Department of Public Health, School of Public Health and Health Sciences, University of Massachusetts, Amherst, 316 Arnold House, 715 North Pleasant St, Amherst, MA, USA.
BMC Public Health. 2012 Dec 9;12:1061. doi: 10.1186/1471-2458-12-1061.
BACKGROUND: The number of people newly infected with human immunodeficiency virus (HIV) has been decreasing in sub-Saharan Africa, but prevalence of the infection remains unacceptably high among young people. Despite the alarming pervasiveness of the virus, young people in this region continue to engage in risky sexual behaviors including unprotected sexual intercourse. In developed countries, parents can play important roles in protecting young people from such behaviors, but evidence regarding the impact of parental involvement is still limited in sub-Saharan Africa. Therefore, we conducted this study to examine the magnitude of risky sexual behaviors and the association of parental monitoring and parental communication with condom use at last sexual intercourse among secondary school students in Dar es Salaam, Tanzania. METHODS: We conducted this cross-sectional study among 2,217 male and female students aged 15 to 24 years from 12 secondary schools in Dar es Salaam. From October to November 2011, we collected data using a self-administered questionnaire. Multiple logistic regression analyses were conducted to examine the association of parental monitoring and parental communication with condom use at last sexual intercourse, adjusting for potential confounders. RESULTS: A total of 665 (30.3%) secondary school students reported being sexually active within the year prior to data collection. Among them, 41.7% had multiple sexual partners, 10.5% had concurrent sexual partners, and 41.1% did not use a condom at last sexual intercourse. A higher level of parental monitoring was associated with increased likelihood of condom use at last sexual intercourse among male students (AOR: 1.56, 95% CI: 1.05-2.32; p = 0.03) but not among female students (AOR: 1.54, 95% CI: 0.71-3.37; p = 0.28). The association between parental communication and condom use at last sexual intercourse among both male and female students was not statistically significant. CONCLUSIONS: A high level of parental monitoring is associated with more consistent condom use among male students in Dar es Salaam, Tanzania -- many of whom have engaged in high-risk sexual behaviors such as multiple sexual partnerships, concurrent sexual partnerships, and unprotected sexual intercourse in the past one year. Interventions should thus be strengthened to reduce multiple sexual partnerships, concurrent sexual partnerships, and to improve parental monitoring among such students toward increasing condom use.
背景：在撒哈拉以南非洲，新感染人类免疫缺陷病毒 (HIV) 的人数一直在减少，但该地区年轻人的感染率仍然高得令人无法接受。尽管该病毒普遍存在令人震惊，但该地区的年轻人仍继续从事包括无保护性行为在内的危险性行为。在发达国家，父母可以在保护年轻人免受此类行为的影响方面发挥重要作用，但在撒哈拉以南非洲，关于父母参与的影响的证据仍然有限。因此，我们进行了这项研究，以调查达累斯萨拉姆坦桑尼亚中学生的危险性行为的严重程度，以及父母监督和父母沟通与上次性行为中使用安全套之间的关联。
方法：我们在达累斯萨拉姆的 12 所中学中对 2217 名 15 至 24 岁的男女学生进行了这项横断面研究。2011 年 10 月至 11 月期间，我们使用自我管理问卷收集数据。进行多变量逻辑回归分析，以调整潜在混杂因素后，研究父母监督和父母沟通与上次性行为中使用安全套之间的关联。
结果：共有 665 名（30.3%）中学生报告在数据收集前一年进行过性行为。其中，41.7%有多个性伴侣，10.5%有同时性伴侣，41.1%上次性行为时没有使用安全套。较高水平的父母监督与男学生上次性行为中使用安全套的可能性增加有关（比值比[OR]：1.56，95%置信区间[CI]：1.05-2.32；p=0.03），但与女学生无关（OR：1.54，95% CI：0.71-3.37；p=0.28）。父母沟通与男学生和女学生上次性行为中使用安全套之间的关联没有统计学意义。
结论：在坦桑尼亚达累斯萨拉姆，高水平的父母监督与男学生更一致地使用安全套有关，其中许多学生过去一年中曾从事过高风险性行为，如多个性伴侣、同时性伴侣和无保护性行为。因此，应加强干预措施，以减少此类学生的多个性伴侣和同时性伴侣，并改善父母监督，以增加安全套的使用。
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