Determinants of Heterosexual Adolescents Having Sex with Female Sex Workers in Singapore
Determinants of Heterosexual Adolescents Having Sex with Female Sex Workers in Singapore
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DOI：
10.1371/journal.pone.0147110
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发表时间：
2016-01-25
期刊：
影响因子：
3.7
通讯作者：
Wong, Mee-Lian
中科院分区：
文献类型：
--
作者：
Ng, Junice Y. S.;Wong, Mee-Lian
目的：我们评估了异性恋青少年中曾与女性性工作者（FSW）发生性关系的比例和社会生态因素。我们还描述了青少年谁报告不一致的安全套使用FSWs.MethodsThis的特点是一个横断面研究（响应率：73%）的300异性性活跃的男性青少年的16至19岁参加国家性病诊所在新加坡之间的2009年和2014年。我们评估了生态因素（个人，父母，同伴，学校和媒体的影响）和性风险行为使用自报问卷。Poisson回归分析获得校正的患病率（aPR）和置信区间（CI）。结果曾与FSW发生性关系的异性恋男性青少年比例为39%。多因素分析显示，16岁以前开始性行为是影响女性性工作者性行为的重要因素（aPR 1.79 CI：1.30-2.46），从未有过性活跃女友（aPR 1.75 CI 1.28-2.38），报告自尊评分较低（aPR 0.96 CI：0.93-0.98），更高的色情评分（aPR 1.03 CI：1.00-1.07）和更频繁地观看色情内容（aPR 1.47 CI：1.04-2.09）。与FSW终生不一致使用安全套的比例为30%。结论在性病门诊就诊的异性恋男性青少年中，有相当比例的人曾与FSW发生过性行为。需要有针对性的干预，解决对这种行为的不同程度的影响。这是因为相当大比例的青少年报告说，与FSW不一致使用避孕套，而FSW可能是将性传播感染传播到社区的桥梁。国家青少年健康调查应包括评估性工作者的商业性访问频率和安全套使用情况，以便进行长期监测和监督。
ObjectivesWe assessed the proportion of and socio-ecological factors associated with ever having had sex with female sex workers (FSWs) among heterosexual adolescents. We also described the characteristics of the adolescents who reported inconsistent condom use with FSWs.MethodsThis is a cross-sectional study (response rate: 73%) of 300 heterosexually active male adolescents of 16 to 19 years attending a national STI clinic in Singapore between 2009 and 2014. We assessed the ecological factors (individual, parental, peer, school and medial influences) and sexual risk behaviors using a self-reported questionnaire. Poisson regression was used to obtain the adjusted prevalence ratios (aPR) and confidence intervals (CI).ResultsThe proportion of heterosexual male adolescents who had ever had sex with FSWs was 39%. Multivariate analysis showed that significant factors associated with ever having had sex with FSWs were sex initiation before 16 years old (aPR 1.79 CI: 1.30-2.46), never had a sexually active girlfriend (aPR 1.75 CI 1.28-2.38), reported lower self-esteem score (aPR 0.96 CI: 0.93-0.98), higher rebelliousness score (aPR 1.03 CI: 1.00-1.07) and more frequent viewing of pornography (aPR 1.47 CI: 1.04-2.09). Lifetime inconsistent condom use with FSWs was 30%.ConclusionsA significant proportion of heterosexual male adolescents attending the public STI clinic had ever had sex with FSWs. A targeted intervention that addresses different levels of influence to this behavior is needed. This is even more so because a considerable proportion of adolescents reported inconsistent condom use with FSWs, who may serve as a bridge of STI transmission to the community. National surveys on adolescent health should include the assessment of frequency of commercial sex visits and condom use with FSWs for long-term monitoring and surveillance.