Gender, peer and partner influences on adolescent HIV risk in rural South Africa.
Gender, peer and partner influences on adolescent HIV risk in rural South Africa.
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DOI：
10.1071/sh10150
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发表时间：
2012-05
期刊：
影响因子：
1.6
通讯作者：
Exner T
中科院分区：
文献类型：
--
作者：
Harrison A;Smit J;Hoffman S;Nzama T;Leu CS;Mantell J;Stein Z;Exner T
为了准备在南非夸祖鲁-纳塔尔省开展以学校为基础的干预措施，对 14-17 岁青少年 (n = 983) 的潜在艾滋病毒危险因素进行了横断面调查。男孩比女孩更有可能报告一生的性活动（37.7% vs. 13.8%，P < 0.01）。在男孩和女孩中，46.1% 的人表示在上次性行为中使用了安全套。与伴侣讨论安全套使用情况是安全套使用的最强预测因素（男孩，比值比 (OR) = 7.39；女孩，OR = 5.58，P < 0.0001）。对于男孩（OR = 1.49，P < 0.0001）和女孩（OR = 1.74，P = 0.02），年龄与性活动独立相关。对于男孩来说，对男性同伴行为的看法与曾经参与过性活动（OR = 1.48，P < 0.01）和上次性行为时使用安全套（OR = 1.79，P < 0.01）有关。将使用安全套等同于拥有众多性伴侣的女孩更有可能使用安全套。在男孩中，结果挑战了一些预期的性别信念：支持女孩主动建立关系和拒绝性行为是性活动的重要预测因素。在女孩中，较高的怀孕风险认知（OR = 1.32，P = 0.02）和知识（OR = 4.85，P = 0.055）与性活动相关。制定更加性别平等的规范可以减少艾滋病毒危险行为。艾滋病毒预防干预措施应建立在现有性别平等信念的基础上，并努力促进其他信念，包括性沟通和谈判技巧，以及积极的同伴规范的示范。
In preparation for a school-based intervention in KwaZulu-Natal, South Africa, a cross-sectional survey of potential HIV risk factors in youth aged 14–17 (n = 983) was conducted. Boys were significantly more likely than girls to report lifetime sexual activity (37.7% v. 13.8%, P < 0.01). Among boys and girls, 46.1% reported condom use at last sex. Discussion of condom use with a partner was the strongest predictor of condom use (boys, odds ratio (OR) = 7.39; girls, OR = 5.58, P < 0.0001). Age was independently associated with sexual activity for boys (OR = 1.49, P < 0.0001) and girls (OR = 1.74, P = 0.02). For boys, perceptions of male peer behaviour were associated with both ever having participated in sexual activity (OR = 1.48, P < 0.01) and condom use at last sex (OR = 1.79, P < 0.01). Girls who equated condom use with having numerous partners were more likely to use them. Among boys, results challenged some expected gender beliefs: support for girls’ initiative in relationship formation and refusal of sex were significant predictors of sexual activity. Among girls, higher pregnancy risk perception (OR = 1.32, P = 0.02) and knowledge (OR = 4.85, P = 0.055) were associated with sexual activity. Creating more gender equitable norms can reduce HIV risk behaviours. HIV prevention interventions should build on existing gender equitable beliefs, and work to promote others, including sexual communication and negotiation skills, and modelling of positive peer norms.