions. The study will apply a social ecological framework to explore protective resilience factors that counter the negative cumulative effects of ACEs on HIV prevention behaviors among young SA women as they transition from adolescence to adulthood. The pro- posed mixed methods research will use data from the co-sponsor’s NIMH R01, Multilevel Mechanisms of HIV Acquisition in Young SA Women. The specific aims of this study are to: 1) Determine the effects of socio-eco- logical resilience in young SA women who have experienced ACEs on their transactional sex behaviors, and utilization of HIV prevention and contraceptive health services; 2) Contextualize how young SA women ex- posed to ACEs understand and experience resilience across multiple socio-ecological levels to navigate and negotiate sexual partnerships, and utilization of contraceptive and HIV prevention services, by using Pho- tovoice, a participatory qualitative research methodology; and 3) Explore convergent and divergent findings with the goal of developing trauma-informed resilience interventions to reinforce combination HIV prevention programs by integrating data from Aims 1 and 2. The proposed fellowship will build on the applicant’s prior re- search experience by supporting their training as a mixed methods global health researcher. The specific train- ing goals of this fellowship are to: 1) Develop the applicant’s theoretical grounding in socio-ecological resilience and trauma-informed care as applied to young ACE-exposed women; 2) Increase the applicant’s quantitative skills to manage data, and analyze, interpret, and present results of statistical models; 3) Deepen the appli- cant’s expertise in qualitative and participatory research skills; 4) Expand the applicant’s capacity to integrate quantitative and qualitative data and present mixed methods research findings; and 5) Advance the applicant’s skills in manuscript development and grantsmanship. These activities will support the applicant’s goal of be- coming a tenure-track HIV prevention mixed methods investigator specializing in adolescent women’s health.

抽象的南非 (SA) 年轻女性是受艾滋病毒影响尤为严重的群体，她们通常遭受不利影响童年经历（ACE）。这些童年创伤与艾滋病毒危险行为呈正相关。研究表明，ACEs 在青少年中同时出现，并创造了累积风险暴露的人生轨迹。 ACE 在 SA 女性中普遍存在，但广泛检验 ACE 影响的数据有限，它们如何影响南非妇女的艾滋病毒预防行为——重新概念化。个人、人际和社区层面的资源，有助于积极适应创伤——提供了一种基于优势的方法来检查这些保护性决定因素如何缓冲负面影响 ACE 的影响会恶化年轻女性的性危险行为以及参与艾滋病毒预防工作这项研究与 NIH 的 HIV 和 HIV 相关战略计划相一致。研究优先领域使用行为和社会科学来深入了解个人的行为和该研究将应用社会生态学来了解影响艾滋病毒和艾滋病毒预防干预措施的背景。探索对抗 ACE 对 HIV 累积负面影响的保护弹性因素的框架南非年轻女性从青春期过渡到成年时的预防行为。提出的混合方法研究将使用来自共同发起人的 NIMH R01《HIV 的多层次机制》的数据本研究的具体目的是： 1) 确定社会生态的影响。在交易性性行为方面经历过 ACE 的年轻南澳女性的逻辑复原力，以及 2）了解年轻的南澳女性如何前使 ACE 能够理解并体验多个社会生态层面的复原力，以导航和通过使用 Pho- 来谈判性伙伴关系、利用避孕药具和艾滋病毒预防服务 tovoice，一种参与性定性研究方法；3) 探索趋同和分歧的发现目标是开发基于创伤的复原力干预措施，以加强艾滋病毒综合预防通过整合目标 1 和 2 的数据来制定计划。拟议的奖学金将建立在申请人之前的研究基础上通过支持他们作为混合方法全球健康研究人员的培训来寻找经验。该奖学金的目标是： 1）发展申请人在社会生态恢复力方面的理论基础以及适用于年轻 ACE 暴露女性的创伤知情护理 2) 增加申请人的定量；管理数据以及分析、解释和呈现统计模型结果的技能；不能在定性和参与性研究技能方面的专业知识； 4）扩大申请人的整合能力；定量和定性数据并呈现混合方法研究结果；以及 5) 推进申请人的研究这些活动将支持申请人的目标：即将成为一名终身教授艾滋病毒预防混合方法调查员，专门研究青少年女性健康。