Persistently high incidence of HIV and poor service uptake in adolescent girls and young women in rural KwaZulu-Natal, South Africa prior to DREAMS.
Persistently high incidence of HIV and poor service uptake in adolescent girls and young women in rural KwaZulu-Natal, South Africa prior to DREAMS.
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DOI：
10.1371/journal.pone.0203193
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发表时间：
2018
期刊：
影响因子：
3.7
通讯作者：
Shahmanesh M
中科院分区：
文献类型：
--
作者：
Chimbindi N;Mthiyane N;Birdthistle I;Floyd S;McGrath N;Pillay D;Seeley J;Zuma T;Dreyer J;Gareta D;Mutevedzi T;Fenty J;Herbst K;Smit T;Baisley K;Shahmanesh M
在南非，少女和年轻妇女首当其冲地受到艾滋病毒流行的影响。“DREAMS”旨在通过多层次综合预防降低艾滋病毒发病率。我们描述了艾滋病毒的发病率和艾滋病毒和性生殖健康（SRH）的吸收AGYW在夸祖鲁-纳塔尔（KZN），之前的梦想。对KZN人口监测点内基于人群的HIV发病率队列中的女性（15-24岁）进行纵向和横断面分析。艾滋病毒感染率的观察时间为居住期间处于危险中的人-年。2011年至2015年期间，对“目前使用避孕药具”和“过去12个月内进行艾滋病毒检测”进行了比较。2015年，15-19岁和20-24岁人群的艾滋病流行率分别为11.0%和34.1%，艾滋病发病率（2011-2015年）分别为4.54%（95%CI：3.89-5.30）和7.45%（95%CI：6.51-8.51），与2006-2010年相比无明显下降。2015年，90.7%的20-24岁的年轻人失业，36.4%和51.7%的15-19岁和20-24岁的年轻奥尔兹报告最近移民; 20.9%和72.6%的15-19岁和20-24奥尔兹的年轻人曾经怀孕。2015年，不到50%的人报告在最近一次性行为中使用避孕套，15-19奥尔兹的15.0%和20-24奥尔兹的48.9%目前正在使用避孕措施，15-19岁和20-24奥尔兹的32.0%和66.7%在过去12个月内进行了艾滋病毒检测。与2011年相比，情况没有改善。与过去12个月内AGYW检测艾滋病毒相关的因素是，调查年-2011年比2015年更有可能（aOR = 0.50），伴侣数量（aOR = 3.25），曾经怀孕（aOR = 2.47）和知道在哪里可以找到ART（aOR = 1.54）。与避孕措施使用相关的因素是年龄较大（aOR = 4.83）;曾经怀孕（aOR = 12.62）;知道在哪里获得ART（aOR = 1.79）和在过去12个月内进行过HIV检测（aOR = 1.74）。在DREAMS之前，AGYW的艾滋病毒发病率很高。艾滋病毒和性健康和生殖健康服务的利用没有改善，而且不太理想。调查结果强调，在这个经济脆弱的地区，需要结合艾滋病毒预防方案，为青少年妇女。
Adolescent girls and young women (AGYW) bear the brunt of the HIV epidemic in South Africa. ‘DREAMS’ aims to reduce HIV incidence through multi-level combination prevention. We describe HIV incidence and uptake of HIV and sexual reproductive health (SRH) by AGYW in KwaZulu-Natal (KZN), prior to DREAMS. Longitudinal and cross-sectional analysis of women (15–24 year old) in a population-based HIV incidence cohort within a demographic surveillance site in KZN. Observation time for HIV incidence was person-years at risk while resident. “Current use of contraceptives” and “having an HIV test in the past 12 months” was compared between 2011 and 2015. In 2015, HIV prevalence was 11.0% and 34.1% and HIV incidence (2011–2015) was 4.54% (95%CI:3.89–5.30) and 7.45% (95%CI:6.51–8.51) per year in 15–19 and 20–24 year olds respectively, with no significant decline compared to 2006–2010. In 2015, 90.7% of 20-24-year-olds were unemployed, 36.4% and 51.7% of 15–19 and 20–24 year olds reported recent migration; 20.9% and 72.6% of 15–19 and 20–24 year olds had ever been pregnant. In 2015, less than 50% reported condom-use at last sex, 15.0% of 15–19 year olds and 48.9% of 20–24 year olds were currently using contraception and 32.0% and 66.7% of 15–19 and 20–24 year olds had tested for HIV in the past 12 months. There had been no improvement compared to 2011. Factors associated with AGYW testing for HIV in the past 12 months were, survey year—2011 more likely than 2015 (aOR = 0.50), number of partners (aOR = 3.25), ever been pregnant (aOR = 2.47) and knowing where to find ART (aOR = 1.54). Factors associated with contraception use were being older (aOR = 4.83); ever been pregnant (aOR = 12.62); knowing where to get ART (aOR = 1.79) and having had an HIV test in past 12 months (aOR = 1.74). Prior to DREAMS, HIV incidence in AGYW was high. HIV and SRH service uptake did not improve and was suboptimal. Findings highlight the need for combination HIV prevention programmes for AGYW in this economically vulnerable area.
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影响因子：
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作者：
Wood, Kate;Jewkes, Rachel
通讯作者：
Jewkes, Rachel
DOI：
10.7196/samj.6201
发表时间：
2013-06-01
期刊：
SAMJ: South African Medical Journal
影响因子：
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作者：
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通讯作者：
London, L
影响因子：
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通讯作者：
Reynolds, Steven J.
影响因子：
2.9
作者：
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通讯作者：
Magadi, Monica Akinyi
影响因子：
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作者：
Peltzer, K.;Matseke, G.
通讯作者：
Matseke, G.