Nội dung được dịch bởi AI, chỉ mang tính chất tham khảo
Thetha Nami: phát triển tham gia của can thiệp điều hướng viên ngang hàng để cung cấp sự ngừa HIV sinh học xã hội cho thanh thiếu niên ở nông thôn Nam Phi
Tóm tắt
Mặc dù có các công cụ y sinh hiệu quả, HIV vẫn là nguyên nhân lớn nhất gây ra bệnh tật/tử vong ở Nam Phi – đặc biệt là trong nhóm thanh thiếu niên và người trẻ. Chúng tôi đã sử dụng nghiên cứu tham gia dựa trên cộng đồng (CBPR), dựa trên các nguyên tắc công bằng xã hội, để phát triển một can thiệp sinh học xã hội do bạn đồng trang lứa dẫn dắt nhằm ngăn ngừa HIV ở KwaZulu-Natal (KZN). Từ tháng 3 năm 2018 đến tháng 9 năm 2019, chúng tôi đã sử dụng CBPR để liên tục đồng sáng tạo và điều chỉnh ngữ cảnh cho một can thiệp sinh học xã hội do bạn đồng trang lứa dẫn dắt nhằm hỗ trợ ngăn ngừa HIV. Nam và nữ từ 18 đến 30 tuổi được lựa chọn bởi các lãnh đạo cộng đồng của 21 khu vực thực hiện can thiệp (izigodi) và đã trải qua 20 tuần đào tạo để trở thành người điều hướng bạn đồng trang lứa. Chúng tôi đã tổng hợp dữ liệu định lượng và định tính được thu thập trong một nghiên cứu từ 2016 đến 2018 thành 17 tình huống minh họa các yếu tố địa phương gây ra HIV. Trong ba hội thảo phát triển can thiệp tham gia và các buổi lập bản đồ cộng đồng, những người điều hướng bạn đồng trang lứa đã tương tác một cách phê phán với các tình huống, nghĩ ra giải pháp và lập bản đồ các thành phần đến chính izigodi của họ. Các thành phần can thiệp đã được lập bản đồ vào Lý thuyết Thay đổi, mà sau khi thực hiện thí điểm trong sáu tháng và đánh giá quy trình, những người điều hướng bạn đồng trang lứa đã hoàn thiện. Can thiệp sẽ được đánh giá trong một thử nghiệm ngẫu nhiên có đối chứng (NCT04532307). Sau khi có các đánh giá bằng văn bản và miệng, 57 trong số 108 người được chọn ban đầu đã tham gia hai hội thảo để thảo luận về các tình huống và đồng sáng tạo Thetha Nami (`nói chuyện với tôi’). Can thiệp bao gồm việc nâng cao sức khỏe do bạn đồng trang lứa dẫn dắt nhằm cải thiện hiệu quả bản thân và nhu cầu về phòng ngừa HIV, giới thiệu đến các nguồn lực xã hội và giáo dục, và các dịch vụ lâm sàng thân thiện với thanh niên để cải thiện việc tiếp cận phòng ngừa HIV. Trong thời gian thí điểm, những người điều hướng bạn đồng trang lứa đã tiếp cận 6871 thanh niên, trong đó 6141 (89%) đã chấp nhận nâng cao sức khỏe và 438 đã được liên kết với dịch vụ chăm sóc. Trong các cuộc phỏng vấn bán cấu trúc, những người điều hướng bạn đồng trang lứa đã mô tả sức hấp dẫn của việc cung cấp thông tin sức khỏe tình dục cho những người đồng trang lứa có độ tuổi và bối cảnh tương tự nhưng mong muốn cung cấp nhiều hơn chỉ là “giới thiệu tiếp”. Trong hội thảo tham gia thứ ba, 54 người điều hướng bạn đồng trang lứa đã cải tiến can thiệp Thetha Nami để thêm ba thành phần: công cụ đánh giá có cấu trúc để điều chỉnh nâng cao sức khỏe và giới thiệu, không gian an toàn và vận động cộng đồng để tạo ra môi trường thuận lợi, và hướng dẫn và điều hướng tài nguyên của bạn đồng trang lứa để cải thiện việc giữ chân trong phòng ngừa HIV. Thanh niên địa phương đã có thể sử dụng chứng cứ để phát triển một can thiệp do bạn đồng trang lứa dẫn dắt được điều chỉnh theo ngữ cảnh nhằm cung cấp sự ngừa HIV sinh học xã hội.
Từ khóa
Tài liệu tham khảo
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