Effective interventions are needed to reduce behavioral risk for HIV among adolescents in sub-Saharan Africa. Numerous promising strategies exist, but the evidentiary basis for choosing among them remains limited. We propose a mixed-methods investigation that integrates focus group discussions (FGDs) and in-depth interviews (IDIs) with a longitudinal cohort study (LCS) of youth and their parents in three communities in southeastern Ghana to identify the ways in which gendered parenting practices, peer group norms, and other factors interact with individual developmental processes and local epidemiological circumstances to shape emerging patterns of sexual behavior among youth in these communities. Initial FGDs will be used to characterize the gendered ideals of sexual behavior that parents hold for their adolescents and the gendered norms of sexual and romantic behavior that prevail among adolescent peer groups in these communities, and will inform the design of instrumentation for the LCS. The LCS will include a younger cohort (aged 13 to 14 years at Wave 1 and 16 to 17 years by Wave 3, N = 900) and an older cohort (aged 18 to 19 years at Wave 1 and 21 to 22 years by Wave 3, N = 900) who, along with their parents/caregivers, will be interviewed three times at 18-month intervals. Girls and boys will be included in equal proportions. LCS interviews will include modules on parenting practices, peer influences, religion and religiosity, gendered personality traits, gender role attitudes, life course expectations, and sexual behaviors. Analytic strategies include generalized confirmatory factor analysis, growth curve modeling, survival analysis, propensity stratification, and latent class modeling to answer specific research questions. Follow-up IDIs with low-risk and high-risk LCS participants will be used to gain further insight into the strategies that adolescent girls and boys use to navigate parental and peer influences and the threat of HIV. The three study communities are characterized by dramatic variations in localized HIV prevalence, allowing us to assess how epidemiological circumstances impinge upon adolescent sexual behavior. The project builds upon an existing collaboration between the Population Research Institute at Penn State University and the Regional Institute for Population Studies at the University of Ghana, and will contribute to the capacity of both institutions to conduct longitudinal demographic research with adolescents in sub-Saharan Africa. Results will be disseminated to several scientific and health promotion audiences, and we will translate our findings into concepts appropriate for the design of effective interventions for adolescent populations in Ghana and elsewhere in sub-Saharan Africa.

Public Health Relevance

Effective interventions are needed to reduce behavioral risk for HIV among adolescents in sub-Saharan Africa, and although numerous promising strategies exist, the evidentiary basis for choosing among these strategies remains limited. We propose a mixed-methods investigation that integrates focus group discussions and in-depth interviews with a three-wave longitudinal cohort study of youth and their parents in three communities in southeastern Ghana. Our goals are to identify the ways in which gendered parenting practices, peer group norms, and other factors interact with individual developmental processes and local epidemiological circumstances to shape emerging patterns of sexual behavior among youth in these communities, and to translate our findings into concepts appropriate for the design of effective interventions in these populations.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Project (R01)
Project #
5R01HD061017-04
Application #
8325442
Study Section
Special Emphasis Panel (ZHD1-DSR-W (17))
Program Officer
Newcomer, Susan
Project Start
2009-09-30
Project End
2014-07-31
Budget Start
2012-08-01
Budget End
2013-07-31
Support Year
4
Fiscal Year
2012
Total Cost
$502,796
Indirect Cost
$13,598
Name
George Washington University
Department
Public Health & Prev Medicine
Type
Schools of Public Health
DUNS #
043990498
City
Washington
State
DC
Country
United States
Zip Code
20052