How empowered are girls/young women in their sexual relationships? Relationship power, HIV risk, and partner violence in Kenya.
How empowered are girls/young women in their sexual relationships? Relationship power, HIV risk, and partner violence in Kenya.
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DOI：
10.1371/journal.pone.0199733
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发表时间：
2018
期刊：
影响因子：
3.7
通讯作者：
Woznica D
中科院分区：
文献类型：
--
作者：
Pulerwitz J;Mathur S;Woznica D
夫妻关系中的性别权力动态可能会限制妇女实现积极的性健康和生殖健康结果。但人们对青少年的人际关系影响力知之甚少，衡量这种影响力的工具也很少在青少年中得到验证。我们测试了青春期女孩和年轻女性(AGYW)中的性关系权力量表(SRPS)，并检查了与选定的健康结果的相关性。在肯尼亚，对15-24岁的AGYW(n=1,101)实施了SRPS的16个项目的改编。验证性因素分析(CFA)和theta系数评估了三个年龄段的量表表现：15-17岁、18-20岁和21-24岁。对关系权力水平进行了检验，并用多元Logistic回归分析了权力、伴侣暴力和HIV风险结果之间的关系。CFAs确定了每个亚组的单因素结构，最终15个项目量表的Thetas是稳健的(>；.82)。大多数受访者报告他们的性关系中的权力有限，而年龄较大的受访者始终报告说他们的权力水平较低。即使在控制了社会经济地位和受教育程度的情况下，人际关系权力也与几个结果密切相关。例如，报告了更多关系权力的AGYW分别降低了12、6和7倍的可能性(分别为21-24岁、18-20岁和15-17岁)经历性暴力(p<；0.001)。在对性伴侣暴力(三个年龄段)、在最后一次性行为时使用安全套(18-20岁)以及增加对伴侣艾滋病毒状况的了解(21-24岁)的多变量分析中也发现了显著的关系。SRPS是衡量AGYW内部几个年龄段的关系权力的良好指标，年龄较大的AGYW和年轻的AGYW对关系权力的体验是不同的。低关系能力是伴侣暴力的始终如一的预测因素，也是艾滋病毒风险的重要预测因素。寻求解决艾滋病毒和暴力问题的干预措施也应明确处理关系权力，并利用经过验证的工具(如SRPS)来评估影响。
Gendered power dynamics within couple relationships can constrain women from achieving positive sexual and reproductive health outcomes. But little is known about relationship power among adolescents, and tools to measure it are rarely validated among adolescents. We tested the Sexual Relationship Power Scale (SRPS) among adolescent girls and young women (AGYW) and examined associations with select health outcomes. A 16-item adaptation of the SRPS was administered to AGYW aged 15–24 in Kenya (n = 1,101). Confirmatory factor analysis (CFA) and theta coefficients assessed scale performance for three age bands: 15–17, 18–20, and 21–24 years old. Relationship power levels were examined and multivariate logistic regressions assessed the relationship between power, and partner violence and HIV risk outcomes. CFAs confirmed a one factor structure for each subgroup, and thetas for final 15-item scales were robust (>.82). Most respondents reported limited power in their sexual relationships, however older respondents consistently reported lower levels of power. Relationship power was strongly associated with several outcomes, even when controlling for socioeconomic status and schooling. For example, AGYW who reported more relationship power were 12, 6, and 7 times less likely (ages 21–24, 18–20, and 15–17, respectively) to experience sexual violence (p<0.001). Significant relationships were also found in multivariate analyses for physical partner violence (all three age bands), using a condom at last sex (18–20-year-olds), and increased knowledge of partner’s HIV status (21–24-year-olds). The SRPS is a good measure of relationship power for several age bands within AGYW, and power is experienced differently by older and younger AGYW. Low relationship power was a consistent predictor of partner violence, as well as an important predictor of HIV risk. Interventions seeking to address HIV and violence should also explicitly address relationship power and utilize validated tools (like the SRPS) to evaluate impacts.
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作者：
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通讯作者：
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DOI：
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