Structural Intervention for Adolescent Alcohol Use and HIV Risk in Tanzania

针对坦桑尼亚青少年饮酒和艾滋病毒风险的结构性干预

基本信息

批准号：
9107764
负责人：
Marni Sommer
金额：
$ 16.63万
依托单位：
COLUMBIA UNIVERSITY HEALTH SCIENCES
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-07-10 至 2018-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9107764
关键词：
Abnormal coordination Address Adolescent Adolescent HIV risk Africa South of the Sahara Age Alcohol Laws Alcohol consumption Alcohols Allied Health Sciences Area Attention Beer Behavior Cereals Communities Consumption Country Data Development Effectiveness Environment Environmental Risk Factor Female Adolescents Future Gender HIV HIV risk HIV-infected adolescents Health Home environment Income Infection Intervention Laws Life Link Male Adolescents Maps Marketing National Institute of Child Health and Human Development Pattern Policies Population Prevalence Process Production Puberty Regulation Research Risk Risk Behaviors Shapes Source Structure Tanzania Universities Unsafe Sex Urbanization Youth adolescent alcohol adolescent alcohol initiation aged alcohol availability alcohol content alcohol use initiation authority binge drinking boys contextual factors design distilled alcoholic beverage environmental intervention evidence base experience family structure high risk sexual behavior high-risk adolescents innovation insight novel strategies prevent public policy on alcohol reduce adolescent alcohol reduced alcohol use response sexual risk taking social transmission process underage drinker underage drinking young woman

项目摘要

DESCRIPTION (provided by applicant): Reducing HIV transmission among adolescents in sub-Saharan Africa (SSA) remains of tremendous urgency. Almost a third of global annual new infections occur in young women aged 15-24 in SSA, and 81% of HIV infected adolescents worldwide live in SSA. There is growing evidence that increasing levels of adolescent alcohol use in SSA may be contributing to these high rates of infection, particularly heavy episodic drinking and early age of alcohol initiation. Both behaviors increase the risk for unsafe sex. Research is urgently needed to understand current patterns of adolescent alcohol use and related sexual risk-taking behaviors in SSA to reduce HIV risk. A potentially effective approach is to change the structures that enable adolescent alcohol use. Recent evidence suggests the potential effectiveness of structural approaches (e.g. underage drinking laws) for reducing adolescent alcohol consumption in high-income countries. A new National Alcohol Policy being developed in Tanzania offers the opportunity to study its efforts to reduce adolescent alcohol use and HIV risk, and to identify gaps in the policy. Tanzania has a population of over 48 million, with 65% under the age of 24, and ranks 12th in global HIV prevalence rates. A recent review of the regulatory status of alcohol identified a significant lack of coordination between agencies. In response, the Ministry of Health is drafting a new alcohol policy. Unlike in high-income countries, the majority of alcohol in Tanzania reportedly continues to be 'home brew' (high alcohol content and limited regulatory oversight). Our prior research suggests an increase in adolescent use of home brew and of commercial beers marketed to youth. The proposed research will examine the current social, community and environmental context of adolescent alcohol initiation and consumption in urban Tanzania, the gendered aspects of consumption, and subsequent experiences of risky sexual behavior. The proposed study is highly innovative because it engages adolescents in an exploration of the synergy between adolescent alcohol use and risky sexual behavior in the context of a new National Alcohol Policy. The findings will provide critical data to inform the development of evidence-based structural interventions aimed at reducing adolescent alcohol use and risky sexual behaviors in SSA. Specific aims: Specific Aim #1: To explore the current patterns of alcohol initiation and consumption by adolescent girls and boys (aged 14-18) in urban Tanzania, including a mapping of types and sources of alcohol availability. Specific Aim #2: To understand the social processes and contextual factors shaping the dynamic between adolescent alcohol consumption and risky sexual behaviors in urban Tanzania, and mapping contexts of high risk where adolescent alcohol use (or purchase/provision) and unsafe sex occur. Specific Aim #3: To inform the development of new, or the adaptation of existing, structural and environmental interventions for reducing the contribution of alcohol consumption to unsafe sexual practices among urban Tanzanian adolescents in the context of a new National Alcohol Policy and existing alcohol laws.

描述（由申请人提供）：减少撒哈拉以南非洲（SSA）青少年的艾滋病毒传播（SSA）仍然非常紧迫。在SSA中，年龄在15-24岁的年轻女性中，几乎三分之一的全球年度新感染发生，全球81％的艾滋病毒感染青少年居住在SSA中。越来越多的证据表明，SSA中的青春期饮酒水平越来越高，可能会导致这些高感染率，尤其是沉重的情节饮酒和幼稚的饮酒年龄。两种行为都会增加性行为不安全的风险。迫切需要进行研究，以了解SSA中青少年饮酒和相关性冒险行为的当前模式以降低HIV风险。一种潜在的有效方法是改变使青少年饮酒的结构。最近的证据表明，结构方法的潜在有效性（例如未成年饮酒法）可以减少高收入国家的青少年饮酒。在坦桑尼亚制定的一项新的国家酒精政策为减少青少年饮酒和艾滋病毒风险的努力提供了机会，并确定政策中的差距。坦桑尼亚人口超过4800万，在24岁以下的65％以下，全球艾滋病毒患病率排名第12。最近对酒精调节状况的综述确定了机构之间严重缺乏协调。在回应，卫生部正在起草新的酒精政策。与高收入国家不同，据报道，坦桑尼亚的大多数酒精仍然是“家用啤酒”（高酒精含量和有限的监管监督）。我们先前的研究表明，青少年使用家用啤酒和向青年推销的商业啤酒的使用增加。拟议的研究将研究坦桑尼亚城市中青少年饮酒和消费的当前社会，社区和环境背景，消费的性别方面以及随后的风险性行为经历。拟议的研究具有很高的创新性，因为它吸引了青少年在新的国家酒精政策的背景下探索青少年饮酒与危险性行为之间的协同作用。这些发现将提供关键数据，以告知旨在减少SSA中青少年饮酒和风险性行为的循证结构干预措施的发展。具体目的：特定目的＃1：探索坦桑尼亚城市的青少年女孩和男孩（14-18岁）的酒精启动和消费模式，包括绘制类型和酒精供应源的映射。具体目的2：了解坦桑尼亚城市青少年饮酒和风险性行为之间动态的社会过程和上下文因素，以及在青少年饮酒（或购买/提供）和不安全性行为的情况下，绘制高风险的高风险环境。特定目的3：在新的国家酒精政策和现有酒精法律的背景下，为了减少坦桑尼亚城市青少年的不安全性实践的贡献，以减少饮酒对不安全性习俗的贡献，以减少现有的结构和环境干预措施的发展或适应现有的结构和环境干预措施的发展。