Is the sexual behaviour of young people in sub-Saharan Africa influenced by their peers? A systematic review.
Is the sexual behaviour of young people in sub-Saharan Africa influenced by their peers? A systematic review.
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DOI：
10.1016/j.socscimed.2015.09.039
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发表时间：
2015-12
期刊：
影响因子：
--
通讯作者：
Hargreaves JR
中科院分区：
文献类型：
--
作者：
Fearon E;Wiggins RD;Pettifor AE;Hargreaves JR
撒哈拉以南非洲的青少年极易感染艾滋病毒、其他性传播感染和意外怀孕。个人行为改变干预措施在减少艾滋病毒发病率和其他生物后果方面的有效性的证据有限，显然需要解决年轻人变得性生活活跃的社会条件。青少年的同龄人是这种社会环境的一个关键方面，可能会对性行为产生重要影响。撒哈拉以南非洲尚未对这一专题进行系统审查。我们搜索了4个数据库，寻找以撒哈拉以南非洲为背景的研究，其中包括对至少一个同伴暴露与样本中的性行为结果之间的关联进行的调整分析，其中至少50%的研究参与者年龄在13岁到20岁之间。我们使用一个框架对同伴暴露进行分类，以区分可能发生影响的不同机制。我们找到了30项研究，保留了11项符合质量标准的研究。共有3个队列研究，1个事件发生时间和7个横断面研究。这11项研究调查了37种不同的同伴接触-结果关联。没有一项研究使用生物学结果，所有研究都询问了同龄人的总体情况，而不是具体的关系。研究在使用理论框架和将同伴影响概念付诸实施的方法上是不同的。所有研究都发现了至少一个同伴接触/结果/分组关联的同伴与性行为之间存在关联的证据。在所有测试的37个结果/暴露/分组关联中，有19个(51%)有证据。没有明确的模式，按同伴接触的类型，结果或青少年亚组。关于同龄人在撒哈拉以南地区青少年性行为中的作用，缺乏确凿的证据。我们认为，纵向设计、生物学成果的使用以及来自社会网络分析的方法是未来研究的优先事项。
Adolescents in sub-Saharan Africa are highly vulnerable to HIV, other sexually transmitted infections (STIs) and unintended pregnancies. Evidence for the effectiveness of individual behaviour change interventions in reducing incidence of HIV and other biological outcomes is limited, and the need to address the social conditions in which young people become sexually active is clear. Adolescents’ peers are a key aspect of this social environment and could have important influences on sexual behaviour. There has not yet been a systematic review on the topic in sub-Saharan Africa. We searched 4 databases to find studies set in sub-Saharan Africa that included an adjusted analysis of the association between at least one peer exposure and a sexual behaviour outcome among a sample where at least 50% of the study participants were aged between 13 and 20 years. We classified peer exposures using a framework to distinguish different mechanisms by which influence might occur. We found 30 studies and retained 11 that met quality criteria. There were 3 cohort studies, 1 time to event and 7 cross-sectional. The 11 studies investigated 37 different peer exposure-outcome associations. No studies used a biological outcome and all asked about peers in general rather than about specific relationships. Studies were heterogeneous in their use of theoretical frameworks and means of operationalizing peer influence concepts. All studies found evidence for an association between peers and sexual behaviour for at least one peer exposure/outcome/sub-group association. Of all 37 outcome/ exposure/sub-group associations tested, there was evidence for 19 (51%). There were no clear patterns by type of peer exposure, outcome or adolescent sub-group. There is a lack conclusive evidence about the role of peers in adolescent sexual behaviour in Sub-Saharan. We argue that longitudinal designs, use of biological outcomes and approaches from social network analysis are priorities for future studies.
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