Food security reduces multiple HIV infection risks for high-vulnerability adolescent mothers and non-mothers in South Africa: a cross-sectional study.
Food security reduces multiple HIV infection risks for high-vulnerability adolescent mothers and non-mothers in South Africa: a cross-sectional study.
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DOI：
10.1002/jia2.25928
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发表时间：
2022-08
影响因子：
6
通讯作者：
中科院分区：
文献类型：
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南部非洲的少女和年轻妇女，包括未成年母亲，艾滋病毒血清转化率和传播率很高。我们需要知道哪些风险导致艾滋病毒感染，以及如何降低这些风险。我们在2018年3月至2019年7月期间采访了1712名青春期女孩和年轻女性（11-23岁），其中包括1024名在20岁之前怀孕并有一个活着的孩子的青少年母亲，他们来自南非东开普省的两个卫生城市。招募是通过社区、学校和保健设施等多种渠道进行的。青少年母亲和七种艾滋病毒风险行为（多个性伴侣，性交易，年龄不同的性别，无避孕套的性行为，物质的性行为，饮酒和不受教育或就业）之间的关联进行了调查，使用广义估计方程方法对多个结果进行了指定，并对9个协变量进行了调整。使用相同的模型，我们调查了过去一周每天在家里有足够的食物（粮食安全）与相同的七种艾滋病毒风险行为之间的关联。当我们发现艾滋病毒状态的适度证据时，我们报告了特定阶层的比值比。平均年龄为17.51岁（SD：2.54），46%的参与者是艾滋病毒感染者。与非母亲相比，青少年母亲饮酒的几率较低（AOR = 0.47，95% CI = 0.29-0.75），但多个性伴侣的几率更高（AOR = 1.93，95% CI = 1.35-2.74），年龄-性别不同（HIV-未感染AOR = 1.73，95% CI = 1.03-2.91;艾滋病毒感染者AOR = 5.10，95%CI = 2.98-8.73），无安全套性行为（AOR = 8.20，95% CI = 6.03-11.13），性别对物质的影响（AOR = 1.88，95% CI = 1.10-3.21）和未接受教育/就业（未感染HIV的AOR = 1.83，95% CI = 1.19-2.83;携带HIV的AOR = 6.30，95% CI = 4.09-9.69）。在非母亲中，食品安全与多个性伴侣（AOR = 0.45，95% CI = 0.26-0.78），交易性行为（AOR = 0.32，95% CI = 0.13-0.82）和未接受教育/就业（AOR = 0.48，95% CI = 0.29-0.77）的几率较低相关。在未成年母亲中，食品安全与性交易的几率较低有关（AOR = 0.17，95% CI = 0.10-0.28），年龄-性别不同（AOR = 0.66，95% CI = 0.47-0.92），性别对物质的影响（AOR = 0.51，95% CI = 0.32-0.82）、饮酒（AOR = 0.45，95% CI = 0.25-0.79）和未接受教育/就业（AOR = 0.56，95% CI = 0.40-0.78）。少女母亲与艾滋病毒感染和传播的多重脆弱性有关。提高粮食安全的社会保障措施有可能减少少女和年轻妇女、特别是少女母亲感染艾滋病毒的风险途径。
Adolescent girls and young women, including adolescent mothers, in Southern Africa have high HIV seroconversion and transmission. We need to know which risks drive HIV infections, and what can reduce these risks. We interviewed 1712 adolescent girls and young women (11–23 years), including 1024 adolescent mothers who had conceived before age 20 and had a living child, from two health municipalities of South Africa's Eastern Cape Province between March 2018 and July 2019. Recruitment was through multiple community, school and health facility channels. Associations between adolescent motherhood and seven HIV risk behaviours (multiple sexual partners, transactional sex, age‐disparate sex, condomless sex, sex on substances, alcohol use and not in education or employment) were investigated using the generalized estimating equations method for multiple outcomes specified with a logit link and adjusting for nine covariates. Using the same model, we investigated associations between having enough food at home every day in the past week (food security) and the same seven HIV risk behaviours. When we found evidence of moderation by HIV status, we report stratum‐specific odds ratios. Mean age was 17.51 years (SD: 2.54), 46% participants were living with HIV. Compared to non‐mothers, adolescent mothers had lower odds of alcohol use (AOR = 0.47, 95% CI = 0.29–0.75), but higher odds of multiple sexual partners (AOR = 1.93, 95% CI = 1.35–2.74), age‐disparate sex (HIV‐uninfected AOR = 1.73, 95% CI = 1.03–2.91; living with HIV AOR = 5.10, 95% CI = 2.98–8.73), condomless sex (AOR = 8.20, 95% CI = 6.03–11.13), sex on substances (AOR = 1.88, 95% CI = 1.10–3.21) and not in education/employment (HIV‐uninfected AOR = 1.83, 95% CI = 1.19–2.83; living with HIV AOR = 6.30, 95% CI = 4.09–9.69). Among non‐mothers, food security was associated with lower odds of multiple sexual partners (AOR = 0.45, 95% CI = 0.26–0.78), transactional sex (AOR = 0.32, 95% CI = 0.13–0.82) and not in education/employment (AOR = 0.48, 95% CI = 0.29–0.77). Among adolescent mothers, food security was associated with lower odds of transactional sex (AOR = 0.17, 95% CI = 0.10–0.28), age‐disparate sex (AOR = 0.66, 95% CI = 0.47–0.92), sex on substances (AOR = 0.51, 95% CI = 0.32–0.82), alcohol use (AOR = 0.45, 95% CI = 0.25–0.79) and not in education/employment (AOR = 0.56, 95% CI = 0.40–0.78). Adolescent motherhood is associated with multiple vulnerabilities to HIV infection and transmission. Social protection measures that increase food security are likely to reduce HIV risk pathways for adolescent girls and young women, especially adolescent mothers.
在埃斯瓦蒂尼，埃塞俄比亚和莫桑比克参加产前护理服务的青春期妇女中，已知的艾滋病毒状况。
影响因子：
3.4
作者：
Njah J;Chiasson MA;Reidy W
通讯作者：
Reidy W