Sexual learning among East African adolescents in the context of generalized HIV epidemics: A systematic qualitative meta-synthesis
Sexual learning among East African adolescents in the context of generalized HIV epidemics: A systematic qualitative meta-synthesis
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DOI：
10.1371/journal.pone.0173225
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发表时间：
2017-03-09
期刊：
影响因子：
3.7
通讯作者：
Draucker, Claire Burke
中科院分区：
文献类型：
--
作者：
Knopf, Amelia S.;McNealy, Kim R.;Draucker, Claire Burke
艾滋病相关疾病是撒哈拉以南非洲青少年死亡的主要原因。肯尼亚、坦桑尼亚和乌干达加起来占撒哈拉以南非洲艾滋病毒感染青少年的21%。联合国处理青少年中流行病的框架要求进行全面的性健康和生殖健康教育。这些艾滋病毒预防工作可以通过综合现有的研究来了解，这些研究涉及正在经历普遍性暴力的国家中青少年的正规和非正规性教育。本研究的目的是描述的过程中，东非青少年生活在广义的HIV epidemies.MethodsQualitative元分析，一个系统的程序，用于整合多个定性研究的结果，解决类似的现象，性学习。32份研究报告符合研究纳入标准。报告进行了评估，在一个四步的分析过程：评估，分类的结果，综合的结果，并构建一个框架，描绘了这个population.ResultsThe框架的过程中的性学习包括三个阶段的性学习：1）被引发的性，2）性的意义，和3）有性经验。青少年通过性别规范、文化习俗和经济结构以及通过对话和正式教育获得性知识。他们通过获取有关性交、生殖和怀孕、性传播感染和人际关系的信息，以及通过发展对这些主题的各种信仰和态度，来理解性。一些青少年描述了满足欲望或需求的性经历，但许多人经历了强迫或暴力的性行为。无论性是想要的，胁迫，或暴力，青少年经历了担心性传播感染或婚前premarrial pregnancy.ConclusionsThe三个阶段的性学习相互作用，以塑造青少年的性生活和他们感染艾滋病毒的风险。这一框架将有助于制定性教育方案，在更广泛的性教育背景下解决艾滋病毒风险问题。
Background AIDS-related illness is the leading cause of mortality for adolescents in sub-Saharan Africa. Together, Kenya, Tanzania, and Uganda account for 21% of HIV-infected adolescents in sub-Saharan Africa. The United Nations framework for addressing the epidemic among adolescents calls for comprehensive sexual and reproductive health education. These HIV prevention efforts could be informed by a synthesis of existing research about the formal and informal sexual education of adolescents in countries experiencing generalized epidem-ics. The purpose of this study was to describe the process of sexual learning among East African adolescents living in the context of generalized HIV epidemics.MethodsQualitative metasynthesis, a systematic procedure for integrating the results of multiple qualitative studies addressing a similar phenomenon, was used. Thirty-two research reports met study inclusion criteria. The reports were assessed in a four-step analytic process: appraisal, classification of findings, synthesis of findings, and construction of a framework depicting the process of sexual learning in this population.ResultsThe framework includes three phases of sexual learning: 1) being primed for sex, 2) making sense of sex, and 3) having sexual experiences. Adolescents were primed for sex through gender norms, cultural practices, and economic structures as well as through conversations and formal instruction. They made sense of sex by acquiring information about sexual inter-course, reproduction and pregnancy, sexually transmitted infections, and relationships and by developing a variety of beliefs and attitudes about these topics. Some adolescents described having sexual experiences that met wants or needs, but many experienced sex that was coerced or violent. Whether sex was wanted, coerced, or violent, adolescents experienced worry about sexually transmitted infections or premarital pregnancy.ConclusionsThe three phases of sexual learning interact to shape adolescents' sexual lives and their risk for HIV infection. This framework will contribute to the development of sexual education programs that address HIV risk within the broader context of sexual learning.