Department of Public Health & Primary Care, University of Cambridge, Cambridge, UK.
BMC Public Health. 2012 Nov 22;12:1022. doi: 10.1186/1471-2458-12-1022.
Despite the possibility of preventing many cases of HIV, malaria and unplanned pregnancy, protective measures are often not taken by those at risk in Uganda. The study aim was to explore young people's perspectives on the reasons why this is so.
Focus groups were conducted with 100 secondary school and college students in Kanungu, Uganda in 2011. Three parallel groups considered HIV, malaria and family planning, and common messages were then explored jointly in a workshop based on the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation and Maintenance).
Participants identified various reasons why preventive action was not always taken. They worried about the effectiveness and side effects of several key interventions: condoms, antiretroviral treatment, various contraceptives and impregnated mosquito nets. Cost, rural isolation and the quality and availability of health services also limited the extent to which people were able to follow health advice. Although there was respect for policy supporting abstinence and fidelity, it was seen as hard to follow and offering inadequate protection when gender imbalance put pressure on women to have sex.
There is an opportunity to improve the uptake of preventive measures by tackling the misconceptions and fears that participants reported with clear, evidence-based messages. This should be done in a way that encourages more open communication about reproductive health between men and women, that reaches out to isolated communities, that draws on both voluntary and government services and enlists young people so that they can shape their future.
尽管有预防许多艾滋病、疟疾和意外怀孕的可能性，但在乌干达，处于危险之中的人往往不采取保护措施。本研究旨在探讨年轻人对这一现象的看法。
2011 年，在乌干达卡农古的一所中学和一所大学中，对 100 名中学生和大学生进行了焦点小组讨论。三组参与者分别考虑了艾滋病、疟疾和计划生育问题，然后根据 RE-AIM 框架（涵盖范围、效果、采纳、实施和维持）在一个研讨会上共同探讨了常见的信息。
参与者指出了人们为什么不总是采取预防措施的各种原因。他们对几种关键干预措施的有效性和副作用表示担忧：避孕套、抗逆转录病毒治疗、各种避孕药具和驱虫蚊帐。成本、农村隔离以及卫生服务的质量和可用性也限制了人们遵循卫生建议的程度。尽管人们尊重支持禁欲和忠诚的政策，但当性别失衡给女性带来性压力时，人们认为该政策难以遵循，而且提供的保护不足。
有机会通过解决参与者报告的误解和恐惧来提高预防措施的接受程度，这可以通过提供明确的基于证据的信息来实现。这应该在鼓励男性和女性更开放地交流生殖健康问题、覆盖孤立社区、利用志愿和政府服务以及争取年轻人参与的方式进行，以便他们能够塑造自己的未来。
