Explaining continued high HIV prevalence in South Africa: socioeconomic factors, HIV incidence and sexual behaviour change among a rural cohort, 2001-2004
Explaining continued high HIV prevalence in South Africa: socioeconomic factors, HIV incidence and sexual behaviour change among a rural cohort, 2001-2004
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DOI：
10.1097/01.aids.0000300534.97601.d6
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发表时间：
2007-11-01
期刊：
影响因子：
3.8
通讯作者：
Pronyk, Paul A.
中科院分区：
文献类型：
--
作者：
Hargreaves, James R.;Bonell, Christopher P.;Pronyk, Paul A.
目的：估计艾滋病毒的发病率，并探讨改变性行为的证据，随着时间的推移，属于不同的社会经济群体在农村southafrica.设计和方法：2001年和2004年之间进行的队列研究，3881人年龄在14-35岁列举了8个村庄有资格。在这两个时间点，至少进行了三次家庭访问，以联系每个合格的受访者。性行为数据收集结构化，以受访者为中心的访谈。艾滋病毒血清状态进行了评估，使用口服液酶联免疫吸附试验在每个timepoint.Results：性行为的数据可从1967个人在这两个时间点。共有1286例基线HIV阴性个体参与了发病率分析。男性艾滋病毒感染率为2.2/100人年，女性为4.9/ 100人年，其中受教育程度最低的群体感染率最高。在晚育组群中，首次性行为的中位年龄较低。2004年报告有多个性伴侣的先前性活跃者人数高于2001年。2001年至2004年，与非配偶伴侣一起使用保险套的情况有所增加。移徙男子更经常报告有多个伴侣。移民和教育程度更高的个人的性别和妇女从富裕的家庭报告较高水平的避孕套use.Discussion：艾滋病毒的发病率很高，在南非农村地区，特别是在妇女的教育程度低。随着时间的推移，一些危险的性行为（过早的性行为，拥有多个性伴侣）变得越来越普遍。避孕套的使用率在上升。现有的艾滋病毒预防战略在促使人口一级的行为改变方面仅部分有效。(c)2007年威科健康。
Objectives: To estimate HIV incidence and explore evidence for changing sexual behaviour over time among men and women belonging to different socioeconomic groups in rural South Africa.Design and methods: A cohort study conducted between 2001 and 2004; 3881 individuals aged 14-35 years enumerated in eight villages were eligible. At least three household visits were made to contact each eligible respondent at both timepoints. Sexual behaviour data were collected in structured, respondent-focused interviews. HIV serostatus was assessed using an oral fluid enzyme-linked immunosorbent assay at each timepoint.Results: Data on sexual behaviour were available from 1967 individuals at both timepoints. A total of 1286 HIV-negative individuals at baseline contributed to the analysis of incidence. HIV incidence was 2.2/100 person-years among men and 4.9/ 100 person-years in women, among whom it was highest in the least educated group. Median age at first sex was lower among later birth cohorts. A higher number of previously sexually active individuals reported having multiple partners in the past year in 2004 than 2001. Condom use with non-spousal partners increased from 2001 to 2004. Migrant men more often reported multiple partners. Migrant and more educated individuals of both sexes and women from wealthier households reported higher levels of condom use.Discussion: HIV incidence is high in rural South Africa, particularly among women of low education. Some risky sexual behaviours (early sexual debut, having multiple sexual partners) are becoming more common over time. Condom use is increasing. Existing HIV prevention strategies have only been partly effective in generating population-level behavioural change. (c) 2007 Wolters Kluwer Health.