Changes in HIV-related behaviours, knowledge and testing among refugees and surrounding national populations: A multicountry study
Changes in HIV-related behaviours, knowledge and testing among refugees and surrounding national populations: A multicountry study
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DOI：
10.1080/09540121.2012.748165
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发表时间：
2013-08-01
影响因子：
1.7
通讯作者：
Schilperoord, Marian
中科院分区：
文献类型：
--
作者：
Dahab, Maysoon;Spiegel, Paul B.;Schilperoord, Marian
据我们所知，目前还没有关于流离失所者在紧急情况后长期难民营定居期间危险性行为发生率的公开数据。为了衡量艾滋病毒相关行为的趋势，我们在2004/2005年的基线和2010/2011年的后续行动中，对居住在肯尼亚、坦桑尼亚和乌干达的难民和周围社区居民进行了一系列跨部门艾滋病毒行为监测调查。除了坦桑尼亚难民营采用系统随机抽样外，我们采用两阶段整群抽样选择参与者。参与者必须在选定的家庭中居住超过几周，年龄在15至49岁之间。我们在三个营地及其周边社区采访了11，582名参与者（基线为6448人，随访为5134人）。多个性伴侣的患病率在基线时介于10.1%和32.6%之间，在随访时介于4.2%和20.1%之间，临时伴侣的患病率在基线时介于8.0%和33.2%之间，在随访时介于3.5%和17.4%之间，交易性伴侣的患病率在基线时介于1.1%和14.0%之间，在随访时介于0.8%和12.0%之间。肯尼亚和乌干达难民营中多重伴侣关系和随意性行为的流行率并不高于本国人。据我们所知，这些数据首次描述和比较了受冲突影响的人口和居住在附近的国民中危险性行为的流行趋势。危险性伴侣的大量减少是有希望的，可能表明艾滋病毒预防方案取得了成功。然而，仍有必要对具体的预防方案进行评价，以评估哪些具体活动以及在多大程度上促成了行为改变。值得注意的是，在肯尼亚和乌干达，难民的多重和临时性伴侣比例低于本国国民，因此不应自动假定其危险性行为比例高于其他地方的邻国国民。
To our knowledge, there is currently no published data on the prevalence of risky sex over time as displaced populations settle into long-term post-emergency refugee camps. To measure trends in HIV-related behaviours, we conducted a series of cross-sectional HIV behavioural surveillance surveys among refugees and surrounding community residents living in Kenya, Tanzania and Uganda, at baseline in 2004/2005 and at follow-up in 2010/2011. We selected participants using two-stage cluster sampling, except in the Tanzanian refugee camp where systematic random sampling was employed. Participants had to reside in a selected household for more than weeks and aged between 15 and 49 years. We interviewed 11,582 participants (6448 at baseline and 5134 at follow-up) in three camps and their surrounding communities. The prevalence of multiple sexual partnerships ranged between 10.1 and 32.6% at baseline and 4.2 and 20.1% at follow-up, casual partnerships ranged between 8.0 and 33.2% at baseline and 3.5 and 17.4% at follow-up, and transactional partnerships between 1.1 and 14.0% at baseline and 0.8 and 12.0% at follow-up. The prevalence of multiple partnerships and casual sex in the Kenyan and Ugandan camps was not higher than among nationals. To our knowledge these data are the first to describe and compare trends in the prevalence of risky sex among conflict-affected populations and nationals living nearby. The large reductions in risky sexual partnerships are promising and possibly indicative of the success of HIV prevention programs. However, evaluation of specific prevention programmes remains necessary to assess which, and to what extent, specific activities contributed to behavioural change. Notably, refugees had lower levels of multiple and casual sexual partnerships than nationals in Kenya and Uganda and thus should not automatically be assumed to have higher levels of risky sexual behaviours than neighbouring nationals elsewhere.