Learning that circumcision is protective against HIV: risk compensation among men and women in Cape Town, South Africa.
Learning that circumcision is protective against HIV: risk compensation among men and women in Cape Town, South Africa.
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DOI：
10.1371/journal.pone.0040753
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Venkataramani AS
中科院分区：
文献类型：
--
作者：
Maughan-Brown B;Venkataramani AS
我们研究了对男性包皮环切术 (MC) 的艾滋病毒保护益处的了解是否会导致南非传统包皮环切人群的风险补偿行为。我们通过研究迄今为止尚未探索过的女性风险补偿来扩展现有文献。我们使用了 2009 年开普地区小组研究中关于科萨男性和女性的数据。受访者被问及是否听说过 MC 可以降低男性感染艾滋病毒的风险、他们感知到的感染艾滋病毒的风险以及安全套的使用。对于每个性别组，我们使用双变量和控制人口特征、艾滋病毒知识/信念和既往性行为的多变量模型来评估风险认知和安全套使用是否因对 MC 保护益处的了解而有所不同。为了进一步检查混杂因素，我们使用了 2005 年浪潮的数据来评估最终了解包皮环切术保护性益处的个人在艾滋病毒风险认知和安全套使用方面是否已经有所不同。 34% 的男性 (n = 453) 和 27% 的女性 (n = 690) 听说包皮环切术可降低男性感染艾滋病毒的风险。知情男性认为感染艾滋病毒的风险略高，并且更有可能在上次性行为时使用安全套（p<0.10）。知情女性认为艾滋病毒风险较低（p<0.05），在上次性行为时（p<0.10）和更一般情况下（p<0.01）使用安全套的可能性较小，并且更有可能与血清状态呈阳性或未知的伴侣放弃安全套（p<0.01）。结果对于协变量调整来说是稳健的，排除了艾滋病毒感染者，并考虑了 2005 年的风险认知和安全套使用情况。我们发现与女性而非男性的风险补偿一致的证据。应进一步关注有关 MC 的新信息以及更广泛的 HIV 风险驱动因素在调节女性性行为方面的作用。
We examined whether knowledge of the HIV-protective benefits of male circumcision (MC) led to risk compensating behavior in a traditionally circumcising population in South Africa. We extend the current literature by examining risk compensation among women, which has hitherto been unexplored. We used data on Xhosa men and women from the 2009 Cape Area Panel Study. Respondents were asked if they had heard that MC reduces a man’s risk of contracting HIV, about their perceived risk of contracting HIV, and condom use. For each gender group we assessed whether risk perception and condom use differed by knowledge of the protective benefits of MC using bivariate and then multivariate models controlling for demographic characteristics, HIV knowledge/beliefs, and previous sexual behaviors. In a further check for confounding, we used data from the 2005 wave to assess whether individuals who would eventually become informed about the protective benefits of circumcision were already different in terms of HIV risk perception and condom use. 34% of men (n = 453) and 27% of women (n = 690) had heard that circumcision reduces a man’s risk of HIV infection. Informed men perceived slightly higher risk of contracting HIV and were more likely to use condoms at last sex (p<0.10). Informed women perceived lower HIV risk (p<0.05), were less likely to use condoms both at last sex (p<0.10) and more generally (p<0.01), and more likely to forego condoms with partners of positive or unknown serostatus (p<0.01). The results were robust to covariate adjustment, excluding people living with HIV, and accounting for risk perceptions and condom use in 2005. We find evidence consistent with risk compensation among women but not men. Further attention should be paid to the role of new information regarding MC, and drivers of HIV risk more broadly, in modulating sexual behavior among women.
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影响因子：
6.2
作者：
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通讯作者：
Dupas, Pascaline
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