Tenkorang Eric Y, Maticka-Tyndale Eleanor
Department of Sociology, Memorial University, St. John's, NL, A1C 5S7, Canada.
University of Windsor, Canada.
Soc Sci Med. 2014 Sep;116:93-101. doi: 10.1016/j.socscimed.2014.06.041. Epub 2014 Jun 24.
The majority of cognitive models used in HIV prevention identify risk perception as essential, and the first step towards safer sexual behaviors. Yet, previous studies have rarely examined risk perceptions as an outcome variable, and the few that have, limited their analysis to individual-level determinants. Conspicuously missing in the literature is how school/community level factors affect risk perceptions among school-going youth. Using data collected from primary school youth in Nyanza, Kenya and employing hierarchical linear modeling, this study examines how both individual and community level factors shape individuals' perceived risks of contracting HIV. Results indicate that measures captured at both individual and school/community levels were significantly associated with risk perception. At the individual level, and for boys, high risk perception was associated with higher knowledge about HIV, rejection of myths surrounding HIV transmission, higher condom use self-efficacy and having engaged in risky sexual behaviors. For girls, it was pressure from others to engage in sexual activity, having engaged in risky sexual behaviors and knowing someone infected with HIV that resulted in increased risk perceptions. Beyond individual level variables, some school/community level factors are significantly associated with risk perception. For instance, boys and girls in communities with higher estimates of AIDS deaths reported higher risk perceptions. Boys in communities where AIDS was acknowledged as the cause of death at funerals were less likely to report high risk perceptions. The findings suggest that interventions targeting HIV prevention among young people in Nyanza, Kenya could benefit immensely from an understanding of how schools and communities affect risk perceptions and behavioral change.
大多数用于艾滋病预防的认知模型都将风险认知视为关键因素,也是迈向更安全性行为的第一步。然而,以往的研究很少将风险认知作为一个结果变量来考察,即便有少数研究这样做了,也只是将分析局限于个体层面的决定因素。文献中明显缺失的是学校/社区层面的因素如何影响在校青少年的风险认知。本研究利用从肯尼亚尼扬扎的小学生那里收集的数据,并采用分层线性模型,考察个体层面和社区层面的因素如何塑造个体对感染艾滋病风险的认知。结果表明,在个体层面以及学校/社区层面所获取的测量指标都与风险认知显著相关。在个体层面,对于男孩来说,高风险认知与对艾滋病的更多了解、摒弃有关艾滋病传播的错误观念、更高的使用避孕套自我效能感以及曾有过危险性行为有关。对于女孩而言,来自他人的性行为压力、曾有过危险性行为以及认识艾滋病感染者会导致风险认知增加。除了个体层面的变量外,一些学校/社区层面的因素也与风险认知显著相关。例如,对艾滋病死亡估计数较高的社区中的男孩和女孩报告的风险认知较高。在葬礼上承认艾滋病是死因的社区中的男孩报告高风险认知的可能性较小。研究结果表明,针对肯尼亚尼扬扎青少年艾滋病预防的干预措施若能了解学校和社区如何影响风险认知及行为改变,将受益匪浅。
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