Jewkes Rachel K, Levin Jonathan B, Penn-Kekana Loveday A
Gender and Health Group, Medical Research Council, Private Bag X385, 0001, Pretoria, South Africa.
Soc Sci Med. 2003 Jan;56(1):125-34. doi: 10.1016/s0277-9536(02)00012-6.
The aim of the paper is to investigate associations between a range of markers of gender inequity, including financial, psychological and physical violence, and two proximal practices in HIV prevention, namely discussion of HIV between partners and the woman suggesting condom use. The paper presents an analysis of data from a cross-sectional study of a representative sample of women from three South African Provinces which was primarily undertaken as an epidemiological study of gender-based violence. A multi-stage sampling design was used with clusters sampled with probability proportional to number of households. Households were randomly selected from within clusters. One randomly selected woman aged 18-49 years was interviewed in each selected home. One thousand three hundred and six women were interviewed (90.3% of eligible women). One thousand one hundred sixty four women had a partner in the previous year and were asked questions related to HIV prevention and gender inequalities in the relationship. The results indicate that discussion of HIV was significantly positively associated with education, living in Mpumalanga Province, the man being a migrant, the woman having multiple partners in the past year and having no confidante. It was significantly negatively associated with living in the Northern Province, the relationship being poor and there being a substantial age difference between partners. The woman suggesting condom use was significantly positively associated with her education, her having multiple partners, domestic violence prior to the past year and financial abuse. It was negatively associated with the relationship being poor. We conclude that this suggests that some indicators of gender inequalities are significantly associated with discussion of HIV and condom use but the direction of association found was both positive and negative. This highlights the need for a more nuanced understanding of gender inequalities and their relationship to HIV risk. Suggestions for key research questions are made.
本文的目的是调查一系列性别不平等指标之间的关联，这些指标包括经济、心理和身体暴力，以及艾滋病病毒预防方面的两种近期行为，即伴侣之间关于艾滋病病毒的讨论以及女性建议使用避孕套。本文对来自南非三个省份的具有代表性的女性样本进行了横断面研究的数据进行了分析，该研究主要作为一项基于性别的暴力的流行病学研究。采用了多阶段抽样设计，集群抽样的概率与家庭数量成正比。从集群中随机选择家庭。在每个选定的家庭中随机选取一名年龄在18至49岁之间的女性进行访谈。共访谈了1306名女性（符合条件女性的90.3%）。1164名女性在过去一年中有伴侣，并被问及与艾滋病病毒预防和关系中的性别不平等相关的问题。结果表明，关于艾滋病病毒的讨论与教育程度、居住在姆普马兰加省、男性为移民、女性在过去一年中有多个伴侣且没有知己显著正相关。与居住在北方省、关系不佳以及伴侣之间存在较大年龄差异显著负相关。女性建议使用避孕套与她的教育程度、有多个伴侣、过去一年之前的家庭暴力以及经济虐待显著正相关。与关系不佳负相关。我们得出结论，这表明一些性别不平等指标与艾滋病病毒的讨论和避孕套的使用显著相关，但所发现的关联方向既有正向的也有负向的。这凸显了需要对性别不平等及其与艾滋病病毒风险的关系有更细致入微的理解。提出了关键研究问题的建议。
