Gender Roles and Ideology Effects on HIV Risk in Tanzania

描述(申请人提供)：与实行一夫一妻制或禁欲一样，使用避孕套是预防艾滋病毒/艾滋病传播的最有效方法之一。然而，避孕套的使用取决于双方的同意和参与，在非洲，男性通常主导性行为。因此，了解夫妻中的性别角色和相对权力如何影响男性的高危性行为，如不一致地使用避孕套、进行有偿性行为或有多个伴侣，对于遏制艾滋病毒/艾滋病在男性和女性人群中的传播至关重要。为了更好地解释这一点，拟议的研究将使用2004-2005年坦桑尼亚人口健康调查(DHS)的最新数据来调查：(1)个人、家庭和关系特征(类型和长度)对男性性危险行为(使用避孕套、喝酒或做爱时喝醉)的影响，以及关系特征的影响如何受到男性的性别态度和艾滋病毒风险相关态度和知识的调节(与之相互作用)；以及，(2)个人、家庭、关系和伴侣的相对特征(年龄、经济、性史、决策)如何影响男性性危险行为(一夫一妻制、使用避孕套、性行为时饮酒或饮酒、有偿性行为)，以及男性的性别态度和艾滋病毒相关态度和知识如何(与之相互作用)调节伴侣的相对特征的影响。拟议研究的结果将有助于确定性别态度和艾滋病毒相关态度和知识的哪些方面与男性危险的性行为有关，并提供信息，为个人和夫妇层面的干预提供信息，以减少影响艾滋病毒在撒哈拉以南非洲传播的做法。在婚姻/同居的背景下，了解伴侣的相对权力对个人行为的影响也将有助于采取其他与艾滋病毒有关的干预措施，例如在家庭内坚持抗逆转录病毒治疗。总体而言，拟议的研究将解决关于性别态度和在性关系中的作用如何促进异性恋男子与艾滋病毒有关的性行为的认识上的一个重大差距，这将有助于制定更有效的方案，以减少艾滋病毒/艾滋病在撒哈拉以南非洲的传播。这项拟议研究的结果将解决坦桑尼亚在性别态度和性关系中的角色如何促进异性恋男子与艾滋病毒相关的性危险行为方面的一个重大认识差距。这项研究使用了男性及其已婚/同居伴侣的信息，以便更好地理解夫妻之间的相对权力如何影响男性的行为。这将有助于制定更有效的公共卫生计划，以减少艾滋病毒/艾滋病在撒哈拉以南非洲的传播。

DESCRIPTION (provided by applicant): Along with practicing monogamy or abstinence, condom use is one of the most effective methods for preventing the spread of HIV/AIDS. However, condom use relies on the agreement and participation of both partners, and in the African context, men typically dominate sexual interactions. Therefore understanding how gender roles and relative power within couples influence male practices of high-risk sexual behaviors, such as inconsistent condom use, engaging in paid sex, or having multiple partners, is essential for countering the spread of the HIV/AIDS across both male and female populations. To better explain this the proposed study will use recent data from the 2004-5 Tanzanian Demographic Health Survey (DHS) to investigate: (1) the effects of individual, household, and relationship characteristics (type and length) on men's sexual risk behaviors (condom use, alcohol use or drunk when have sex), as well as how the effects of relationship characteristics are moderated by (interact with) men's gender attitudes and HIV-risk related attitudes and knowledge; and, (2) how individual, household, relationship, and partners' relative characteristics (age, economic, sexual history, decision-making) influence men's sexual risk behaviors (monogamous, condom use, alcohol use or drunk when have sex, paid sex), as well as how the effects of partners' relative characteristics are moderated by (interact with) men's gender attitudes and HIV-related attitudes and knowledge. The results from the proposed study will help to identify which aspects of gender attitudes and HIV-related attitudes and knowledge are related to men's risky sexual behaviors, and provide information that will inform individual- and couple-level interventions to decrease practices that influence the spread of HIV in sub-Saharan Africa. Understanding the effects of partners' relative power on individual behavior within the context of marriage/ cohabitation will also inform other HIV-related interventions such as adherence to anti-retroviral therapies within families. Overall the proposed study will address a significant gap in the understanding of how gender attitudes and roles in sexual relationships contribute to heterosexual men's HIV-related sexual risk behaviors which will aid in the development of more effective programs to reduce the spread of HIV/AIDS in sub-Saharan Africa. The results from the proposed study will address a significant gap in the understanding of how gender attitudes and roles in sexual relationships contribute to heterosexual men's HIV-related sexual risk behaviors in Tanzania. The study uses information from men and their married/cohabiting partners in order to better understand how relative power within couples influences men's behaviors. This will aid in the development of more effective public health programs to reduce the spread of HIV/AIDS in sub- Saharan Africa.