Elifson Kirk W, Klein Hugh, Sterk Claire E
Rollins School of Public Health, Emory University.
Womens Health Urban Life. 2010 Dec;9(2):80-106.
Despite widespread intervention efforts to curtail the spread of HIV, heterosexual transmission of HIV continues to drive the HIV/AIDS epidemic in the United States, especially among women. Research has shown that knowledge about HIV and AIDS is relatively great, even among persons who engage in high rates of risky sexual behaviors. This begs the question: What characteristics underlie and are predictive of involvement in unprotected sex? The objective of this paper is to examine the factors that are associated with engaging in unprotected sex in a population of urban, at-risk, heterosexually-active women. Conceptually, the research is guided by the notion of understanding risk and, theoretically, by the Theory of Gender and Power. Face-to-face structured interviews were conducted with 178 sexually active adult at-risk heterosexual women in Atlanta, Georgia. Street outreach efforts were used to identify potential study participants, and ethnographic mapping and targeted sampling procedures guided the recruitment process. Using a multivariate path analysis approach, three factors-marital status, having two drug-abusing parents, and negative attitudes toward condom use-were identified as predictors of unsafe sex. Further exploration of the latter measure yielded two factors that were statistically-significant multivariate predictors of attitudes toward using condoms: age and self-esteem level. Structural equation modeling was used to assess the fit of a risk-prediction model containing all of these measures, and it was shown to be supported quite strongly by the data.
尽管为遏制艾滋病毒传播开展了广泛的干预措施，但在美国，艾滋病毒的异性传播仍在推动艾滋病毒/艾滋病的流行，尤其是在女性中。研究表明，即使在从事高风险性行为比例较高的人群中，对艾滋病毒和艾滋病的了解也相对较多。这就引出了一个问题：参与无保护性行为的背后有哪些特征，并且可以预测这种行为？本文的目的是研究与城市中处于风险中的、有异性性行为的女性群体中参与无保护性行为相关的因素。从概念上讲，该研究以理解风险的概念为指导，从理论上讲，以性别与权力理论为指导。对佐治亚州亚特兰大市178名有异性性行为的成年高危异性恋女性进行了面对面的结构化访谈。通过街头外展工作来确定潜在的研究参与者，人种志绘图和定向抽样程序指导了招募过程。使用多元路径分析方法，确定了三个因素——婚姻状况、有两个吸毒的父母以及对使用避孕套持消极态度——作为不安全性行为的预测因素。对后一项指标的进一步探索产生了两个在统计上具有显著意义的多元预测因素，即年龄和自尊水平，它们与使用避孕套的态度有关。使用结构方程模型来评估包含所有这些指标的风险预测模型的拟合度，结果表明该模型得到了数据的有力支持。
