Manzou Rumbidzai, Schumacher Christina, Gregson Simon
Manicaland HIV/STI Prevention Project. Biomedical Research and Training Institute, Harare, Zimbabwe ; Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom.
Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States.
PLoS One. 2014 Jan 20;9(1):e86060. doi: 10.1371/journal.pone.0086060. eCollection 2014.
Religion is an important underlying determinant of HIV spread in sub-Saharan Africa. However, little is known about how religion influences changes in HIV prevalence and associated sexual behaviours over time.
To compare changes in HIV prevalence between major religious groups in eastern Zimbabwe during a period of substantial HIV risk reduction (1998-2005) and to investigate whether variations observed can be explained by differences in behaviour change.
We analysed serial cross-sectional data from two rounds of a longitudinal population survey in eastern Zimbabwe. Univariate and multivariate logistic regression models were developed to compare differences in sexual behaviour and HIV prevalence between religious groups and to investigate changes over time controlling for potential confounders.
Christian churches were the most popular religious grouping. Over time, Spiritualist churches increased in popularity and, for men, Traditional religion and no religion became less and more common, respectively. At baseline (1998-2000), HIV prevalence was higher in Traditionalists and in those with no religion than in people in Christian churches (men 26.7% and 23.8% vs. 17.5%, women: 35.4% and 37.5% vs. 24.1%). These effects were explained by differences in socio-demographic characteristics (for Traditional and men with no religion) or sexual behaviour (women with no religion). Spiritualist men (but not women) had lower HIV prevalence than Christians, after adjusting for socio-demographic characteristics (14.4% vs. 17.5%, aOR = 0.8), due to safer behaviour. HIV prevalence had fallen in all religious groups at follow-up (2003-2005). Odds of infection in Christians reduced relative to those in other religious groups for both sexes, effects that were mediated largely by greater reductions in sexual-risk behaviour and, possibly, for women, by patterns of conversion between churches.
Variation in behavioural responses to HIV between the major church groupings has contributed to a change in the religious pattern of infection in eastern Zimbabwe.
宗教是撒哈拉以南非洲地区艾滋病毒传播的一个重要潜在决定因素。然而，关于宗教如何随时间影响艾滋病毒流行率的变化以及相关性行为，我们知之甚少。
比较津巴布韦东部在艾滋病毒风险大幅降低期间（1998 - 2005年）主要宗教群体之间艾滋病毒流行率的变化，并调查观察到的差异是否可以用行为变化的差异来解释。
我们分析了津巴布韦东部两轮纵向人口调查的系列横断面数据。建立了单变量和多变量逻辑回归模型，以比较宗教群体之间性行为和艾滋病毒流行率的差异，并在控制潜在混杂因素的情况下调查随时间的变化。
基督教教会是最受欢迎的宗教群体。随着时间的推移，唯灵论教会越来越受欢迎，对于男性来说，传统宗教信徒减少，无宗教信仰者增多。在基线时（1998 - 2000年），传统宗教信徒和无宗教信仰者中的艾滋病毒流行率高于基督教教会信徒（男性：26.7%和23.8%对17.5%，女性：35.4%和37.5%对24.1%）。这些影响可以通过社会人口学特征（传统宗教信徒和无宗教信仰的男性）或性行为（无宗教信仰的女性）的差异来解释。在调整社会人口学特征后，唯灵论男性（但不是女性）的艾滋病毒流行率低于基督教徒（14.4%对17.5%，调整后的比值比 = 0.8），这是由于行为更安全。在随访时（2003 - 2005年），所有宗教群体的艾滋病毒流行率都有所下降。男女基督教徒的感染几率相对于其他宗教群体都有所降低，这种影响主要是由性风险行为的更大幅度减少介导的，对于女性来说，可能还与教会之间的转换模式有关。
主要教会群体对艾滋病毒的行为反应差异导致了津巴布韦东部感染的宗教模式发生变化。
