Sexual risk reduction needs of adolescents living with HIV in a clinical care setting
Sexual risk reduction needs of adolescents living with HIV in a clinical care setting
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DOI：
10.1080/09540120701867099
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发表时间：
2008-01-01
影响因子：
1.7
通讯作者：
Colebunders, Robert
中科院分区：
文献类型：
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作者：
Bakeera-Kitaka, Sabrina;Nabukeera-Barungi, Nicolette;Colebunders, Robert
随着抗逆转录病毒疗法的日益普及，感染艾滋病毒的年轻人需要有针对性的支持，以采取健康的性行为。在这一目标群体中，在提供文化上适当的二级预防和减少性风险的技术方面存在差距。这项形成性研究评估了在乌干达坎帕拉儿科传染病诊所就诊的11-21岁感染艾滋病毒的年轻人的性健康和生殖健康需求和问题，以及性风险的决定因素。信息-动机-行为技能模型提供了理论指导。社会人口学和选定的性心理数据进行了评估，使用一个简短的匿名问卷。共有75名感染艾滋病毒的年轻人参加了8次重点小组讨论。此外，还与成年关键线人（服务提供者）进行了一次重点小组调查。大约四分之一的年轻参与者报告了以前或现在的性经历。这项研究揭示了在生殖健康、艾滋病毒传播和避孕方法方面的知识差距。保护的动机包括对未来的希望，良好的咨询，以及对性活动后果的恐惧，如意外怀孕。采取预防性行为的障碍包括同伴压力、贫穷、与艾滋病毒有关的耻辱、对伴侣的无知、饮酒以及为年长者生孩子的愿望。在这种情况下，血清反应呈阳性的年轻人缺乏具体的行为技能，如向其性伴侣透露艾滋病毒状况，这与害怕被拒绝和耻辱密切相关。艾滋病毒阳性青年需要得到支持，以发展适当的行为技能，采取健康的性行为。这一领域的干预措施必须适合青年的发展需要，并适合青年的具体需要。结构性干预措施应同时解决和减少与艾滋病毒有关的耻辱感和感染艾滋病毒的年轻人的社会经济需求。
As anti-retroviral therapy becomes increasingly available, young people living with HIV need tailored support to adopt healthy sexual behaviors. There has been a gap in the availability of culturally appropriate techniques for secondary prevention and sexual risk reduction in this target group. This formative study assessed sexual and reproductive health needs and problems, as well as determinants of sexual risk-taking among young people living with HIV aged 11-21 years attending the Paediatric Infectious Disease Clinic in Kampala, Uganda. Theoretical guidance was provided by the Information-Motivation-Behavioral Skills Model. Socio-demographic and selected psychosexual data were assessed using a brief anonymous questionnaire. A total of 75 young people living with HIV participated in eight focus group discussions. In addition, one focus group was conducted with adult key informants ( service providers). About a quarter of the young participants reported prior or current sexual experience. The study revealed knowledge gaps relating to reproductive health, HIV transmission, and contraceptive methods. Motivations for protection included hope for the future, good counseling, and fear of the consequences of sexual activity such as unwanted pregnancies. Barriers to adopting preventive behaviors included peer pressure, poverty, HIV-related stigma, ignorance of their partners, alcohol use, and a desire to have children for the older ones. Young sero-positive people in this setting lacked specific behavioral skills, such as disclosure of HIV status to their sexual partners, this being closely linked to fear of rejection and stigma. HIV-positive youths need support in developing the appropriate behavioral skills to adopt healthy sexual behaviors. Interventions in this field need to be developmentally appropriate and tailored to young people's specific needs. Structural interventions should at the same time address and reduce HIV-related stigma and socio-economic needs of young people living with HIV.