Reducing sexual risk taking behaviors among adolescents who engage in transactional sex in post-conflict Liberia.
Reducing sexual risk taking behaviors among adolescents who engage in transactional sex in post-conflict Liberia.
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DOI：
10.1080/17450128.2011.647773
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发表时间：
2012-01-01
影响因子：
1.1
通讯作者：
Dennis B
中科院分区：
文献类型：
--
作者：
Atwood KA;Kennedy SB;Shamblen S;Taylor CH;Quaqua M;Bee EM;Gobeh ME;Woods DV;Dennis B
在撒哈拉以南非洲，交易性行为(TS)与艾滋病毒/性传播疾病感染、怀孕、早婚和性暴力相关。很少有适合SSA的基于西方的艾滋病毒预防计划检查了干预对这一群体的影响。这篇文章考察了对利比里亚六年级学生(年龄范围14-17岁)进行的艾滋病毒预防干预，发现在大样本中增加避孕套和其他媒介的使用，是否对从事TS的人的性行为和媒介产生了显著影响。使用注意力匹配的小组随机对照设计，利比里亚蒙罗维亚的四对匹配小学被随机分配到经过调整的八个模块的艾滋病毒预防或一般健康课程。与其他研究参与者相比，干预对性危险行为的九个月的影响和那些从事TS的人的中介被提出。在我们的六年级学生样本中(n=714)，有12%的人曾经从事过TS。大多数女性(52%)报告说，他们承诺用什么来换取性爱，而大多数男性(52%)报告说，他们既是礼物的赠与者，也是性礼物的接受者。与其他学生相比，无论是干预组还是对照组，与其他学生相比，那些参与TS的学生报告的性伴侣数量增加更多，性交频率更高，更有可能尝试怀孕或其他人怀孕，在9个月的随访中保护性态度和艾滋病毒风险认知的下降幅度更大。我们的干预虽然在普通在校青少年样本中取得了成功，但并没有影响参与TS的青少年的危险行为或中介。未来的研究应该探索TS嵌入其中的复杂的性经济，并考虑使艾滋病毒预防干预措施适应这一高危群体的需求。
Transactional sex (TS) has been correlated with HIV/STD infection, pregnancy, early marriage, and sexual violence in sub-Saharan Africa (SSA). Few Western-based HIV prevention programs adapted for SSA have examined intervention impacts for this group. This article examines whether an HIV prevention intervention, delivered to sixth-grade students in Liberia (age range 14–17) and found to increase condom use and other mediators for the larger sample, significantly impacted sexual behaviors and mediators for those who engaged in TS. Using an attention-matched, group-randomized controlled design, four matched pairs of elementary schools in Monrovia, Liberia, were randomly assigned to an adapted eight-module HIV prevention or a general health curriculum. Nine-month impacts of the intervention on sexual risk behaviors and mediators for those who engaged in TS, when compared with other study participants, are presented. Twelve percent of our sample of sixth graders (n = 714) ever engaged in TS. The majority of females reported being promised something in exchange for sex (52%), whereas the majority of males (52%) reported being both the giver and recipient of gifts in exchange for sex. Compared with other students, those who engaged in TS reported greater increases in the number of sex partners, reported greater frequency of sexual intercourse, were more likely to try to get pregnant or someone else pregnant, and reported greater reductions in protective sexual attitudes and HIV risk perception at the nine month follow-up, in both the intervention and the control groups. Our intervention, although successful for the general in-school adolescent sample, did not impact risk behaviors or mediators for adolescents who engaged in TS. Future research should explore the complex sexual economy in which TS is embedded and consider adapting HIV prevention interventions to the needs of this high-risk group.