Dorjgochoo Tsogzolmaa, Noel Francine, Deschamps Marie Marcelle, Theodore Harry, Dupont William, Wright Peter F, Fitzgerald Dan W, Vermund Sten H, Pape Jean W
Institute for Global Health, Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN 37232-0242, USA.
J Acquir Immune Defic Syndr. 2009 Dec 1;52(4):498-508. doi: 10.1097/QAI.0b013e3181ac12a8.
Many Haitian adolescents and youth are highly vulnerable to HIV infection. It was important to define the risk factors of the young people who are already seeking care.
Among 3391 sexually active 13- to 25-year-olds in our Voluntary Counseling and Testing (VCT) Center in Port-au-Prince from October 2005 to September 2006, we assessed associations between demographic and behavioral factors and HIV status using multivariable logistic regression analyses.
We diagnosed HIV infection in 6.3% of 2533 females and 5.5% of 858 males. Age-specific prevalence was 3.4% for 13- to 15-year-olds, 4.7% for 16-19, and 6.8% for 20-25 (P = 0.02). Poor education, not residing with parents, currently or formerly married, having a child, and being self-referred or referred by others VCT services were significant predictors of HIV in females. HIV infection was associated with considering oneself at higher risk, although most youth did not recognize this risk. HIV in females was also associated with suspected/confirmed sexually transmitted infection, especially genital ulcers (ORadj = 2.28, 95% confidence interval: 1.26 to 4.13), years of sexual activity (Ptrend = 0.07), and suspicion that partners had other partners or an sexually transmitted infection. Among males, HIV was associated with drug use (though uncommon) and sexual debut with a casual/unknown person (ORadj = 3.18, 95% confidence interval: 1.58 to 6.42). HIV-infected young people were more likely to be rapid plasma reagin positive and less likely to use condoms.
Young Haitians are a key target for HIV prevention and care and avail themselves readily of youth-focused VCT services.
许多海地青少年极易感染艾滋病毒。确定已寻求治疗的年轻人的风险因素很重要。
2005年10月至2006年9月期间，在我们位于太子港的自愿咨询和检测（VCT）中心的3391名13至25岁有性活动的人群中，我们使用多变量逻辑回归分析评估了人口统计学和行为因素与艾滋病毒感染状况之间的关联。
在2533名女性中，我们诊断出6.3%感染艾滋病毒，在858名男性中，这一比例为5.5%。13至15岁人群的特定年龄患病率为3.4%，16至19岁为4.7%，20至25岁为6.8%（P = 0.02）。教育程度低、不与父母同住、目前或曾经结婚、育有子女以及自行前往或由他人转介至VCT服务机构，是女性感染艾滋病毒的重要预测因素。艾滋病毒感染与自认为风险较高有关，尽管大多数年轻人并未意识到这种风险。女性感染艾滋病毒还与疑似/确诊的性传播感染有关，尤其是生殖器溃疡（校正比值比=2.28，95%置信区间：1.26至4.13）、性活动年限（趋势P = 0.07）以及怀疑性伴侣有其他性伴侣或患有性传播感染。在男性中，艾滋病毒感染与吸毒（尽管不常见）以及与偶然相识/身份不明的人初次发生性行为有关（校正比值比=3.18，95%置信区间：1.58至6.42）。感染艾滋病毒的年轻人更有可能快速血浆反应素呈阳性，且使用避孕套的可能性较小。
海地年轻人是艾滋病毒预防和治疗的关键目标人群，他们很容易接受以年轻人为重点的VCT服务。
