Stroeken Koen, Remes Pieter, De Koker Petra, Michielsen Kristien, Van Vossole Anke, Temmerman Marleen
Ghent University, Ghent, Belgium.
AIDS Care. 2012;24(2):186-94. doi: 10.1080/09540121.2011.596519. Epub 2011 Jul 25.
The overall decline of the HIV epidemic in Sub-Saharan Africa conceals how the HIV burden has shifted to fall on areas that have been more difficult to reach. This review considers out-of-school youth, a category typically eluding interventions that are school-based. Our review of descriptive studies concentrates on the most affected region, Southern and Eastern Africa, and spans the period between 2000 and 2010. Among the relatively small but increasing number of studies, out-of-school youth was significantly associated with risky sexual behavior (RSB), more precisely with early sexual debut, high levels of partner concurrency, transactional sex, age-mixing, low sexually transmitted infection (STI)/HIV risk perception, a high lifetime number of partners, and inconsistent condom use. Being-in-school not only raises health literacy. The in-school (e.g., age-near) sexual network may also be protective, an effect which the better-studied (and regionally less significant) variable of educational attainment cannot measure. To verify such double effect of being-in-school we need to complement the behavioral research of the past decade with longitudinal cohort analyses that map sexual networks, in various regions.
撒哈拉以南非洲地区艾滋病毒疫情的整体下降掩盖了艾滋病毒负担如何转移到更难触及的地区这一情况。本综述关注失学青年，这是一类通常无法从学校干预措施中受益的人群。我们对描述性研究的综述集中在受影响最严重的地区，即南部非洲和东部非洲，时间跨度为2000年至2010年。在相对较少但数量不断增加的研究中，失学青年与危险性行为显著相关，更确切地说，与初次性行为过早、性伴侣并发率高、交易性行为、年龄混杂、性传播感染/艾滋病毒风险认知低、终身性伴侣数量多以及避孕套使用不一致有关。在校不仅能提高健康素养。校内（例如年龄相近）性网络也可能具有保护作用，而受研究较多（且在区域上不太显著）的教育程度变量无法衡量这种效果。为了验证在校的这种双重作用，我们需要用绘制不同地区性网络的纵向队列分析来补充过去十年的行为研究。
