The Continuing Challenge of Reducing HIV Risk among Haitian Youth: The Need for Intervention.
The Continuing Challenge of Reducing HIV Risk among Haitian Youth: The Need for Intervention.
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DOI：
10.1177/2325957411418119
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发表时间：
2015-05-01
影响因子：
--
通讯作者：
Malow, Robert M
中科院分区：
文献类型：
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作者：
Devieux, Jessy G;Rosenberg, Rhonda;Malow, Robert M
迫切需要采取干预措施，解决影响海地青年从事危险行为的多种因素-贫困、药物使用、过早初次性行为和暴力。该国不断恶化的社会经济和政治状况对社会文化环境和迄今为止控制危险行为的边界产生了有害影响。从历史上看，以社区为基础的支持家庭单位的拉库制度已经解体，导致传统的养育模式被打破。不稳定的经济制度也导致越来越多地使用贫困家庭的儿童，这些儿童通过restavek制度被送到其他家庭当仆人。传统制度的崩溃，加上经济和政治日益不稳定，对海地青少年产生了重大影响。在男孩中，药物使用水平的增加与多个性伙伴关系和过早的性行为有关。在女孩中，性虐待和强迫性行为的发生率极高，导致艾滋病毒感染率相对较高。虽然他们中的大多数人都接触到了行为改变的信息，但行为改变本身却滞后了，因为许多青少年没有准确地感知他们的风险暴露。本次审查探讨了艾滋病毒在海地青年中传播的风险，重点是脆弱性因素，包括药物使用、文化和社会经济背景，并提出了干预建议。需要采取一种专门为海地青年设计的生态系统办法，并考虑到环境背景和文化。
There is a dire need for interventions that will address the multiple factors--poverty, substance use, early sexual debut, and violence--that influence Haitian youth's engagement in risky behaviors. The deteriorating socioeconomic and political state of the country has had a deleterious effect on the sociocultural milieu and on the boundaries that have heretofore kept risky behaviors in check. Historically, the lakou system, a community-based approach that supports the family unit, has disintegrated, leading to the disruption of traditional parenting patterns. The unstable economic system has also led to the increasing use of children from poor families, who through the restavek system, are sent to work as servants in other households. The breakdown of traditional systems, coupled with the increasing economic and political instability, has had a significant effect on Haitian adolescents. Among boys, increased levels of substance use have been associated with multiple sex partnerships and very early sexual debut. Among girls, extremely high rates of sexual abuse and forced sex have led to relatively high levels of HIV. While the majority of them have been exposed to behavior change messages, behavior change itself has lagged because many adolescents do not accurately perceive their risk exposure. This review explores the risks of HIV transmission among Haitian youth, with a focus on vulnerability factors, including substance use, culture, and the socioeconomic context, and provides recommendations for intervention. An ecosystemic approach, designed specifically for Haitian youth and that takes environmental context and culture into account, is needed.