Couples Advancing Together for Safer Conception (CAT-SC): A couples’-based intervention to improve engagement in sexual and reproductive health services for mobile fisherfolk in Kenya

夫妻共同推进安全受孕 (CAT-SC)：基于夫妻的干预措施，旨在提高肯尼亚流动渔民对性健康和生殖健康服务的参与度

• 批准号: 10618411
• 负责人: Sarah A Gutin
• 金额: $ 18.18万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-02-01 至 2028-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10618411
• 关键词: AIDS prevention; Address; Affect; Africa South of the Sahara; Age; Attention; Behavior; Behavior Therapy; Behavioral; Caring; Child; Clinic; Collaborations; Communication; Complement; Conceptions; Counseling; Couples; Data; Dedications; Educational workshop; Epidemic; Evaluation; Face; Feedback; Female; Fertility; Fishes; Gender; Geography; Goals; HIV; HIV Infections; HIV/AIDS; Health; Health Personnel; Household; Human; Incidence; Infant; Infrastructure; Insemination; Internal Migrations; International Migrations; Interpersonal Relations; Intervention; Interview; Kenya; Knowledge; Link; Location; Manuals; Marital Relationships; Measures; Mentorship; Methods; Motivation; National Institute of Mental Health; Outcome; Participant; Periodicals; Population; Prevalence; Prevention; Prevention strategy; Preventive; Protocols documentation; Provider; Psychology; Public Health; Reproductive Health; Reproductive Health Services; Reproductive Rights; Research; Research Personnel; Research Priority; Risk; Scientist; Services; Sexual Health; Stretching; Surveys; Techniques; Testing; Training; Transact; Vagina; Vulnerable Populations; Woman; acceptability and feasibility; care outcomes; career; child bearing; cohort; design; flexibility; high risk; high risk sexual behavior; implementation intervention; improved; innovation; insight; intervention delivery; male; men; men' s group; neglect; neonatal health; pharmacologic; pre-exposure prophylaxis; preference; pregnant; prevent; prevention service; preventive intervention; randomized trial; recruit; reproductive; residence; self testing; sex; sexually active; skills; social; social stigma; theories; therapy design; transmission process; uptake

PROJECT SUMMARY / ABSTRACT Mobile fishermen and their partners along Lake Victoria in western Kenya are a vulnerable population in need of improved sexual and reproductive health (SRH)/HIV prevention efforts because of their high mobility, high HIV prevalence, poor HIV care engagement, and high-risk sexual behaviors such as relationship concurrency and a local transactional sex economy. Safer conception (SC) is a strategy to prevent HIV transmission and is an entry point for life-long HIV prevention efforts, but current interventions to improve SC uptake have neglected to address couple relationship dynamics (e.g. communication skills). This K01 proposal is to support Dr. Sarah Gutin’s long-term career goal to become an independent social-behavioral scientist conducting innovative research on engaging couples and promoting male engagement in SRH/HIV prevention services. To achieve this career goal, and in collaboration with a dedicated mentorship team, Dr. Gutin proposes training to: 1) gain knowledge of theories and research on the psychology of interpersonal relationships in mobile populations; 2) develop mixed methods skills to collect, analyze, and integrate dyadic qualitative and quantitative data; and 3) acquire couples-based behavioral intervention adaptation, implementation, and analytic skills. The overall research objective is to adapt an innovative couples-based HIV prevention intervention, ‘Jamii Bora’ and assess the interventions’ potential to promote male engagement for SC among mobile couples. The specific aims are to: 1) identify dyadic-level barriers and facilitators to male engagement in SC; 2) adapt the Jamii Bora intervention to improve male engagement in SC among Kenyan fisherfolk; and 3) assess intervention feasibility, acceptability, and implementation. Dyadic mixed methods will be used in Aim 1 including qualitative in-depth interviews, survey piloting, and a quantitative survey. In Aim 2, Dr. Gutin will adapt the Jamii Bora couples’ intervention for fishermen and their primary female partners with feedback from mobile couples and healthcare providers who will take part in separate intervention design workshops. In Aim 3, Dr. Gutin will conduct a preliminary assessment of the adapted intervention to evaluate feasibility and acceptability. The proposed research will employ an innovative couples-based intervention approach to improve relationship dynamics (e.g., communication) that are urgently needed to impact mobile couples’ SC uptake and retention in SRH/HIV services. This integrated training and research plan will prepare Dr. Gutin to launch an independent research career conducting couples research with varied populations and health outcomes, and provide preliminary data for a pilot to test the couples’ intervention, followed by a randomized trial with mobile couples. By focusing on research to improve the relationship context for couples disproportionately burdened by HIV, it is possible to limit HIV transmission risks and improve long-term uptake of SRH/HIV preventive behaviors and services.

项目概要/摘要 肯尼亚西部维多利亚湖沿岸的流动渔民及其伙伴是需要帮助的弱势群体 性与生殖健康 (SRH)/艾滋病毒预防工作的改善，因为其高流动性、高 艾滋病毒感染率、艾滋病毒护理参与度差以及高风险性行为（例如同时关系） 当地的性交易经济（SC）是预防艾滋病毒传播的一项战略。 终生艾滋病毒预防工作的切入点，但目前提高 SC 吸收的干预措施已经 忽视了解决夫妻关系动态（例如沟通技巧）。 Sarah Gutin 博士的长期职业目标是成为一名独立的社会行为科学家 关于让夫妇参与和促进男性参与性健康和生殖健康/艾滋病毒预防服务的创新研究。 为了实现这一职业目标，古廷博士与专门的指导团队合作，建议进行培训 1）获得移动人际关系心理学的理论和研究知识 2）培养混合方法技能来收集、分析和整合二元定性和 3) 获得基于夫妻的行为干预适应、实施和 总体研究目标是采用基于夫妻的创新型艾滋病毒预防方法。 干预措施“Jamii Bora”，并评估干预措施促进男性参与 SC 的潜力 具体目标是：1）确定男性参与的二元层面的障碍和促进因素。 2) 调整 Jamii Bora 干预措施以提高肯尼亚渔民中男性参与 SC 的程度； 评估目标 1 中将使用的干预措施的可行性、可接受性和实施情况。 在目标 2 中，古丁博士将 根据来自渔民及其主要女性伴侣的反馈，调整 Jamii Bora 夫妇的干预措施 流动夫妇和医疗保健提供者将参加单独的干预设计研讨会。 3、Gutin博士将对调整后的干预措施进行初步评估，以评估可行性和 拟议的研究将采用一种基于夫妇的创新干预方法。 改善关系动态（例如沟通），这是影响流动情侣的 SC 所迫切需要的 这项综合培训和研究计划将使古廷博士做好准备 开展独立研究事业，开展针对不同人群和健康状况的夫妻研究 结果，并为试点提供初步数据来测试夫妇的干预，然后进行随机 通过专注于改善夫妻关系环境的研究来进行试验。 艾滋病毒负担过重，有可能限制艾滋病毒传播风险并提高长期吸收率 SRH/HIV 预防行为和服务。