文化习俗与青少年孤儿和非孤儿的性风险行为：来自肯尼亚西部社区的定性研究。
Cultural practices and sexual risk behaviour among adolescent orphans and non-orphans: a qualitative study on perceptions from a community in Western Kenya.
机构信息
Department of Health Promotion, Maastricht University, Maastricht, Netherlands.
出版信息
BMC Public Health. 2014 Jan 27;14:84. doi: 10.1186/1471-2458-14-84.
BACKGROUND
This study explored community perceptions of cultural beliefs and practices that may increase sexual risk behaviour of adolescents, to understand more about meaning they hold within the culture and how they expose adolescent orphans and non-orphans to higher risks in a high HIV and teenage pregnancy prevalence context.
METHODS
Using a qualitative descriptive cross-sectional design 14 focus group discussions were conducted with 78 adolescents and 68 parents/guardians purposively selected to represent their communities. Thirteen key informant interviews were also conducted with community leaders, health care and child welfare workers, and adolescents who were also selected purposively. The two methods were used to explore how cultural beliefs and practices predispose adolescent orphans and non- orphans to risky sexual behaviours. Data were analysed through line-by-line coding, grouped into families and retrieved as themes and sub-themes.
RESULTS
Identified cultural practices that predisposed adolescents orphans and non-orphans to risky sexual behaviours included: adolescent sleeping arrangements, funeral ceremonies, replacing a deceased married daughter with her younger sister in marriage, widow inheritance among boys, early marriage among girls, and preference for boys/sons. Cultural risks perceived to equally affect both orphans and non-orphans were sleeping arrangements, funeral ceremonies, and sister replacement. Factors associated more with orphans than non-orphans were widow inheritance among boys and a preference for boy over girl children.
CONCLUSIONS
Adolescent sexual risk reduction programs should be developed considering the specific cultural context, using strategies that empower communities to challenge the widely accepted cultural norms that may predispose young people in general to sexual risks while targeting those that unequally influence orphans.
背景
本研究旨在探讨社区对可能增加青少年性风险行为的文化信仰和习俗的看法，以深入了解这些文化信仰和习俗在文化中的意义，以及它们如何在高 HIV 和青少年怀孕流行的背景下使青少年孤儿和非孤儿面临更高的风险。
方法
采用定性描述性横断面设计，对 78 名青少年和 68 名父母/监护人进行了 14 次焦点小组讨论，这些青少年和父母/监护人是根据社区代表性有目的地选择的。还对 13 名社区领导、医疗保健和儿童福利工作者以及有目的选择的青少年进行了 13 次关键知情人访谈。这两种方法都用于探讨文化信仰和习俗如何使青少年孤儿和非孤儿更容易发生危险的性行为。通过逐行编码进行数据分析，将数据分为不同的组，然后提取为主题和子主题。
结果
确定了使青少年孤儿和非孤儿容易发生危险性行为的文化习俗，包括：青少年的睡眠安排、葬礼仪式、用已故已婚女儿的妹妹代替她结婚、男孩的寡妇继承、女孩的早婚以及对男孩/儿子的偏好。被认为同样影响孤儿和非孤儿的文化风险包括睡眠安排、葬礼仪式和妹妹替代。与非孤儿相比，与孤儿更相关的因素是男孩的寡妇继承和对男孩的偏好。
结论
应根据特定的文化背景制定青少年性风险降低计划，使用赋予社区权力的战略，挑战可能使年轻人普遍面临性风险的广泛接受的文化规范，同时针对那些不平等地影响孤儿的规范。
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