Transactional Sex Amongst AIDS-Orphaned and AIDS-Affected Adolescents Predicted by Abuse and Extreme Poverty
Transactional Sex Amongst AIDS-Orphaned and AIDS-Affected Adolescents Predicted by Abuse and Extreme Poverty
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DOI：
10.1097/qai.0b013e31822f0d82
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发表时间：
2011-11-01
影响因子：
3.6
通讯作者：
Meinck, Franziska
中科院分区：
文献类型：
--
作者：
Cluver, Lucie;Orkin, Mark;Meinck, Franziska
目标：人们对家庭艾滋病对青少年虐待和性健康结果的影响知之甚少。目的是确定家庭性艾滋病是否：（1）与严重的身体、情感和性虐待有关;（2）与性交易剥削有关;（3）探讨家庭性艾滋病和性交易之间的关系是否由极端贫困和虐待介导。设计：南非贫困社区青少年自我报告研究。2009年对2005年研究的随访达到了71%的保留率（n = 723）。2009年的样本包括艾滋病孤儿（n = 236），其他孤儿（n = 231）和非孤儿（n = 220）青少年，其主要照顾者是艾滋病患者（n = 109），其他患者（n = 147）和健康（n = 220）。虐待和交易性行为进行了测量，使用广泛使用和验证的自我报告measurements.Results：艾滋病和父母艾滋病预测情感和身体虐待和交易性剥削。非艾滋病原因造成的孤儿或父母疾病，以及有健康的照顾者，并不能预测任何虐待结果。与健康家庭中的青少年相比，受艾滋病“双重”影响的青少年遭受严重精神和身体虐待的可能性高出3倍，女孩遭受交易性性剥削的可能性高出6倍。受艾滋病影响家庭中的青少年发生性交易的风险增加，是由于极端贫困和遭受虐待。家庭艾滋病、食物不安全和暴露于虐待的综合影响使女孩的性交易患病率从1%上升到57%.Conclusions：来自受艾滋病影响家庭的青少年非常容易受到严重的身体和情感虐待和性交易。这对儿童保护和艾滋病毒预防服务方面的政策和方案拟订产生了影响。
Objectives: Little is known about impacts of familial AIDS on abuse and sexual health outcomes amongst adolescents. Objectives were to determine whether familial AIDS is: (1) associated with severe physical, emotional, and sexual abuse; (2) associated with transactional sexual exploitation; and (3) explore whether relationships between familial AIDS and transactional sex are mediated by extreme poverty and abuse.Design: Adolescent self-report study in deprived South African communities.Methods: A 2009 follow-up of a 2005 study achieved 71% retention (n = 723). The 2009 sample included AIDS-orphaned (n = 236), otherorphaned (n = 231), and non-orphaned (n = 220) adolescents, whose primary caregivers were AIDS sick (n = 109), other sick (n = 147), and healthy (n = 220). Abuse and transactional sex were measured using widely used and validated self-report measures.Results: AIDS orphanhood and parental AIDS sickness predicted emotional and physical abuse and transactional sexual exploitation. Orphanhood or parental sickness by non-AIDS causes, and having healthy caregivers, did not predict any abuse outcomes. Adolescents "dually" affected by AIDS orphanhood and sickness showed a 3-fold likelihood of severe emotional and physical abuse and, amongst girls, a 6-fold likelihood of transactional sexual exploitation, compared with those in healthy families. Heightened risk of transactional sex amongst adolescents in AIDS-affected families was mediated by extreme poverty and abuse exposure. In combination, the effects of familial AIDS, food insecurity, and exposure to abuse raised prevalence of transactional sex amongst girls from 1% to 57%.Conclusions: Adolescents from AIDS-affected families are highly vulnerable to severe physical and emotional abuse and transactional sex. This has implications for policy and programming in child protection and HIV prevention services.