Callegari Lisa, Harper Cynthia C, van der Straten Ariane, Kamba Mavis, Chipato Tsungai, Padian Nancy S
Department of Obstretrics, Gynecology, and Reproductive Sciences, School of Medicine, University of San Francisco, California, USA.
Sex Transm Dis. 2008 Jun;35(6):624-30. doi: 10.1097/OLQ.0b013e31816b3208.
Condom use to prevent HIV in Africa has increased in nonmarital sexual encounters but remains low within marriage. Married women of reproductive age, however, are at high risk of HIV.
This study investigated factors associated with consistent condom use after a brief intervention.
We conducted an HIV prevention condom intervention with a cohort of 394 married women, aged 17 to 47, recruited from clinics in Zimbabwe. Consistent condom users were ineligible. At enrollment, participants received education and were offered free male and female condoms and HIV testing. Women completed a follow-up questionnaire at 2-months. We used logistic regression analysis to measure the association of protected sex (i.e., 100% use of male or female condoms) at follow-up with condom attitudes, negotiation skills, HIV risk perception and testing.
At follow-up, 179 (48.5%) women reported consistent condom use throughout the study, and 318 (87%) reported condom use at last sexual episode; 72 women tested HIV-positive, only 4 of whom reported at enrollment that it was likely that they were infected. Results showed that women who tested positive were more likely to report consistent condom use (OR 2.9, 95% CI 1.7-5.2). HIV risk perceptions and condom negotiation self-efficacy increased postintervention, and were significantly associated with consistent condom use. Hormonal contraception was negatively associated with consistent condom use (OR 0.3, 95% CI 0.19-0.65).
Married women reported significant increases in consistent condom use in response to a brief intervention, especially if HIV-positive.
在非洲，非婚性行为中使用避孕套预防艾滋病毒的情况有所增加，但婚内使用情况仍然较低。然而，育龄已婚妇女感染艾滋病毒的风险很高。
本研究调查了在进行简短干预后与持续使用避孕套相关的因素。
我们对从津巴布韦诊所招募的394名年龄在17至47岁之间的已婚妇女进行了艾滋病毒预防避孕套干预。持续使用避孕套的女性不符合条件。在入组时，参与者接受了教育，并获得了免费的男用和女用避孕套以及艾滋病毒检测。女性在2个月时完成了一份随访问卷。我们使用逻辑回归分析来衡量随访时安全性行为（即100%使用男用或女用避孕套）与避孕套态度、谈判技巧、艾滋病毒风险认知和检测之间的关联。
在随访时，179名（48.5%）女性报告在整个研究过程中持续使用避孕套，318名（87%）报告在最后一次性行为中使用了避孕套；72名女性艾滋病毒检测呈阳性，其中只有4人在入组时报告有可能已被感染。结果显示，检测呈阳性的女性更有可能报告持续使用避孕套（比值比2.9，95%置信区间1.7 - 5.2）。干预后，艾滋病毒风险认知和避孕套谈判自我效能有所提高，并且与持续使用避孕套显著相关。激素避孕与持续使用避孕套呈负相关（比值比为0.3，95%置信区间0.19 - 0.65）。
已婚妇女报告称，在进行简短干预后，持续使用避孕套的情况显著增加，尤其是艾滋病毒呈阳性的妇女。
