Tanaka Yasuo, Kunii Osamu, Hatano Tamaki, Wakai Susumu
Japanese Red Cross Society, 1-1-3 Shiba Daimon, Minato-ku, Tokyo 105-8521, Japan.
Health Place. 2008 Sep;14(3):434-52. doi: 10.1016/j.healthplace.2007.07.005. Epub 2007 Sep 21.
Little is known about HIV infection risks and risk behaviours of refugees living in resource-scarce post-emergency phase camps in Africa. Our study at Nyarugusu Camp in Tanzania, covering systematically selected refugees (n = 1140) and refugees living with HIV/AIDS (PLWHA) (n = 182), revealed that the level of HIV risk of systematically selected refugees increased after displacement, particularly regarding the number having transactional sex for money or gifts, while radio broadcast messages are perceived to promote a base of risk awareness within the refugee community. While condoms are yet to be widely used in the camp, some refugees having transactional sex tended to undertake their own health initiatives such as using a condom, under the influence of peer refugee health workers, particularly health information team (HIT) members. Nevertheless, PLWHA were less faithful to one partner and had more non-regular sexual partners than the HIV-negative group. Our study revealed that community-based outreach by refugee health workers is conducive to risk behaviour prevention in the post-emergency camp setting. It is recommended to increase the optimal use of "radio broadcast messages" and "HIT," which can act as agents to reach out to wider populations, and to strengthen the focus on safer sex education for PLWHA; the aim being to achieve dual risk reduction for both refugees living with and without HIV/AIDS.
对于生活在非洲资源匮乏的紧急情况后阶段营地中的难民的艾滋病毒感染风险及风险行为，人们了解甚少。我们在坦桑尼亚尼亚鲁古苏营地开展的研究，涵盖了系统选取的难民（n = 1140）以及感染艾滋病毒/艾滋病的难民（PLWHA，n = 182），结果显示，系统选取的难民在流离失所后的艾滋病毒风险水平有所上升，尤其是在为钱或礼物进行交易性行为的人数方面，而广播信息被认为在难民社区内促进了一定程度的风险意识。虽然避孕套在营地尚未得到广泛使用，但一些进行交易性行为的难民在难民同伴健康工作者，特别是健康信息团队（HIT）成员的影响下，倾向于采取自己的健康举措，如使用避孕套。然而，与艾滋病毒阴性群体相比，感染艾滋病毒/艾滋病的难民对单一伴侣的忠诚度较低，且有更多非固定性伴侣。我们的研究表明，难民健康工作者开展的社区外展活动有利于在紧急情况后营地环境中预防风险行为。建议增加对“广播信息”和“健康信息团队”的优化利用，它们可作为接触更广泛人群的媒介，并加强对感染艾滋病毒/艾滋病的难民进行安全性行为教育的力度；目标是实现对感染和未感染艾滋病毒/艾滋病的难民双重降低风险。
