British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, BC, Canada.
Public Health. 2011 Nov;125(11):791-4. doi: 10.1016/j.puhe.2011.09.008. Epub 2011 Oct 11.
Educational programs targeted towards youth to prevent HIV transmission are based on a model that increased knowledge equals reduced risk behaviour. This study explored HIV knowledge among a cohort of young drug users, and their perceptions of HIV risk acquisition.
Between September 2005 and August 2009, youth who used illegal drugs were recruited into a prospective cohort known as the at-risk youth study (ARYS) in Vancouver, Canada. Participants completed an 18 item HIV Knowledge Questionnaire (HIV-KQ-18) and responses were scored dichotomously (i.e., ≥15 indicating high knowledge and <15 indicating low knowledge). We compared high- and low-scoring youth using Pearson's chi-square test and logistic regression. We also examined youths' perceptions of risk for acquiring HIV compared to their peers.
Of 589 youth recruited into ARYS, the mean age was 22 (interquartile range [IQR]: 20-24), 186 (31.6%) were female, and 143 (24.3%) were of Aboriginal ancestry. The median score on the HIV-KQ- 18 was 15 (IQR: 12-16). Internal reliability was high (Cronbach's α=0.82). The analyses demonstrated that youth with higher HIV knowledge were more likely to be older (adjusted odds ratio [AOR]=1.08, per year older p=0.031), completed high school (AOR=1.42, p=0.054), and engage in unprotected intercourse (AOR=1.73, p=0.023). The majority of respondents (77.6%) perceived themselves to be at lower risk for acquiring HIV in comparison to their peers.
HIV knowledge scores of participants were surprisingly low for an urban Canadian setting as was their HIV risk perception. Higher HIV knowledge was not associated with reduced sexual risk behaviour. Results demonstrate that education programs are not reaching or impacting this high-risk population. Given the complex forces that promote HIV risk behaviour, prevention programs should be fully evaluated and must recognize the unique characteristics of drug-using youth and factors that drive risk among this population.
针对青少年的预防 HIV 传播的教育项目基于这样一种模式，即增加知识等于降低风险行为。本研究探索了一群年轻吸毒者的 HIV 知识水平，以及他们对 HIV 风险获得的看法。
2005 年 9 月至 2009 年 8 月期间，在加拿大温哥华，我们招募了使用非法药物的年轻人进入一个称为高危青年研究（ARYS）的前瞻性队列。参与者完成了 18 项 HIV 知识问卷（HIV-KQ-18），并将答案分为两类（即，≥15 表示高知识，<15 表示低知识）。我们使用 Pearson's chi-square 检验和逻辑回归比较高得分和低得分的年轻人。我们还比较了年轻人对自己获得 HIV 风险的看法与他们的同龄人。
在 589 名进入 ARYS 的年轻人中，平均年龄为 22 岁（四分位间距[IQR]：20-24），186 人（31.6%）为女性，143 人（24.3%）为原住民血统。HIV-KQ-18 的中位数得分为 15（IQR：12-16）。内部可靠性很高（Cronbach's α=0.82）。分析表明，HIV 知识较高的年轻人更有可能年龄较大（调整后的优势比[AOR]=1.08，每增加 1 岁，p=0.031），完成高中教育（AOR=1.42，p=0.054），并发生无保护性行为（AOR=1.73，p=0.023）。大多数受访者（77.6%）认为自己感染 HIV 的风险低于同龄人。
在加拿大城市环境中，参与者的 HIV 知识得分令人惊讶地低，他们的 HIV 风险感知也是如此。较高的 HIV 知识与性行为风险的降低无关。研究结果表明，教育项目并未接触到或影响到这一高危人群。鉴于促进 HIV 风险行为的复杂因素，预防计划应进行全面评估，必须认识到吸毒青年的独特特征以及驱动该人群风险的因素。
