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关于同时期性伴侣和避孕套使用的话语与行为之间的脱节:来自马拉维青年定性研究的结果。

Disconnect between discourse and behavior regarding concurrent sexual partnerships and condom use: findings from a qualitative study among youth in Malawi.

机构信息

The George Washington University School of Public Health and Health Services, Department of Global Health, Washington, DC, United States.

出版信息

Glob Health Promot. 2012 Dec;19(4):20-8. doi: 10.1177/1757975912464249.

Abstract

The practice of concurrent sexual partnerships (CP) is posited to be a contributor to the elevated risk of HIV transmission among youth in Malawi. The lens through which Malawian youth conceptualize the practices of CP and condom use has yet to be fully explored. The current study--a secondary data analysis of semi-structured in-depth interviews (n = 19) with Malawian youth aged 18 to 22 years--addresses this gap. Participants were interviewed about their sexual relationships and behavior, as well as their perceptions and knowledge regarding condom use and CP. In order to ensure that youth engaged in CP were oversampled, the recruitment process asked potential respondents to self-identify whether they currently participated in CP. Of the total sample (n = 19), 13 self-identified as currently engaging in CP. Data were analyzed using a grounded theory approach. This qualitative study highlights a disconnect between the high level of knowledge youth exhibit about HIV prevention methods and their actual reported condom use and CP behaviors. While some youth claimed to use condoms, their discourse demonstrated fluidity in that use changed over time, or interest in changing behavior was expressed, or was inconsistent between partnerships. The disconnect between knowledge of the consequences of risky sexual behavior and actual behavior was most evident among inconsistent condom users engaged in CP. This finding indicates knowledge alone has a limited role in the adoption of lower risk behaviors such as condom use and reduction of CP among youth. Moreover, findings from this study can inform HIV prevention programs operating in Malawi and the sub-Saharan Africa region by enabling them to provide tailored, more persuasive health promotion and prevention messaging.

摘要

同时拥有多个性伴侣的行为被认为是导致马拉维青年艾滋病毒传播风险增加的一个因素。然而,马拉维青年对这种同时拥有多个性伴侣行为和使用避孕套的做法的看法尚未得到充分探讨。本研究——对 18 至 22 岁马拉维青年的半结构式深入访谈(n=19)的二次数据分析——解决了这一差距。参与者接受了关于他们的性关系和行为以及他们对使用避孕套和同时拥有多个性伴侣的看法和知识的采访。为了确保对同时拥有多个性伴侣的青年进行过抽样,招募过程要求潜在受访者自我识别他们是否目前正在参与同时拥有多个性伴侣。在总样本(n=19)中,有 13 人自我认定目前正在参与同时拥有多个性伴侣。数据采用扎根理论方法进行分析。这项定性研究强调了青年对艾滋病毒预防方法的高度了解与他们实际报告的避孕套使用和同时拥有多个性伴侣行为之间存在脱节。虽然一些青年声称使用避孕套,但他们的言论表明使用情况具有流动性,即使用情况随着时间的推移而变化,或者表示有改变行为的兴趣,或者在不同的伴侣之间不一致。在参与同时拥有多个性伴侣的不一致避孕套使用者中,这种知识与危险性行为后果之间的脱节最为明显。这一发现表明,仅靠知识在青年中采用更安全的性行为(如使用避孕套和减少同时拥有多个性伴侣)方面的作用有限。此外,本研究的结果可以为在马拉维和撒哈拉以南非洲地区开展的艾滋病毒预防项目提供信息,使它们能够提供有针对性的、更有说服力的健康促进和预防信息。

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