Impact of Counseling Received by Adolescents Undergoing Voluntary Medical Male Circumcision on Knowledge and Sexual Intentions.
Impact of Counseling Received by Adolescents Undergoing Voluntary Medical Male Circumcision on Knowledge and Sexual Intentions.
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接受自愿医疗男性包皮环切术的青少年接受的咨询对知识和性意向的影响。
DOI：
10.1093/cid/cix973
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发表时间：
2018
期刊：
影响因子：
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通讯作者：
Bonnecwe
中科院分区：
文献类型：
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作者：
Kaufman,MichelleR;Patel,EshanU;Dam,KimH;Packman,ZoeR;VanLith,LynnM;Hatzold,Karin;Marcell,ArikV;Mavhu,Webster;Kahabuka,Catherine;Mahlasela,Lusanda;Njeuhmeli,Emmanuel;SeifertAhanda,Kim;Ncube,Getrude;Lija,Gissenge;Bonnecwe
背景关于自愿医疗男性包皮环切 (VMMC) 服务期间提供的咨询对青少年人类免疫缺陷病毒 (HIV) 知识、VMMC 知识或 VMMC 后预防性性意向的影响知之甚少。这项研究评估了咨询对知识和意图的影响。方法对 3 个国家的 1293 名青少年客户进行了调查（南非，n = 299；坦桑尼亚，n = 498；津巴布韦，n = 496）。在接受 VMMC 术前咨询之前以及术后大约 10 天的随访调查中，对青少年进行了 HIV 和 VMMC 知识项目评估。在后续调查中，性活跃的青少年被问及他们的性意图。患病率 (PR) 和 95% 置信区间 (CI) 通过改进的泊松回归模型和广义估计方程和稳健方差估计来计算。结果关于 VMMC 后的 HIV 预防知识，年龄较大的青少年比年轻青少年更有可能知道男性应该使用安全套（年龄 10-14 岁，41.1%；15-19 岁，84.2%；aPR， 1.38 [95% CI，1.19–1.60]），性伴侣较少（10–14 岁，8.1%；15–19 岁，24.5%；aPR，2.10 [95% CI，1.30–3.39]），对一位伴侣忠诚（10–14 岁，5.7%；15–19 岁）年，23.2%；aPR，2.79 [95% CI， 1.97–3.97]）进一步保护自己免受艾滋病毒感染。年龄较大的青少年在大多数类别的知识方面都表现出更大的进步，在有关性伴侣数量（aPR，2.01 [95% CI，1.18–3.44]）和 VMMC 后对一位伴侣的忠诚度（aPR，3.28 [95% CI，2.22–4.86]）的问题上差异显着。然而，性活跃青少年的总体预防知识水平和降低艾滋病毒风险的性意向明显较低，特别是考虑到青少年仅在7-10天前接受过咨询。结论需要改进青少年VMMC咨询，以增加知识和术后预防性性意向。
BackgroundLittle is known regarding the impact of counseling delivered during voluntary medical male circumcision (VMMC) services on adolescents’ human immunodeficiency virus (HIV) knowledge, VMMC knowledge, or post-VMMC preventive sexual intentions. This study assessed the effect of counseling on knowledge and intentions.MethodsSurveys were conducted with 1293 adolescent clients in 3 countries (South Africa, n = 299; Tanzania, n = 498; Zimbabwe, n = 496). Adolescents were assessed on HIV and VMMC knowledge-based items before receiving VMMC preprocedure counseling and at a follow-up survey approximately 10 days postprocedure. Sexually active adolescents were asked about their sexual intentions in the follow-up survey. Prevalence ratios (PRs) and 95% confidence intervals (CIs) were calculated by modified Poisson regression models with generalized estimating equations and robust variance estimators.ResultsRegarding post-VMMC HIV prevention knowledge, older adolescents were significantly more likely than younger adolescents to know that a male should use condoms (age 10–14 years, 41.1%; 15–19 years, 84.2%; aPR, 1.38 [95% CI, 1.19–1.60]), have fewer sex partners (age 10–14 years, 8.1%; age 15–19 years, 24.5%; aPR, 2.10 [95% CI, 1.30–3.39]), and be faithful to one partner (age 10–14 years, 5.7%; age 15–19 years, 23.2%; aPR, 2.79 [95% CI, 1.97–3.97]) to further protect himself from HIV. Older adolescents demonstrated greater improvement in knowledge in most categories, differences that were significant for questions regarding number of sex partners (aPR, 2.01 [95% CI, 1.18–3.44]) and faithfulness to one partner post-VMMC (aPR, 3.28 [95% CI, 2.22–4.86]). However, prevention knowledge levels overall and HIV risk reduction sexual intentions among sexually active adolescents were notably low, especially given that adolescents had been counseled only 7–10 days prior.ConclusionsAdolescent VMMC counseling needs to be improved to increase knowledge and postprocedure preventive sexual intentions.