Moving Beyond the Individual- A Data-driven Approach to Improving the Evidence on the Role of Community and Societal Determinants of HIV among Adolescent Girls and Young Women in Sub-Saharan Africa

超越个人——采用数据驱动的方法来改善关于艾滋病毒在撒哈拉以南非洲地区少女和年轻妇女中的社区和社会决定因素的作用的证据

• 批准号: 10619319
• 负责人: Domonique M Reed
• 金额: $ 4.47万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-03-01 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10619319
• 关键词: AIDS prevention; Acquired Immunodeficiency Syndrome; Address; Adolescent; Adolescent HIV risk; Advanced Development; Affect; Africa South of the Sahara; African American; Age; Algorithms; Area; Assessment tool; Attitude; Behavior; Behavioral Sciences; Biological; Cameroon; Censuses; Characteristics; Communities; Community Developments; Complex; Computing Methodologies; Country; Dangerousness; Data; Data Science; Data Set; Data Sources; Development; Disease Pathway; Disparate; Disparity; Education; Effectiveness; Environment; Epidemic; Epidemiology; Feedback; Female Adolescents; Fostering; Foundations; Future; Gender; Goals; HIV; HIV Infections; HIV Seropositivity; HIV disparities; HIV risk; Housing; Individual; Infection; Intervention; Knowledge; Laws; Malawi; Measurement; Mental Depression; Mentorship; Methodology; Mission; Modeling; National Institute of Mental Health; Pathway interactions; Pattern; Policies; Population; Prevention; Prevention Research; Prevention approach; Principal Investigator; Process; Psyche structure; Public Health; Recording of previous events; Research; Research Personnel; Research Priority; Risk; Risk Assessment; Risk Factors; Role; Rwanda; Science; Scientific Inquiry; Scientist; Sexually Transmitted Diseases; Social Processes; Societal Factors; Societies; Source; Structure; Techniques; Training; Transact; Uganda; Vulnerable Populations; aged; analytic epidemiology; analytical tool; big-data science; burden of illness; career; community-level factor; contextual factors; data integration; experience; health disparity; health seeking behavior; high risk; high risk sexual behavior; improved; innovation; interest; intervention effect; knowledge base; novel; population based; pre-exposure prophylaxis; preservation; preventive intervention; sex; structural determinants; therapy design; therapy development; trend; young woman

PROJECT SUMMARY/ABSTRACT Adolescent girls and young women (AGYW) in sub-Saharan Africa (SSA), the epicenter of the global HIV epidemic, have carried the primary burden of new HIV infections in this area for at least 30 years. Research has prioritized characterizing the individual predictors of HIV infection among AGYW by creating risk assessment tools that identify high-risk sub-populations for targeted HIV prevention efforts. Despite substantial efforts, there remains a disproportionate burden of disease among this vulnerable population, suggesting a need to identify and assess targets of intervention beyond the individual. The primary goals of this R36 dissertation proposal, Moving Beyond the Individual: A Data-driven Approach to Informing the Evidence on the Role of Community and Societal Determinants of HIV among Adolescent Girls and Young Women in Sub- Saharan Africa, are to create a comprehensive data source that will facilitate new ways of assessing HIV risk among AGYW, generating improved knowledge about individual, interpersonal, community, and societal risk factors; to characterize the interplay among these variables; and to assess the impact of interventions that target community and societal drivers of infection to inform improved prevention efforts. To achieve these goals, we propose three aims that will leverage publicly available, population-based data from five countries in SSA (Cameroon, Eswatini, Malawi, Rwanda, and Uganda) and apply advanced data science and epidemiologic methodologies. Aim 1 is to integrate publicly available data from the Population-based HIV Impact Assessment Project (individual, interpersonal, community), the Population and Housing Census (community), and UNAIDS Law and Policy Indicators (societal) to create a large, multi-level public health dataset. Aim 2 is to characterize and graphically depict the pathways among individual, interpersonal, community, and societal risk factors of HIV infection among AGYW using causal discovery algorithms to identify underlying disease pathways. Aim 3 is to estimate the impact of intervening on community and societal drivers of HIV infection among AGYW using parametric g-computation to model proposed intervention effects. To examine these aims, we will take a novel, intersectional approach to assess HIV behavioral science inquiries by leveraging causal discovery algorithms and g-computation. Findings from this research will advance the National Institute of Mental Health Division of AIDS Research’s priority to improve the knowledge base informing interventions, thereby advancing the development of interventions that go beyond the individual to reduce the burden of HIV among AGYW. The research and mentorship of this R36 proposal have been carefully crafted to optimize the ongoing doctoral training and research experience of the Principal Investigator of this study while fostering her development as an African American independent research scientist in the future.

项目摘要/摘要 撒哈拉以南非洲（SSA）的青少年女孩和年轻妇女（AGYW），全球艾滋病毒的中心 流行病至少30年在该区域遭受了新的HIV感染的主要燃烧。研究 已经优先考虑AGYW中艾滋病毒感染的个体预测因素 评估工具，以确定针对有针对性的艾滋病毒预防工作的高风险亚种群。尽管很大 努力，在这个脆弱的人群中仍然存在不成比例的疾病伯恩伯恩，这表明 需要识别和评估个人以外的干预目标。 R36的主要目标 论文提案，超越个人：一种以数据为基础的方法来告知有关证据的证据 青少年女孩和年轻妇女在子中的社区和社会决定因素的作用 撒哈拉非洲，将创建一个全面的数据源，以促进评估艾滋病毒风险的新方法 在AGYW中，提高了有关个人，人际，社区和社会风险的知识 因素；表征这些变量之间的相互作用；并评估干预措施的影响 针对感染的社区和社会驱动因素，以帮助改进的预防工作。实现这些 目标，我们提出了三个目标，这些目标将利用来自五个国家 /地区的公开可用的基于人群的数据 SSA（喀麦隆，埃斯瓦蒂尼，马拉维，卢旺达和乌干达），应用高级数据科学和 流行病学方法。目的1是整合基于人群的艾滋病毒的公开数据 影响评估项目（个人，人际，社区），人口和住房人口普查 （社区），并独立于法律和政策指标（社会）来创建大型多层公共卫生 数据集。 AIM 2是表征并图形地描述个体，人际关系之间的途径 使用因果发现算法，社区和艾滋病毒感染的社会风险因素 识别潜在的疾病途径。目标3是估计干预对社区和社会的影响 使用参数G-Compuntion在AGYW中艾滋病毒感染的驱动因素，以模拟拟议的干预效果。 为了检查这些目标，我们将采用一种新颖的，交叉的方法来评估HIV行为科学 通过利用因果发现算法和G-Compunt的查询。这项研究的结果将 促进美国国立心理健康研究所的艾滋病研究优先事项，以提高知识 基础告知干预措施，从而推进了超出个人的干预措施的发展 减少AGYW中的艾滋病毒的燃烧。该R36提案的研究和心态已经 精心制作以优化主要研究者的持续博士培训和研究经验 在这项研究的同时，她促进了她作为非裔美国人独立研究科学家的发展 未来。