了解贫困背景下孤儿和非孤儿青少年的性风险：肯尼亚尼亚萨省的一项定性研究。
Understanding orphan and non-orphan adolescents' sexual risks in the context of poverty: a qualitative study in Nyanza Province, Kenya.
机构信息
Department of Health Promotion, Maastricht University, Maastricht, The Netherlands.
出版信息
BMC Int Health Hum Rights. 2013 Jul 25;13:32. doi: 10.1186/1472-698X-13-32.
BACKGROUND
Some studies show orphanhood to be associated with increased sexual risk-taking while others have not established this relationship, but have found factors other than orphanhood as predictors of sexual risk behaviours and outcomes among adolescents. This study examines community members' perceptions of how poverty influences adolescent sexual behaviour and outcomes in four districts of Nyanza Province, Kenya.
METHODS
Eight study sites within the four districts were randomly selected. Focus group discussions were conducted with a purposive sample of adolescents, parents and caregivers. Key informant interviews were undertaken with a purposive sample of community leaders, child welfare and healthcare workers, and adolescents. The two methods elicited information on factors perceived to predispose adolescent orphans and non-orphans to sexual risks. Data were analysed through line-by-line coding, grouped into families and retrieved as themes and sub-themes.
RESULTS
Participants included 147 adolescents and parents/caregivers in 14 focus groups and 13 key informants. Poverty emerged as a key predisposing factor to sexual risk behaviour among orphans and non-orphans. Poverty was associated with lack of food, poor housing, school dropout, and engaging in income generating activities, all of which increase their vulnerability to transactional sex, early marriage, sexual experimentation, and the eventual consequences of increased risk of unintended pregnancies and STI/HIV.
CONCLUSION
Poverty was perceived to contribute to increasing sexual risks among orphan and non-orphan adolescents through survival strategies adopted to be able to meet their basic needs. Policies for prevention and intervention that target adolescents in a generalized poverty and HIV epidemic should integrate economic empowerment for caregivers and life skills for adolescents to reduce vulnerabilities of orphan and non-orphan adolescents to sexual risk behaviour.
背景
一些研究表明，孤儿身份与增加的性冒险行为有关，而其他研究则没有建立这种关系，但发现孤儿身份以外的其他因素是青少年性风险行为和结果的预测因素。本研究考察了社区成员对贫困如何影响肯尼亚尼亚萨省四个地区青少年性行为和结果的看法。
方法
在四个地区内随机选择了 8 个研究地点。采用目的抽样法对青少年、父母和照顾者进行了焦点小组讨论。采用目的抽样法对社区领导、儿童福利和医疗保健工作者以及青少年进行了关键知情人访谈。这两种方法都收集了认为容易使青少年孤儿和非孤儿面临性风险的因素的信息。通过逐行编码进行数据分析，将数据分组为家庭，并提取为主题和子主题。
结果
参与者包括 14 个焦点小组中的 147 名青少年和父母/照顾者以及 13 名关键知情人。贫困是孤儿和非孤儿发生性行为风险的一个关键促成因素。贫困与缺乏食物、住房简陋、辍学以及从事创收活动有关，所有这些都增加了他们进行易货性交易、早婚、性实验的脆弱性，最终导致意外怀孕和性传播感染/艾滋病毒风险增加的后果。
结论
社区成员认为，贫困通过为满足基本需求而采取的生存策略，导致孤儿和非孤儿青少年的性风险增加。针对普遍贫困和艾滋病毒流行的青少年的预防和干预政策应将照顾者的经济赋权和青少年的生活技能纳入其中，以减少孤儿和非孤儿青少年对性风险行为的脆弱性。
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