RAND Corporation, Santa Monica, CA 90407, USA.
AIDS Behav. 2010 Oct;14(5):1055-65. doi: 10.1007/s10461-010-9673-4.
In Africa, HIV infections occur mostly in stable relationships, yet little is known about the determinants of condom use in this context. We examined condom use among 272 coupled HIV clients in Uganda who had just screened for ART eligibility; 128 had an HIV-positive partner, 47 HIV-negative, and 97 a partner with unknown HIV status. Sixty-six percent reported unprotected sex with their partner over the past 6 months (57-70% across the three subgroups). Multiple variables among socioeconomic characteristics, physical health, social support, and psychosocial adjustment were correlated with condom use in bivariate analysis, but in multivariate analysis, condom use self-efficacy was the only predictor of condom use in the total sample and subgroups; church attendance and physical functioning were also predictors among unknown status couples. This analysis reveals high rates of unprotected sex among coupled HIV clients, regardless of partner's HIV status, and suggests multiple targets for prevention.
在非洲，艾滋病毒感染主要发生在稳定的关系中，但对于这一背景下避孕套使用的决定因素知之甚少。我们研究了乌干达 272 对刚刚接受抗逆转录病毒治疗资格筛查的艾滋病毒感染者夫妇中的避孕套使用情况；其中 128 人的伴侣艾滋病毒检测呈阳性，47 人的伴侣艾滋病毒检测呈阴性，97 人的伴侣艾滋病毒检测呈未知状态。66%的人报告在过去 6 个月内与伴侣发生过无保护性行为（三个亚组的比例分别为 57-70%）。在单变量分析中，社会经济特征、身体健康、社会支持和心理社会调整方面的多个变量与避孕套使用相关，但在多变量分析中，避孕套使用自我效能感是总样本和亚组中避孕套使用的唯一预测因素；在未知状态的伴侣中，参加教堂活动和身体功能也是预测因素。这项分析揭示了艾滋病毒感染者夫妇中无保护性行为的高发生率，无论其伴侣的艾滋病毒状况如何，并表明存在多个预防目标。
