转型期迷失:乌干达北部古卢区处于紧急情况后阶段过渡营地的年轻人中的艾滋病毒流行率及感染相关因素
Lost in transition: HIV prevalence and correlates of infection among young people living in post-emergency phase transit camps in Gulu District, Northern Uganda.
作者信息
Patel Sheetal, Schechter Martin T, Sewankambo Nelson K, Atim Stella, Kiwanuka Noah, Spittal Patricia M
机构信息
School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada ; Centre for Health Evaluation and Outcome Sciences, Vancouver, British Columbia, Canada.
Makerere University College of Health Sciences, Kampala, Uganda.
出版信息
PLoS One. 2014 Feb 28;9(2):e89786. doi: 10.1371/journal.pone.0089786. eCollection 2014.
OBJECTIVE
Little is known about HIV infection and the related vulnerabilities of young people living in resource-scarce, post-emergency transit camps that are now home to thousands of Internally Displaced Persons (IDPs) following two decades of war in northern Uganda. The objective of this analysis was to assess the prevalence and correlates of HIV infection among young people living in post-conflict transition in Gulu District, northern Uganda.
METHODS
In 2010, a cross-sectional demographic and behavioural survey was conducted in two of Gulu District's sub-counties with 384 purposively selected transit camp residents aged 15 to 29 years. Biological specimens were collected for rapid HIV testing in the field and confirmatory laboratory testing. Multivariable logistic regression identified independent determinants of HIV infection.
RESULTS
HIV prevalence was alarmingly high at 12.8% (95% CI: 9.6%, 16.5%). The strongest determinant of HIV infection among young people was a non-consensual sexual debut (adjusted odds ratio [AOR], 9.88; 95% CI: 1.70-18.06). Residing in Awach sub-county (AOR, 2.93; 95% CI: 1.28-6.68), experiencing STI symptoms in the previous 12 months (AOR, 2.36; 95% CI: 1.43-6.17), and practicing dry sex (AOR, 2.31; 95% CI: 1.04-5.13) were other key determinants of HIV infection.
CONCLUSIONS
Study findings contribute to filling an important gap in epidemiological evidence and are useful for planning public health interventions in northern Uganda that effectively target young people in post-conflict transition and support them in the resettlement process. Findings serve to recommend reaching beyond traditional prevention programming in a way more effectively beneficial to young people in post-conflict settings by developing population-specific responses sensitive to local contexts and sufficient to address the underlying causes of the complex risk factors influencing the spread of HIV.
目的
对于乌干达北部经历了二十年战争后,如今成为数千名境内流离失所者(IDP)家园的资源匮乏的紧急过渡营地中年轻人的艾滋病毒感染情况及其相关脆弱性,我们了解甚少。本分析的目的是评估乌干达北部古卢区冲突后过渡阶段年轻人中艾滋病毒感染的患病率及其相关因素。
方法
2010年,在古卢区的两个次县进行了一项横断面人口统计和行为调查,有目的地选取了384名年龄在15至29岁的过渡营地居民。采集生物样本以进行现场快速艾滋病毒检测和实验室确诊检测。多变量逻辑回归确定了艾滋病毒感染的独立决定因素。
结果
艾滋病毒患病率高得惊人,为12.8%(95%置信区间:9.6%,16.5%)。年轻人中艾滋病毒感染的最强决定因素是非自愿首次性行为(调整后的优势比[AOR],9.88;95%置信区间:1.70 - 18.06)。居住在阿瓦奇次县(AOR,2.93;95%置信区间:1.28 - 6.68)、在过去12个月内出现性传播感染症状(AOR,2.36;95%置信区间:1.43 - 6.17)以及进行干性性行为(AOR,2.31;95%置信区间:1.04 - 5.13)是艾滋病毒感染的其他关键决定因素。
结论
研究结果有助于填补流行病学证据中的一个重要空白,对于规划乌干达北部的公共卫生干预措施很有用,这些措施能有效针对冲突后过渡阶段的年轻人,并在重新安置过程中为他们提供支持。研究结果表明,通过制定针对当地情况且足以解决影响艾滋病毒传播的复杂风险因素根本原因的针对特定人群的应对措施,超越传统预防方案,以一种对冲突后环境中的年轻人更有效的方式开展工作。
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