Gavin Lorrie, Galavotti Christine, Dube Hazel, McNaghten A D, Murwirwa Munyaradzi, Khan Rizwana, St Louis Michael
U.S. Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
J Adolesc Health. 2006 Oct;39(4):596.e11-8. doi: 10.1016/j.jadohealth.2006.03.002.
To identify factors associated with human immunodeficiency virus (HIV) infection among adolescent females in Zimbabwe and appropriate prevention strategies for this vulnerable population.
A total of 1807 females aged 15-19 years completed a questionnaire and provided a blood sample for HIV testing as part of a nationally representative survey. Associations between HIV infection and factors operating at the individual, household, partner and community levels, as well as sexual behavior, were explored through bivariate and multivariate logistic regression analyses. Two multivariate models were fitted: the first model considered sexual risk behaviors and contextual variables, whereas the second model considered only contextual variables.
Of 1807 adolescent females, 192 (10.6%) were HIV positive, and 41% of HIV-positive adolescent females reported no sexual risk behaviors. In the first multivariate model, the risk associated with number of lifetime sexual partners was increased for 1 partner (odds ratio [OR] = 2.4, 95% confidence interval [CI] = 1.57-3.6), 2 partners (OR = 4.4, 95% CI = 2.22-8.55), and 3 or more partners (OR = 6.3, 95% CI = 2.56-15.7) as compared with having 0 partners. Believing that people with HIV have many sexual partners (OR = 1.71, 95% CI = 1.14-2.57) and that the man should take the initiative to have sex (OR = 1.55, 95% CI = 1.03-2.32) were also risk factors. In the second model, increased risk was associated with having ever married or lived with a man (OR = 1.99, 95% CI = 1.18-3.35) as well as the attitudes above. Decreased risk of HIV infection was associated with having a job (OR = .39, 95% CI = .18-.88), main activity in past 12 months was as a student (OR = .39, 95% CI = .19-.80), participation in school-based lectures on sexual health (OR = .49, 95% CI = .27-.87), and perceiving that AIDS is a somewhat serious problem in the community (OR = .55, 95% CI = .33-.92).
Adolescent females in Zimbabwe who are married, not attending school and/or are unemployed, are at heightened risk for HIV infection. Interventions that improve their educational and employment opportunities, strengthen school-based prevention services, foster more equitable gender attitudes, and make marriage safer by, for example, promoting knowledge of partners' serostatus before marriage, may reduce their risk. Future research priorities are proposed.
确定津巴布韦青春期女性感染人类免疫缺陷病毒（HIV）的相关因素，并为这一弱势群体制定合适的预防策略。
作为一项具有全国代表性的调查的一部分，共有1807名15至19岁的女性完成了问卷调查，并提供了血液样本进行HIV检测。通过双变量和多变量逻辑回归分析，探讨了HIV感染与个体、家庭、伴侣和社区层面的因素以及性行为之间的关联。拟合了两个多变量模型：第一个模型考虑了性风险行为和背景变量，而第二个模型仅考虑背景变量。
在1807名青春期女性中，192人（10.6%）HIV呈阳性，41%的HIV阳性青春期女性报告没有性风险行为。在第一个多变量模型中，与终身性伴侣数量相关的风险，与0个伴侣相比，1个伴侣（优势比[OR]=2.4，95%置信区间[CI]=1.57 - 3.6）、2个伴侣（OR = 4.4，95% CI = 2.22 - 8.55）以及3个或更多伴侣（OR = 6.3，95% CI = 2.56 - 15.7）有所增加。认为感染HIV的人有多个性伴侣（OR = 1.71，95% CI = 1.14 - 2.57）以及认为男性应主动发生性行为（OR = 1.55，95% CI = 1.03 - 2.32）也是风险因素。在第二个模型中，风险增加与曾经结婚或与男性同居（OR = 1.99，95% CI = 1.18 - 3.35）以及上述态度有关。HIV感染风险降低与有工作（OR = 0.39，95% CI = 0.18 - 0.88）、过去12个月的主要活动是学生（OR = 0.39，95% CI = 0.19 - 0.80）、参加学校性健康讲座（OR = 0.49，95% CI = 0.27 - 0.87）以及认为艾滋病在社区是一个较为严重的问题（OR = 0.55，95% CI = 0.33 - 0.92）有关。
津巴布韦已婚、未上学和/或失业的青春期女性感染HIV的风险更高。改善她们的教育和就业机会、加强学校预防服务、培养更公平的性别态度以及通过例如在婚前推广了解伴侣血清学状态的知识使婚姻更安全等干预措施，可能会降低她们的风险。提出了未来的研究重点。
