Ukwuani Festus A, Tsui Amy O, Suchindran Chirayath M
Carolina Population Center, University of North Carolina at Chapel Hill, USA.
J Acquir Immune Defic Syndr. 2003 Oct 1;34(2):203-13. doi: 10.1097/00126334-200310010-00011.
This study explored the relationships between individual-, household-, and community-level variables and condom use to prevent HIV infection in women and men in Uganda and Tanzania using multilevel modeling. Using data from the Demographic and Health Surveys for Uganda (1995) and Tanzania (1996) as well as data collected by the MEASURE Evaluation Project at the Carolina Population Center for Tanzania (1996 and 1999), the study found higher condom use among men than women. There was also heterogeneity in condom use among different clusters for both women and men. More specifically, women and men living in clusters with higher indicators of development were more likely to use condoms to prevent HIV infection. In addition, condom use was much more prevalent in areas where health care services were nearby (0-5 km). In addition, condom use was more common among women (but not men) who lived in clusters where HIV/AIDS testing, counseling, and treatment were provided. The results further revealed that education improved condom use; however, the effect of education was considerably reduced in the models that included HIV/AIDS knowledge and cluster-level variables. The positive effect of household wealth on condom use also diminished after controlling for the effects of the knowledge and cluster-level factors. Knowledge about HIV and perceiving oneself to be at risk for contracting HIV infection improved condom use.
本研究采用多层次模型，探讨了乌干达和坦桑尼亚个体、家庭及社区层面的变量与男女使用避孕套预防艾滋病毒感染之间的关系。利用乌干达（1995年）和坦桑尼亚（1996年）的人口与健康调查数据，以及卡罗莱纳人口中心针对坦桑尼亚开展的衡量评估项目收集的数据（1996年和1999年），研究发现男性使用避孕套的比例高于女性。男女在不同群组中的避孕套使用情况也存在差异。具体而言，生活在发展指标较高群组中的男女更有可能使用避孕套预防艾滋病毒感染。此外，在医疗保健服务距离较近（0至5公里）的地区，避孕套的使用更为普遍。此外，在提供艾滋病毒/艾滋病检测、咨询和治疗的群组中，女性（而非男性）使用避孕套的情况更为常见。结果还显示，教育程度的提高会增加避孕套的使用；然而，在纳入艾滋病毒/艾滋病知识和群组层面变量的模型中，教育的影响大幅降低。在控制了知识和群组层面因素的影响后，家庭财富对避孕套使用的积极影响也有所减弱。对艾滋病毒的了解以及认为自己有感染艾滋病毒的风险会增加避孕套的使用。
