Hallman Kelly
Afr J AIDS Res. 2005 May;4(1):37-50. doi: 10.2989/16085900509490340.
Recent evidence suggests that the burden of new HIV infections in sub-Saharan Africa is concentrated among young people, especially females. Even in a country such as South Africa where knowledge among young people of how to protect oneself from infection is rather high, such information may not always be usable in daily situations of economic and social disadvantage that characterise many of their lives. Despite this possibility, there are surprisingly few definitive studies that examine the effects of socioeconomic status on HIV risk and prevention behaviours among youth in South Africa. Using household survey data collected in 2001, this study investigates how socioeconomic disadvantage has influenced the sexual behaviour and experiences of 4 000 young women and men aged 14-24 years in KwaZulu-Natal province - an area characterised by high HIV prevalence and high rates of poverty and inequality. Socioeconomic disadvantage, measured here as low relative household wealth, is found to be associated with a variety of unsafe sexual behaviours and experiences, particularly for females. Among young women low wealth is associated with earlier sexual debut, having had multiple sexual partners in the year before the survey, and lower chances of condom use at last sex. It is also associated with increased chances that first female sexual experience is non-consensual and with higher odds of females having traded sex and having experienced physically forced sex. For females and males, low wealth reduces the chances of discussing safe-sex practices with the most recent sexual partner. Without sufficient attention, during the design and placement of HIV prevention programmes, to the gendered economic and social conditions in which individuals live - conditions that can make people more or less vulnerable to behaviours and experiences that may lead to infection - the potential effectiveness of the global response to HIV/AIDS is sacrificed.
近期证据表明，撒哈拉以南非洲地区新增艾滋病毒感染负担集中在年轻人，尤其是女性身上。即便在南非这样一个年轻人对如何预防感染的知晓率颇高的国家，在他们许多人所处的经济和社会劣势的日常情境中，此类信息可能并不总能派上用场。尽管存在这种可能性，但令人惊讶的是，几乎没有权威研究探讨社会经济地位对南非青年艾滋病毒感染风险及预防行为的影响。本研究利用2001年收集的家庭调查数据，调查社会经济劣势如何影响夸祖鲁 - 纳塔尔省4000名年龄在14至24岁的年轻男女的性行为及经历，该地区艾滋病毒感染率高，且贫困和不平等程度高。此处衡量的社会经济劣势为家庭相对财富低，研究发现其与多种不安全的性行为及经历相关，尤其是对女性而言。在年轻女性中，低财富与初次性行为更早、在调查前一年有多个性伴侣以及最近一次性行为时使用避孕套的几率较低有关。它还与首次女性性经历为非自愿的几率增加以及女性从事性交易和经历身体强迫性行为的几率较高有关。对女性和男性来说，低财富都会降低与最近一次性伴侣讨论安全性行为做法的几率。如果在艾滋病毒预防项目的设计和实施过程中，没有充分关注个人所处的性别化经济和社会状况——这些状况会使人或多或少容易受到可能导致感染的行为和经历的影响——那么全球应对艾滋病毒/艾滋病的潜在成效就会受到损害。
