Exploring associations between adolescent sexual and reproductive health stigma and HIV testing awareness and uptake among urban refugee and displaced youth in Kampala, Uganda.
Exploring associations between adolescent sexual and reproductive health stigma and HIV testing awareness and uptake among urban refugee and displaced youth in Kampala, Uganda.
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DOI：
10.1080/26410397.2019.1695380
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发表时间：
2019-12
影响因子：
6
通讯作者：
Kipenda CU
中科院分区：
文献类型：
--
作者：
Logie CH;Okumu M;Mwima SP;Kyambadde P;Hakiza R;Kibathi IP;Kironde E;Musinguzi J;Kipenda CU
乌干达收容了130多万难民，是探索对城市难民和流离失所的青年进行艾滋病毒检测的突出背景。我们在乌干达坎帕拉的城市难民和流离失所的青年中调查了耻辱(艾滋病毒相关和青春期性健康和生殖健康[SRH]相关)与艾滋病毒检测服务意识和艾滋病毒检测接受之间的关系。我们对难民和流离失所的少女和青年妇女(AGYW)和16-24岁的青春期男孩和青年男子(ABYM)进行了横断面调查。我们对青少年SRH污名量表进行了探索性和验证性因素分析，确定了一个双因素结构(“性行为与怀孕污名”，“现代计划生育与堕胎污名”)。我们进行了多变量Logistic回归分析，以确定调整后的HIV检测服务知晓和检测接受的风险比。在参与者中(n=445；平均年龄=19.59，SD=2.60；AGYW：n=333；74.7%)，三分之二的人知道他们所在社区的艾滋病毒检测服务，超过一半(56.0%)的人接受过终身艾滋病毒检测。在对AGYW进行的调整多变量回归分析中发现：(A)较高的性行为和怀孕耻辱以及现代计划生育和堕胎耻辱与艾滋病毒检测服务意识的降低有关，(B)现代计划生育和堕胎耻辱与终身HIV检测的几率降低相关。耻辱与ABYM中的艾滋病毒检测意识/感染无关。AGYW的艾滋病毒检测服务知晓率低于ABYM，但AGYW更有可能接受过检测，并将青少年SRH污名作为检测障碍。解决青少年SRH污名问题可能会优化AGYW的艾滋病毒检测。
Uganda, hosting over 1.3 million refugees, is a salient context for exploring HIV testing with urban refugee and displaced youth. We examined associations between stigma (HIV-related and adolescent sexual and reproductive health [SRH]-related) and HIV testing services awareness and HIV testing uptake among urban refugee and displaced youth in Kampala, Uganda. We implemented a cross-sectional survey with refugee and displaced adolescent girls and young women (AGYW) and adolescent boys and young men (ABYM) aged 16-24. We conducted exploratory and confirmatory factor analysis of an adolescent SRH stigma scale and identified a two-factor structure (“Sexual activity & pregnancy stigma”,”Modern family planning & abortion stigma”). We conducted multivariable logistic regression analysis to determine the adjusted risk ratio for HIV testing services awareness and testing uptake. Among participants (n=445; mean age=19.59, SD=2.60; AGYW: n=333; 74.7%), two-thirds were aware of HIV testing services in their community and over half (56.0%) had received a lifetime HIV test. In adjusted multivariable regression analysis findings with AGYW: (a) higher sexual activity & pregnancy stigma and modern family planning & abortion stigma were associated with reduced odds of HIV testing services awareness, and (b) modern family planning & abortion stigma was associated with reduced lifetime HIV testing odds. Stigma was not associated with HIV testing awareness/uptake among ABYM. HIV testing services awareness among AGYW was lower than among ABYM, yet AGYW were more likely to have been tested and to experience adolescent SRH stigma as a testing barrier. Addressing adolescent SRH stigma may optimise AGYW's HIV testing.
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发表时间：
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