Jama Shai Nwabisa, Jewkes R, Levin Jonathan, Dunkle K, Nduna Mzikazi
Gender and Health Research Unit, Medical Research Council, Pretoria, South Africa.
AIDS Care. 2010 Nov;22(11):1379-85. doi: 10.1080/09540121003758465.
Despite high levels of awareness of HIV, condom use, particularly consistent use, is suboptimal among young South African women. This paper aims to investigate the factors associated with both any condom use and consistent use by young rural women. In this study 1204 sexually active female volunteers, aged 15-26 years, were selected using a two-stage procedure in which firstly 70 clusters were selected and thereafter up to 20 women per cluster were selected, to participate in a cluster randomised controlled trial of an HIV behavioural intervention. This study is analysing cross-sectional data from a baseline survey thus no causal inferences can be drawn. A structured questionnaire was administered at a baseline interview. An estimated 19.9% of young women reported consistent condom use in the 12 months before the interview, while 44.5% reported inconsistent use. Any condom use was associated with higher condom use self-efficacy (adjusted odds ratio (aOR) 1.59; 95% CI 1.41, 1.77), less association of trust with suggested condom use (aOR 0.86; 95% CI 0.82, 0.91), knowing one's HIV status (aOR 2.86; 95% CI 1.52, 5.39) and having a more educated mother (aOR 1.71; 95% CI 1.26, 2.33). Having had just one partner was associated with a lesser likelihood of any condom use (aOR 0.14; 95% CI 0.10, 0.20). Consistent use, compared with inconsistent use, was associated with having just one partner (aOR 3.25; 95% CI 2.23, 4.73), less relationship conflict (aOR 0.84; 95% CI 0.75, 0.91) and higher gender equity in relationships with a male partner (aOR 1.43; 95% CI 1.15, 1.77). Our findings suggest that gender equity, monogamy and harmonious relationships play a positive role in enabling women to reduce their risk for HIV infection. Such aspects of relationship context could form a significant part of the progressive strategies required for HIV-prevention interventions to be successful.
尽管对艾滋病毒的认知程度较高，但在南非年轻女性中，避孕套的使用情况，尤其是持续使用情况并不理想。本文旨在调查与农村年轻女性使用避孕套及持续使用避孕套相关的因素。在本研究中，采用两阶段程序选取了1204名年龄在15至26岁之间的性活跃女性志愿者，首先选取70个群组，然后每个群组选取多达20名女性，参与一项艾滋病毒行为干预的群组随机对照试验。本研究正在分析来自基线调查的横断面数据，因此无法得出因果推断。在基线访谈时发放了一份结构化问卷。据估计，19.9%的年轻女性报告在访谈前的12个月内持续使用避孕套，而44.5%的女性报告使用情况不一致。任何避孕套使用情况都与更高的避孕套使用自我效能感相关（调整后的优势比（aOR）为1.59；95%置信区间为1.41，1.77），与建议使用避孕套的信任关联度较低（aOR为0.86；95%置信区间为0.82，0.91），知晓自己的艾滋病毒感染状况（aOR为2.86；95%置信区间为1.52，5.39）以及有受教育程度更高的母亲（aOR为1.71；95%置信区间为1.26，2.33）。仅有一个性伴侣与任何避孕套使用情况的可能性较低相关（aOR为0.14；95%置信区间为0.10，0.20）。与使用情况不一致相比，持续使用避孕套与仅有一个性伴侣相关（aOR为3.25；95%置信区间为2.23，4.73），关系冲突较少（aOR为0.84；95%置信区间为0.75，0.91）以及与男性伴侣的关系中性别平等程度更高（aOR为1.43；95%置信区间为1.15，1.77）。我们的研究结果表明，性别平等、一夫一妻制和和谐关系在使女性降低艾滋病毒感染风险方面发挥着积极作用。关系背景的这些方面可能构成艾滋病毒预防干预措施取得成功所需的渐进性策略的重要组成部分。
