Harrison Kathleen McDavid, Claass Johanna, Spiegel Paul B, Bamuturaki Judith, Patterson Njogu, Muyonga Michael, Tatwebwa Lillian
Afr J AIDS Res. 2009 Mar;8(1):29-41. doi: 10.2989/AJAR.2009.8.1.4.717.
We used a standardised behavioural surveillance survey (BSS), modified to be directly relevant to populations in conflict and post-conflict settings as well as to their surrounding host populations, to survey the populations of a refugee settlement in south-western Uganda and its surrounding area. Two-stage probability sampling was used to conduct 800 interviews in each population. The BSS questionnaire adapted for displaced populations was administered to adults aged 15-59 years. It collected information on HIV knowledge, attitudes and practices; issues before, during and after displacement; level of interaction and sexual exploitation among the refugees and host communities (i.e., nationals). Population parameters were compared and 95% confidence intervals were calculated for core HIV indicators. The demographic characteristics were similar (except for educational achievement), and HIV awareness was very high (>95%) in both populations. The refugees reported more-accepting attitudes towards persons with HIV than did nationals (19% versus 13%; p < 0.01). More refugees than nationals reported ever having had transactional sex (10% versus 6%; p < 0.01), which mostly occurred post-displacement. Five percent of females among both the refugees and nationals reported experiencing forced sex, which mostly occurred post-displacement and after the arrival of refugees, respectively. Nationals reported more frequent travel to refugee settlements than reported by refugees to national villages (22% versus 11%; p < 0.01). The high mobility and frequent interactions of these two populations suggest that integrated HIV programmes should be developed and would be an efficient use of resources. Evidence suggesting that female refugees may be at elevated risk for HIV infection, due to forced sex, transactional sex and other vulnerabilities, warrants further examination through qualitative research. The findings indicate a need for additional, focused HIV-prevention programmes, such as youth education, for both refugees and Ugandan nationals.
我们采用了一项标准化行为监测调查（BSS），该调查经过修改，与冲突及冲突后环境中的人群及其周边的收容人群直接相关，以此对乌干达西南部一个难民安置点及其周边地区的人群进行调查。采用两阶段概率抽样法，在每个群体中进行800次访谈。适用于流离失所人群的BSS问卷由15至59岁的成年人填写。问卷收集了有关艾滋病毒知识、态度和行为的信息；流离失所前、期间和之后的问题；难民与收容社区（即本国居民）之间的互动程度和性剥削情况。比较了人群参数，并计算了核心艾滋病毒指标的95%置信区间。除教育程度外，两群体的人口特征相似，且两群体中的艾滋病毒知晓率都很高（>95%）。难民对艾滋病毒感染者的态度比本国居民更为包容（分别为19%和13%；p<0.01）。报告有过交易性性行为的难民比本国居民更多（分别为10%和6%；p<0.01），这种情况大多发生在流离失所之后。难民和本国居民中分别有5%的女性报告曾遭受强迫性行为，这大多分别发生在流离失所之后和难民抵达之后。本国居民报告前往难民安置点的频率高于难民前往本国村庄的频率（分别为22%和11%；p<0.01）。这两个人群的高流动性和频繁互动表明，应制定综合艾滋病毒防治方案，这将是对资源的有效利用。有证据表明，由于强迫性行为、交易性性行为和其他脆弱性因素，女性难民感染艾滋病毒的风险可能更高，这值得通过定性研究作进一步调查。研究结果表明，需要针对难民和乌干达本国居民制定更多有针对性的艾滋病毒预防方案，如青年教育。
