MacPhail C, Campbell C
CSIR Mining Technology, Auckland Park, South Africa.
Soc Sci Med. 2001 Jun;52(11):1613-27. doi: 10.1016/s0277-9536(00)00272-0.
Levels of heterosexually transmitted HIV infection are high amongst South African youth, with one recent survey reporting levels of 18.9% amongst 17-20 year olds and 43.1% amongst 21-25 year olds. In these groups levels of knowledge about HIV are high, but perceived vulnerability and reported condom use are low. Much existing research into youth HIV in developing countries relies on survey measures which use individual knowledge, attitudes and reported behaviour as variables in seeking to explain HIV transmission amongst this group. This paper reports on a focus group study that seeks to complement existing individual-level quantitative findings with qualitative findings highlighting community and social factors that hinder condom use amongst youth in the township of Khutsong, near Carletonville. Study informants comprised 44 young women and men in the 13-25 year age group. Data analysis highlighted six factors hindering condom use: lack of perceived risk; peer norms; condom availability; adult attitudes to condoms and sex; gendered power relations and the economic context of adolescent sexuality. Informants did not constitute a homogenous group in terms of their understandings of sexuality. While there was clear evidence for the existence of dominant social norms which place young peoples' sexual health at risk, there was also evidence that many young people are self-consciously critical of the norms that govern their sexual behaviour, despite going along with them, and that they are aware of the way in which peer and gender pressures place their health at risk. There was also evidence that a minority of youth actively challenge dominant norms and behave in counter-normative and health-enhancing ways. The actively contested nature of dominant sexual norms provides a fertile starting point for peer education programmes that seek to provide the context for the collective negotiation of alternative sexual norms that do not endanger young peoples' sexual health.
在南非青年中，通过异性传播的艾滋病毒感染率很高，最近的一项调查显示，17至20岁人群中的感染率为18.9%，21至25岁人群中的感染率为43.1%。在这些群体中，对艾滋病毒的知晓率很高，但自认为的易感染性和报告的避孕套使用率很低。发展中国家现有的许多关于青年艾滋病毒的研究依赖于调查手段，这些手段将个人知识、态度和报告的行为作为变量，试图解释该群体中的艾滋病毒传播情况。本文报告了一项焦点小组研究，旨在用定性研究结果补充现有的个人层面定量研究结果，这些定性研究结果突出了阻碍卡尔顿维尔附近库特松镇青年使用避孕套的社区和社会因素。研究对象包括44名年龄在13至25岁之间的青年男女。数据分析突出了阻碍使用避孕套的六个因素：缺乏感知风险；同伴规范；避孕套的可获得性；成年人对避孕套和性行为的态度；性别权力关系以及青少年性行为的经济背景。就对性行为的理解而言，研究对象并非同质群体。虽然有明确证据表明存在将年轻人的性健康置于危险境地的主导社会规范，但也有证据表明，许多年轻人虽然遵循这些规范，但自觉地对支配其性行为的规范持批评态度，并且他们意识到同伴压力和性别压力使其健康面临风险的方式。还有证据表明，少数青年积极挑战主导规范，并以反规范和增进健康的方式行事。主导性规范的积极争议性质为同伴教育计划提供了一个富有成效的起点，这些计划旨在为集体协商不危及年轻人性健康的替代性性规范提供背景。
