Predictors of HIV, HIV Risk Perception, and HIV Worry Among Adolescent Girls and Young Women in Lilongwe, Malawi.
Predictors of HIV, HIV Risk Perception, and HIV Worry Among Adolescent Girls and Young Women in Lilongwe, Malawi.
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DOI：
10.1097/qai.0000000000001567
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发表时间：
2018-01-01
期刊：
影响因子：
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通讯作者：
Pettifor A
中科院分区：
文献类型：
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作者：
Price JT;Rosenberg NE;Vansia D;Phanga T;Bhushan NL;Maseko B;Brar SK;Hosseinipour MC;Tang JH;Bekker LG;Pettifor A
撒哈拉以南非洲地区的少女和年轻女性 (AGYW) 的艾滋病毒患病率和发病率较高。我们试图了解哪些单独和组合的艾滋病毒风险因素会导致风险，以及这些因素是否与艾滋病毒担忧和风险认知相关。这项研究正在马拉维利隆圭的四个公共卫生中心进行（2016-2017 年）。 AGYW 15-24 岁被招募参加一项评估四种服务提供模式的研究。在每个卫生中心，参与者完成了一项基线调查，评估社会经济、行为、生物医学和伙伴关系特征；自我报告的艾滋病毒状况；如果未感染艾滋病毒，则艾滋病毒风险认知（高与低或无）和艾滋病毒担忧（有与无）。我们分析了基线特征与艾滋病毒患病率、风险认知和担忧之间的关联。在 1000 名 AGYW 中，中位年龄为 19 岁（IQR 17-21）。三十三名参与者报告感染了艾滋病毒。十五个特征与 HIV 感染相关。危险因素越多，HIV 患病率越高（≤4 个因素，0.5%；5-8 个因素，6%；>8 个因素，21%）。拥有更多的风险因素也与更高的风险感知 (p<0.001) 和更高的担忧 (p<0.001) 相关。然而，在那些有超过 8 个危险因素的人中，52% 的人认为自己不属于高风险，21% 的人没有报告任何艾滋病毒担忧。大多数 AGYW 认为感染艾滋病毒的风险很小，即使是那些风险最高的人也是如此。作为艾滋病毒预防级联中的一个关键缺口，需要准确的风险感知来为这一弱势群体制定有效和持续的组合预防策略。
Adolescent girls and young women (AGYW) in sub-Saharan Africa have high HIV prevalence and incidence. We sought to understand which HIV risk factors individually and in combination contribute to risk, and whether these factors are associated with HIV worry and risk perception. This study is ongoing at four public health centers in Lilongwe, Malawi (2016–2017). AGYW 15-24 years old were recruited to participate in a study assessing four models of service delivery. At each health center, participants completed a baseline survey assessing socio-economic, behavioral, biomedical and partnership characteristics; self-reported HIV status; and, if HIV-uninfected, HIV risk perception (high versus low or none) and HIV worry (any versus none). We analyzed associations between baseline characteristics and HIV prevalence, risk perception, and worry. Among 1000 AGYW, median age was 19 years (IQR 17–21). Thirty-three participants reported being HIV-infected. Fifteen characteristics were associated with HIV infection. Having more risk factors was associated with higher HIV prevalence (≤4 factors, 0.5%; 5-8 factors, 6%; >8 factors, 21%). Having more risk factors was also associated with higher risk perception (p<0.001) and higher worry (p<0.001). However, among those with >8 risk factors, 52% did not consider themselves to be at high risk and 21% did not report any HIV worry. Most AGYW perceive little risk of HIV acquisition, even those at highest risk. As a critical gap in the HIV prevention cascade, accurate risk perception is needed to tailor effective and sustained combination prevention strategies for this vulnerable population.