Eaton Liberty, Flisher Alan J, Aarø Leif E
Department of Psychiatry and Mental Health, University of Cape Town, Groote Schuur Hospital, Observatory 7925, South Africa.
Soc Sci Med. 2003 Jan;56(1):149-65. doi: 10.1016/s0277-9536(02)00017-5.
A growing body of evidence points to the complexity of sexual behaviour. HIV risk behaviour is influenced by factors at three levels: within the person, within the proximal context (interpersonal relationships and physical and organisational environment) and within the distal context (culture and structural factors). This paper presents the findings of a review of research on the factors promoting and perpetuating unsafe sexual behaviour in South African youth. Papers included in the review were dated between 1990 and 2000 and addressed sexual behaviour of youth between the ages of 14 and 35 years. Both published works and unpublished reports and dissertations/theses were included. The review concluded that at least 50% of young people are sexually active by the age of 16 years; the majority of school students who had ever experienced sexual intercourse reported at the most one partner in the previous year, with a persistent minority of between 1% and 5% of females and 10-25% of males having more than four partners per year; and between 50% and 60% of sexually active youth report never using condoms. In terms of explanations for unsafe sexual behaviour among South African youth, the findings illustrate the powerful impact of the proximal and distal contexts, and in particular, the pervasive effect of poverty and social norms that perpetuate women's subordination within sexual relationships. Personal factors and the proximal and distal contexts interact to encourage HIV risk behaviour in ways that are not fully captured by social-cognitive models. The findings will be of interest to researchers and practitioners in the fields of adolescent sexual behaviour and HIV prevention in developing countries.
越来越多的证据表明性行为具有复杂性。艾滋病病毒风险行为受到三个层面因素的影响：个人层面、近端环境（人际关系以及物理和组织环境）层面和远端环境（文化和结构因素）层面。本文介绍了一项关于促进和使南非青年不安全性行为长期存在的因素的研究综述结果。该综述纳入的论文发表于1990年至2000年之间，涉及14至35岁青年的性行为。已发表的作品以及未发表的报告和学位论文均被纳入。该综述得出结论，至少50%的年轻人在16岁时就有性行为；大多数有过性交经历的在校学生报告称，上一年最多只有一个性伴侣，持续有1%至5%的女性和10%至25%的男性每年有超过四个性伴侣；50%至60%的性活跃青年报告从未使用过避孕套。就对南非青年不安全性行为的解释而言，研究结果表明近端和远端环境具有强大影响，尤其是贫困和社会规范的普遍影响，这些因素使女性在性关系中一直处于从属地位。个人因素与近端和远端环境相互作用，以社会认知模型无法完全涵盖的方式鼓励艾滋病病毒风险行为。这些研究结果将引起发展中国家青少年性行为和艾滋病预防领域的研究人员和从业人员的兴趣。
