Associations between Forced Sexual Initiation, HIV Status, Sexual Risk Behavior, Life Stressors, and Coping Strategies among Adolescents in Nigeria.
Associations between Forced Sexual Initiation, HIV Status, Sexual Risk Behavior, Life Stressors, and Coping Strategies among Adolescents in Nigeria.
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DOI：
10.1371/journal.pone.0155210
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Cáceres CF
中科院分区：
文献类型：
--
作者：
Folayan MO;Harrison A;Brown B;Odetoyinbo M;Stockman JK;Ajuwon AJ;Cáceres CF
有些人通过身体上的强迫性行为来经历他们的第一次性交，这会影响他们经历和应对压力的方式。我们根据尼日利亚青少年强迫性行为的历史和艾滋病毒状况，研究了他们在性危险行为、压力源经历以及压力应对策略的使用方面的差异。我们分析了通过对尼日利亚 12 个州进行人口调查招募的 436 名性活跃的 10-19 岁青少年的数据。利用拉扎勒斯和福克曼的压力和应对概念框架，我们评估了报告强迫性行为的青少年是否更有可能报告艾滋病毒性行为，将与社会期望、医疗保健和身体形象、失落和悲伤相关的压力事件报告为压力源，以及使用更多的回避而不是适应性应对策略来管理压力。我们还评估了艾滋病毒状况是否影响压力源的经历和应对策略的使用。 81 名青少年 (18.6%) 报告有强迫性行为史；这些参与者更有可能报告肛交行为（OR：5.04；95% CI：2.14-11.87）和交易性行为（OR：2.80；95% CI：1.56-4.95）。无强迫性行为历史的青少年更有可能将与社会期望相关的生活事件（OR：1.03；95％CI：0.96-1.11）以及失落和悲伤（OR：1.34；95％CI：0.73-2.65）视为压力源，但与医疗护理和身体形象相关的生活事件则不然（OR：0.63;95％CI： 0.34–1.18）。他们也更有可能使用适应性反应（OR：1.48；95％CI：0.62-3.50）而不是回避反应（OR：0.90；95％CI：0.49-1.64）来应对压力，尽管这些差异并不显着。更多有强迫性行为史且艾滋病毒呈阳性的青少年被认为是压力源、与医疗护理和身体形象相关的生活事件 (p = 0.03) 以及失落和悲伤 (p = 0.009)。报告强迫性行为和艾滋病毒阴性状态的青少年使用宗教作为应对策略的可能性明显较小（OR：0.28；95％CI：0.09-0.83）。强迫性行为的历史和艾滋病毒感染状况影响了对事件作为压力源的看法以及具体应对策略的使用。我们的研究结果可以为预防和解决尼日利亚和其他国家青少年强迫性行为的最佳实践干预措施和政策提供参考。
Some individuals experience their first sexual intercourse through physically forced sex, which affects the way they experience and cope with stress. We examined differences in sexual risk behavior, experience of stressors, and use of stress-coping strategies among adolescents in Nigeria based on their history of forced sexual initiation and HIV status. We analyzed data from 436 sexually active 10–19-year-old adolescents recruited through a population-based survey from 12 Nigerian states. Using Lazarus and Folkman’s conceptual framework of stress and coping, we assessed if adolescents who reported forced sexual initiation were more likely to report HIV sexual risk practices, to report as stressors events related to social expectations, medical care and body images, and loss and grief, and to use more avoidance than adaptive coping strategies to manage stress. We also assessed if HIV status affected experience of stressors and use of coping strategies. Eighty-one adolescents (18.6%) reported a history of forced sexual initiation; these participants were significantly more likely to report anal sex practices (OR: 5.04; 95% CI: 2.14–11.87), and transactional sex (OR: 2.80; 95% CI: 1.56–4.95). Adolescents with no history of forced sexual initiation were more likely to identify as stressors, life events related to social expectations (OR: 1.03; 95% CI: 0.96–1.11) and loss and grief (OR: 1.34; 95% CI: 0.73–2.65), but not those related to medical care and body images (OR: 0.63; 95% CI: 0.34–1.18). They were also more likely to use adaptive responses (OR: 1.48; 95% CI: 0.62–3.50) than avoidance responses (OR: 0.90; 95% CI: 0.49–1.64) to cope with stress, though these differences were not significant. More adolescents with a history of forced sexual initiation who were HIV positive identified as stressors, life events related to medical care and body images (p = 0.03) and loss and grief (p = 0.009). Adolescents reporting forced sexual initiation and HIV-negative status were significantly less likely to use religion as a coping strategy (OR: 0.28; 95% CI: 0.09–0.83). History of forced sexual initiation and HIV status affected perception of events as stressors and use of specific coping strategies. Our study findings could inform best practice interventions and policies to prevent and address forced sexual initiation among adolescents in Nigeria and other countries.