A Multilevel Intervention to Reduce HIV Risk among Networks of Men in Tanzania

降低坦桑尼亚男性网络中艾滋病毒风险的多层次干预措施

基本信息

批准号：
9037056
负责人：
Suzanne Maman
金额：
$ 52.55万
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：
2012
资助国家：
美国
起止时间：
2012-07-16 至 2018-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9037056
关键词：
AIDS prevention Acquired Immunodeficiency Syndrome Address African Alcohol or Other Drugs use Businesses Camping Censuses Cluster randomized trial Coitus Counseling Country Data Economics Enrollment Evaluation Event Fees Female Funding Future Gender HIV HIV risk Health Health Promotion Health Promotion and Education Health behavior Human Herpesvirus 2 Incidence Intervention Lead Leadership Link Location Maps Mediating Mediator of activation protein Mental Health Methodology Methods National Institute of Mental Health Outcome Prevalence Publishing Randomized Reporting Research Risk Risk Behaviors Sampling Sexual Partners Sexually Transmitted Diseases Social Network Social support Surveys Tanzania Testing Time Training Woman Work Youth base consistent condom use design gang gender-based violence high risk high risk men improved innovation male health meetings member men physical conditioning programs protective behavior scale up secondary outcome sexual debut sexual violence social social group therapy design transmission process uptake ward young man young woman

项目摘要

DESCRIPTION (provided by applicant): Finding venues and effective strategies to engage young men who are at high risk of transmitting and acquiring HIV has remained a persistent challenge in the field of HIV prevention. The proposed study applies innovative, multilevel intervention methods to engage social networks of young men in Dar es Saalam, Tanzania to reduce HIV risk and the perpetration of gender-based violence. Prior work by our team in this setting identified networks of young men at high risk for HIV who belong to what are called "camps." Camps are semiformal organizations of youth, mostly men, who socialize regularly in a fixed location. Through funding from NIMH (R21MH80577) we enumerated and described 73 camps within one ward (equivalent to US census tract) of Dar es Salaam. Based on findings from the preliminary studies, we developed and piloted an intervention that combines microfinance with health promotion training for camp leaders. The intervention addressed the structural and social determinants of men's risk for HIV, while also leveraging the strong network ties that exist among men in camps. Building on this preliminary work the proposed study has two aims: 1) To enumerate and characterize camps in four wards of Dar es Salaam where young men at high risk for HIV acquisition and transmission socialize in order to generate a pool of camps for inclusion in the larger trial; 2) To conduct a cluster randomized trial among 2808 men belonging to 54 camps located within four wards of Dar es Salaam, to determine whether men in camps randomized to receive a microfinance and health leadership intervention have a lower incidence of sexually transmitted infections and report perpetrating less physical or sexual violence against female sexual partners as compared to men belonging to camps that are randomized to a control condition. Secondary outcomes include HIV risk and protective behaviors including: uptake of HIV counseling and testing; a reduction in unprotected sexual intercourse; correct and consistent condom use; deferral of sexual debut; a reduction in the number of sexual partners and sexual concurrency. Key mediators are hope, future orientation, collective efficacy, social support and social influence. All men in the selected camps will be enrolled and followed for 30 months. Quantitative and qualitative assessments will occur at baseline, 12 months and 30 months. If the proposed multilevel intervention proves efficacious at reducing risk behaviors among young men, the approach is one that can be adapted, scaled-up and applied to work with young men in other global settings.

描述（由申请人提供）：寻找场地和有效的策略，使他们与艾滋病毒的高风险和收购艾滋病毒的高风险相关的年轻人仍然是预防艾滋病毒领域的持续挑战。拟议的研究采用了创新的多层次干预方法来吸引坦桑尼亚达累斯·萨拉姆（Dar Es Saalam）的年轻男子的社交网络，以降低艾滋病毒的风险和基于性别的暴力的犯罪。我们团队在此环境中的事先工作确定了属于所谓的“营地”的年轻人的高风险的年轻人网络。营地是年轻人（大多数是男人）的半身组织，他们定期在固定地点进行社交。通过NIMH（R21MH80577）的资金，我们列举并描述了达累斯萨拉姆一个病房（相当于美国人口普查区）内的73个营地。根据初步研究的发现，我们开发了一种干预措施，将小额信贷与营地领导者的健康促进培训相结合。该干预措施解决了男性患艾滋病毒风险的结构和社会决定因素，同时还利用了营地中男性之间存在的牢固网络关系。在这项初步工作的基础上，拟议的研究有两个目的：1）列举和描述达累斯萨拉姆四周中的营地，在那里，年轻的年轻人对艾滋病毒收购和传播的高风险社交社交，以便为大型试验纳入一个营地； 2）在达es萨拉姆（Dar Es Salaam）四周内的2808名男子中进行集群随机试验，以确定营地中的男人是否随机接受小额信贷和健康领导干预措施的性传播感染的发生率较低，并报告与属于属于对照的男性相比，对阵营的人性暴力或对女性的性暴力较少，而对训练营的男性则持续了较少。次要结果包括艾滋病毒风险和保护行为，包括：吸收艾滋病毒咨询和测试；减少了无保护的性交；正确且一致的避孕套使用；延期性首次亮相；性伴侣的数量减少和性并发。主要的调解人是希望，未来的取向，集体效力，社会支持和社会影响力。选定营地中的所有男人将被招募，并遵循30个月。定量和定性评估将在基线，12个月零30个月进行。如果拟议的多层次干预证明有效地减少了年轻人的风险行为，则该方法是可以适应，扩大规模并应用于在其他全球环境中与年轻人合作的方法。

项目成果

期刊论文数量（9）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Leveraging strong social ties among young men in Dar es Salaam: A pilot intervention of microfinance and peer leadership for HIV and gender-based violence prevention.

DOI：
10.1080/17441692.2015.1094105
发表时间：
2016-12
期刊：
Global public health
影响因子：
3.3
作者：
Maman S;Kajula L;Balvanz P;Kilonzo M;Mulawa M;Yamanis T
通讯作者：
Yamanis T

Correlates of Anxiety and Depression among Young Men Living in Dar es Salaam, Tanzania.

生活在坦桑尼亚达累斯萨拉姆的年轻人焦虑和抑郁的相关性。

DOI：
10.1007/s11469-018-9993-6
发表时间：
2020
期刊：
International journal of mental health and addiction
影响因子：
8
作者：
Hill,LaurenM;Kajula,LusajoJ;Maman,Suzanne
通讯作者：
Maman,Suzanne

Perpetration and Victimization of Intimate Partner Violence Among Young Men and Women in Dar es Salaam, Tanzania.

DOI：
10.1177/0886260515625910
发表时间：
2018-08
期刊：
Journal of interpersonal violence
影响因子：
2.5
作者：
Mulawa M;Kajula LJ;Yamanis TJ;Balvanz P;Kilonzo MN;Maman S
通讯作者：
Maman S

"Mtoto Wa Nyoka Ni Nyoka," The Child of a Snake is a Snake: A Narrative Analysis of Adverse Childhood Experiences and Perpetration of Interpersonal Violence Among Men in Dar es Salaam, Tanzania.

DOI：
10.1177/0886260521997443
发表时间：
2022-07
期刊：
Journal of interpersonal violence
影响因子：
2.5
作者：
Zietz S;Kajula L;Martin S;Moracco B;Shanahan M;Maman S
通讯作者：
Maman S

Vijana Vijiweni II: a cluster-randomized trial to evaluate the efficacy of a microfinance and peer health leadership intervention for HIV and intimate partner violence prevention among social networks of young men in Dar es Salaam.

DOI：
10.1186/s12889-016-2774-x
发表时间：
2016-02-03
期刊：
BMC public health
影响因子：
4.5
作者：
Kajula L;Balvanz P;Kilonzo MN;Mwikoko G;Yamanis T;Mulawa M;Kajuna D;Hill L;Conserve D;Reyes HL;Leatherman S;Singh B;Maman S
通讯作者：
Maman S