Contraceptive Method Mix and HIV Risk Behaviors Among Kenyan Adolescent Girls and Young Women Seeking Family Planning Services: Implications for Integrating HIV Prevention.
Contraceptive Method Mix and HIV Risk Behaviors Among Kenyan Adolescent Girls and Young Women Seeking Family Planning Services: Implications for Integrating HIV Prevention.
复制标题
DOI：
10.3389/frph.2021.667413
复制
发表时间：
2021
影响因子：
--
通讯作者：
Pintye J
中科院分区：
文献类型：
--
作者：
Nyaboe E;Larsen A;Sila J;Kinuthia J;Owiti G;Abuna F;Kohler P;John-Stewart G;Pintye J
背景：了解寻求避孕的青春期少女和年轻妇女（AGYW）的艾滋病毒风险行为有助于在计划生育（FP）诊所内整合艾滋病毒预防服务。方法：2018年10月至2019年4月，我们在肯尼亚基苏木的4家计划生育诊所进行调查，评估未感染HIV的AGYW寻求避孕的风险行为。所有15至24岁的AGYW在收到计划生育服务后被邀请参加。开始或重新避孕的少女和年轻妇女也包括在这项分析中。长效可逆避孕（LARC）包括宫内避孕器、植入物或注射剂。非larc方法包括口服避孕药（OCP）或避孕套。我们使用经验风险评分来评估艾滋病毒风险行为；HIV风险评分≥5（对应于5 - 15%的HIV发病率）定义为“高”HIV风险。结果：共纳入555名寻求FP的AGYW。中位年龄为22岁[四分位差（IQR） 20-23]，中位受教育年限为12年（IQR 10-12）；23%的AGYW的HIV风险评分≥5。最常见的避孕方式是注射（43%），其次是植入（39%）。在调整教育程度、怀孕史和婚姻状况后，LARC使用者比非LARC使用者更频繁地从事交易性行为[6比0%，调整患病率(PR) = 1.17, 95% CI 1.09-1.29, p < 0.001]；LARC的使用与HIV风险评分≥5分无关。在LARC使用者中，与使用其他LARC方法的AGYW相比，使用注射剂的AGYW更频繁地发生无套性行为（85比75%，调整PR = 1.52, 95% CI 1.09-2.10, p = 0.012）；注射使用与HIV风险评分≥5分无关。结论：寻求避孕的少女和年轻妇女往往有较高的艾滋病毒风险，强调了将艾滋病毒预防纳入计划生育的重要性。避孕和预防艾滋病毒的多用途技术尤其可以使AGYW受益。
Background: Understanding HIV risk behaviors among adolescent girls and young women (AGYW) seeking contraception could help inform integrating HIV prevention services within family planning (FP) clinics. Methods: From 10/2018 to 04/2019, we conducted a survey at 4 FP clinics in Kisumu, Kenya to evaluate risk behaviors among AGYW without HIV infection seeking contraception. All AGYW aged 15–24 were invited to participate following receipt of FP services. Adolescent girls and young women initiating or refilling contraception were included in this analysis. Long-acting reversible contraceptives (LARC) included intrauterine devices, implants, or injectables. Non-LARC methods included oral contraceptive pills (OCP) or condoms. We used an empiric risk score to assess HIV risk behaviors; HIV risk scores of ≥5 (corresponding to 5–15% HIV incidence) defined “high” HIV risk. Results: Overall, 555 AGYW seeking FP were included. Median age was 22 years [interquartile range (IQR) 20–23], median completed education was 12 years (IQR 10–12); 23% of AGYW had HIV risk scores of ≥5. The most frequent form of contraception was injectables (43%), followed by implants (39%). After adjustment for education, prior pregnancy, and marital status, LARC users more frequently engaged in transactional sex than non-LARC users [6 vs. 0%, adjusted prevalence ratio (PR) = 1.17, 95% CI 1.09–1.29, p < 0.001]; LARC use was not associated with HIV risk scores ≥5. Among LARC users, AGYW using injectables more frequently had condomless sex compared to AGYW using other LARC methods (85 vs. 75%, adjusted PR = 1.52, 95% CI 1.09–2.10, p = 0.012); injectable use was not associated with HIV risk scores ≥5. Conclusions: Adolescent girls and young women seeking contraception frequently had high HIV risk, emphasizing the importance of integrating HIV prevention within FP. Multipurpose technologies for contraception and HIV prevention could particularly benefit AGYW.