Speizer Ilene S, Gómez Anu Manchikanti, Stewart James, Voss Paul
Gillings School of Global Public Health, Department of Maternal and Child Health, University of North Carolina at Chapel Hill, 27516, USA.
AIDS Educ Prev. 2011 Oct;23(5):437-47. doi: 10.1521/aeap.2011.23.5.437.
Most studies on HIV risk in sub-Saharan Africa focus on individual-level sociodemographic and behavioral correlates of risk. Only recently have researchers and programmers considered the context within which individuals live. This study uses the 2005-6 Zimbabwe Demographic and Health Survey to examine the correlation between the prevalence of HIV at the community level and the prevalence of HIV risk-taking behaviors. Results show that women and men living in communities with higher HIV prevalence in the opposite sex are at increased risk of HIV. In addition, rural women and men living in communities with greater premarital and nonmarital sex are at greater risk of HIV. Finally, HIV prevalence is higher among women and men living in urban areas with higher intimate partner violence. Programs should address community-level social norms that make high-risk behaviors acceptable and thus increase all women and men's risk of HIV, not just those engaged in high-risk behaviors.
撒哈拉以南非洲地区大多数关于艾滋病病毒风险的研究都聚焦于个体层面与风险相关的社会人口学和行为因素。直到最近,研究人员和规划者才开始考虑个体所处的环境。本研究利用2005 - 2006年津巴布韦人口与健康调查,来检验社区层面艾滋病病毒感染率与艾滋病病毒风险行为发生率之间的相关性。结果显示,生活在异性艾滋病病毒感染率较高社区的女性和男性感染艾滋病病毒的风险增加。此外,生活在婚前和非婚性行为较多社区的农村女性和男性感染艾滋病病毒的风险更大。最后,生活在亲密伴侣暴力发生率较高的城市地区的女性和男性艾滋病病毒感染率更高。各项计划应应对那些使高风险行为被接受从而增加所有女性和男性(而非仅仅是那些从事高风险行为者)感染艾滋病病毒风险的社区层面社会规范。