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Integrated Framework for Assessing Multi-level Determinants of HIV Acquisition Affecting Adolescent Girls and Young
Maryam Al-Mujtaba1, Micheal V Relf, Laura C Nyblade
1Author Affiliations: Duke University School of Nursing, Durham, North Carolina (Ms Al-Mujtaba, Dr Relf, and Dr Mulawa); Duke Global Health Institute (Drs Relf, and Mulawa); and RTI International, Durham, NC (Dr Nyblade).
Abstract:
Adolescent girls and young women (AGYW) aged 15 to 24 face disproportionate human immunodeficiency virus acquisition risk in sub-Saharan Africa, yet existing frameworks inadequately address their multilevel, gender-specific determinants. We developed INFORM-HERS (INtegrated Framework fOR assessing Multilevel determinants of human immunodeficiency virus acquisition among AGYW) using "Up and Down" theory integration of 3 established frameworks: Theory of Gender and Power, Modified Social Ecological Model, and Center for Latino Adolescent and Family Health Framework of Social Determinants of Health Mechanisms. INFORM-HERS incorporates gender inequality risk factors, social protective factors, and AGYW-specific developmental transitions, providing a theoretical foundation for multilevel interventions in sub-Saharan Africa.
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