Partner age differences and associated sexual risk behaviours among adolescent girls and young women in a cash transfer programme for schooling in Malawi.
Partner age differences and associated sexual risk behaviours among adolescent girls and young women in a cash transfer programme for schooling in Malawi.
复制标题
DOI：
10.1186/s12889-018-5327-7
复制
发表时间：
2018-03-27
影响因子：
4.5
通讯作者：
Delva W
中科院分区：
文献类型：
--
作者：
Beauclair R;Dushoff J;Delva W
性关系中的年龄差异被认为是撒哈拉以南非洲艾滋病毒传播的一个关键风险因素，但证据仍然不确定。SIHR研究是马拉维现金转移计划的一项随机分组试验，发现干预组中的年轻女性不太可能有25岁或以上的性伴侣，并且与对照组相比，在随访时检测出HIV和HSV-2阳性的可能性较小。我们研究了干预组女孩的年龄差异小于对照组的假设，以及大的年龄差异与关系水平的艾滋病毒传播风险因素相关：不一致的安全套使用，性行为频率和关系持续时间。我们对13-22岁的学龄、收入和健康风险（SIHR）研究中的女学生进行了基线分析（n = 2907）。我们使用线性混合效应模型研究了研究臂、试验阶段和参与者年龄对性关系年龄差异的影响。使用累积-链接混合效应模型估计关系年龄差异对安全套使用和性行为频率的影响，并使用考克斯比例风险模型估计关系年龄差异对关系持续时间的影响。我们控制了女孩的年龄，伴侣的数量，学习小组和学习回合。平均而言，接受现金转移的女孩与对照组相比，在关系方面的年龄差异较小，尽管估计差异在统计学上不显著（-0.43岁; 95%CI：-1.03，0.17）。参与者年龄越大，年龄差异越小（每增加4岁，年龄差异为-0.67; 95%CI：-0.99，-0.35）。在对照组中，在现金转移结束后，平均年龄差异比干预期间大0.82岁（95%CI：0.43，1.21），这表明研究对整个社区行为的可能间接影响。在治疗组中，较大的年龄差异与较低的安全套使用水平，更频繁的性行为和更长的关系持续时间有关。现金转移方案可以通过鼓励年轻妇女建立年龄相仿的关系来防止艾滋病毒的传播，这种关系的特点是增加避孕套的使用和减少性行为的频率。这些方案的好处可能扩大到那些没有直接收到现金的人。本文的在线版本（10.1186/s12889-018-5327-7）包含补充材料，可供授权用户使用。
Age disparities in sexual relationships have been proposed as a key risk factor for HIV transmission in Sub-Saharan Africa, but evidence remains inconclusive. The SIHR study, a cluster randomised trial of a cash transfer programme in Malawi, found that young women in the intervention groups were less likely to have had a sexual partner aged 25 or older, and less likely to test positive for HIV and HSV-2 at follow-up compared to control groups. We examined the hypotheses that girls in the intervention groups had smaller age differences than control groups and that large age differences were associated with relationship-level HIV transmission risk factors: inconsistent condom use, sex frequency, and relationship duration. We conducted an analysis of schoolgirls in the Schooling, Income, and Health Risk (SIHR) study aged 13-22 at baseline (n = 2907). We investigated the effects of study arm, trial stage and participant age on age differences in sexual relationships using a linear mixed-effects model. Cumulative-link mixed-effects models were used to estimate the effect of relationship age difference on condom use and sex frequency, and a Cox proportional hazard model was used to estimate the effect of relationship age difference on relationship duration. We controlled for the girl’s age, number of partners, study group and study round. Girls receiving cash transfers, on average, had smaller age differences in relationships compared to controls, though the estimated difference was not statistically significant (− 0.43 years; 95% CI: -1.03, 0.17). The older the participant was, the smaller her age differences (− 0.67 per 4-year increase in age; 95% CI: -0.99, − 0.35). Among controls, after the cash transfers had ended the average age difference was 0.82 years larger than during the intervention (95% CI: 0.43, 1.21), suggesting a possible indirect effect of the study on behaviour in the community as a whole. Across treatment groups, larger age differences in relationships were associated with lower levels of condom use, more frequent sex, and longer relationship durations. Cash-transfer programmes may prevent HIV transmission in part by encouraging young women to form age-similar relationships, which are characterised by increased condom use and reduced sex frequency. The benefits of these programmes may extend to those who are not directly receiving the cash. The online version of this article (10.1186/s12889-018-5327-7) contains supplementary material, which is available to authorized users.
登录
查看更多内容
影响因子：
2.8
作者：
d'Albis, Hippolyte;Augeraud-Veron, Emmanuelle;Ducrot, Arnaud
通讯作者：
Ducrot, Arnaud
DOI：
10.1097/qad.0000000000001553
发表时间：
2017-07-31
期刊：
AIDS (London, England)
影响因子：
--
作者：
Akullian A;Bershteyn A;Klein D;Vandormael A;Bärnighausen T;Tanser F
通讯作者：
Tanser F
影响因子：
168.9
作者：
Baird, Sarah J.;Garfein, Richard S.;Oezler, Berk
通讯作者：
Oezler, Berk
影响因子：
13.7
作者：
Baird, Sarah;McIntosh, Craig;Oezler, Berk
通讯作者：
Oezler, Berk
影响因子：
--
作者：
Altman, DG;Royston, P
通讯作者：
Royston, P