AIDS risk and prevention among adolescents.
AIDS risk and prevention among adolescents.
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青少年艾滋病风险和预防。
DOI：
10.1016/0277-9536(91)90446-j
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发表时间：
1991
期刊：
影响因子：
--
通讯作者：
Kegeles,SM
中科院分区：
文献类型：
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作者：
Boyer,CB;Kegeles,SM
虽然相对较少的青少年被诊断出患有艾滋病，青少年中无症状的人类免疫缺陷病毒(艾滋病毒)感染的程度在很大程度上仍不清楚，但人们有理由对青少年感染艾滋病毒的风险感到担忧。潜伏期(从最初感染到完全发展为艾滋病的时间)估计平均为8年，因此很可能大多数20多岁的艾滋病患者(占所有艾滋病患者的20%)在青少年时期感染了艾滋病毒。许多青少年的性活动和吸毒活动使他们面临更大的艾滋病毒传播风险。性传播疾病(STD)在性活跃的青少年中普遍存在，是发病率的主要原因。即使在“艾滋病时代”，性传播疾病的发病率也在持续上升。这些比率令人担忧，因为与获得和传播性病有关的行为也是与艾滋病毒传播有关的行为。此外，性传播疾病的存在可能会增加艾滋病毒传播的可能性。尽管避孕套降低了艾滋病毒传播的风险，但在性活跃的青少年中，避孕套的使用率仍然很低。减少或消除高危行为是限制艾滋病毒进一步传播的唯一途径。有效的预防方案应该以危险行为的模型和理论为基础，以便能够设计方案来改变那些导致不良危险行为的因素。艾滋病风险降低模型(ARRM)就是这种社会生理模型的一个例子。ARRM模型描述了为什么人们坚持从事高风险活动或努力改变这些活动。从理论上讲，减少危险性行为的三个阶段是：(1)认识到自己的活动使自己容易感染艾滋病毒；(2)决定改变危险的性行为并致力于该决定；(3)克服制定决定的障碍，包括性沟通问题，并在必要时寻求帮助，以学习减少危险行为的策略。每个阶段都包括一些在以前的研究中被认为对从事“健康”或低风险行为很重要的概念。必须制定和实施创新战略，以惠及所有青少年，从上学并与家人生活在一起的青少年，到离家出走、住在拘留所或因其他原因被剥夺“公民权”的青少年。为了达到最有效的效果，艾滋病毒预防方案必须采用将认知和行为技能培训相结合的策略。这些方案的设计必须与年龄相适应，并对青少年群体中的文化价值观、宗教信仰、性别角色和习俗敏感。此外，这些方案应该利用各种传播策略，重要的是，对它们在预防和减少艾滋病毒危险行为方面的有效性进行评估。
Although relatively few teenagers have been diagnosed with AIDS and the extent of asymptomatic human immunodeficiency virus (HIV) infection among adolescents remains largely unknown, there is cause for concern about teens' risk of contracting HIV disease. The incubation period (the time from initial infection to the development of full-blown AIDS) is estimated to average eight years, and therefore it is probable that most of the individuals in their twenties who have AIDS (20% of all the people with AIDS) contracted HIV during their teenage years. The sexual and drug use activities of many teenagers place them at increased risk for HIV transmission. Sexually transmitted diseases (STDs) are pervasive and a major cause of morbidity among sexually active adolescents. The rates of STDs have continued to rise even during the ‘age of AIDS’. These rates are of concern since the behaviors associated with the acquisition and transmission of STDs are also the behaviors associated with HIV transmission. In addition, the presence of STDs may increase the likelihood of HIV transmission.Although condoms reduce the risk of HIV transmission, their use remains low among sexually active teenagers. Reducing or eliminating high risk behaviors is the only way to limit further spread of HIV. Effective prevention programs should be based on models and theories of risk behavior so that the programs can be designed to change those factors which lead to the undesirable risky behaviors. The AIDS Risk Reduction Model (ARRM) is presented as an example of such a social-physiological model. The ARRM model characterizes why people persist in engaging in high risk activities or make efforts to alter those activities. The three stages theorized to be necessary to reduce risky sexual activities are: (1) recognizing that one's activities make oneself vulnerable to contracting HIV; (2) making the decision to alter risky sexual behaviors and committing to that decision; (3) overcoming barriers to enacting the decision, including problems in sexual communication and seeking help when necessary to learn strategies to reduce risky behaviors. Each stage includes a number of constructs identified in prior research as important for engaging in ‘healthy’ or low risk behaviors.Innovative strategies must be developed and implemented to reach all adolescents, ranging from teenagers who attend school and live with their families to those teens who are runaways, live in detention facilities or are otherwise ‘disenfranchised’. To be most effective, HIV prevention programs must utilize strategies which combine cognitive and behavioral skills training. These programs must be designed to be age appropriate and sensitive to cultural values, religious beliefs, sex roles, and customs within adolescent groups. In addition, these programs should utilize a variety of communication strategies, and importantly, be evaluated for their effectiveness in preventing and reducing HIV risk behavior.