撒哈拉以南非洲地区青少年艾滋病毒检测的预测因素：一项横断面研究。
Predictors of HIV Testing among Youth in Sub-Saharan Africa: A Cross-Sectional Study.
作者信息
Asaolu Ibitola O, Gunn Jayleen K, Center Katherine E, Koss Mary P, Iwelunmor Juliet I, Ehiri John E
机构信息
Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N Martin Avenue, Tucson, Arizona, 85724, United States of America.
Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N Martin Avenue, Tucson, Arizona, 85724, United States of America.
出版信息
PLoS One. 2016 Oct 5;11(10):e0164052. doi: 10.1371/journal.pone.0164052. eCollection 2016.
INTRODUCTION
In spite of a high prevalence of HIV infection among adolescents and young adults in sub-Saharan Africa, uptake of HIV testing and counseling among youth in the region remains sub-optimal. The objective of this study was to assess factors that influence uptake of HIV testing and counseling among youth aged 15-24 years in sub-Saharan Africa.
METHODS
This study used the Demographic and Health Survey (DHS) data from countries that represent four geographic regions of sub-Saharan Africa: Congo (Brazzaville), representing central Africa (DHS 2011-2012); Mozambique, representing southern Africa (DHS 2011); Nigeria, representing western Africa (DHS 2013); and Uganda, representing eastern Africa (DHS 2011). Analyses were restricted to 23,367 male and female respondents aged 15-24 years with complete data on the variables of interest. Chi-square tests and logistic regression models were used to assess predictors of HIV testing. Statistical significance was set at p< 0.01.
RESULTS
The analysis revealed that a majority of the respondents were female (78.1%) and aged 20-24-years (60.7%). Only a limited proportion of respondents (36.5%) had ever tested for HIV and even fewer (25.7%) demonstrated comprehensive knowledge of HIV/AIDS. There was a significant association between HIV testing and respondents' gender, age, age at sexual debut, and comprehensive knowledge of HIV in the pooled sample. Older youth (adjusted OR (aOR) = 2.19; 99% CI = 1.99-2.40) and those with comprehensive knowledge of HIV (aOR = 1.98; 1.76-2.22) had significantly higher odds of ever being tested for HIV than younger respondents and those with limited HIV/AIDS knowledge respectively. Furthermore, men had lower odds of HIV testing than women (aOR = 0.32; 0.28-0.37).
CONCLUSIONS
Reaching youth in sub-Saharan Africa for HIV testing continues to be a challenge. Public health programs that seek to increase HIV counseling and testing among youth should pay particular attention to efforts that target high-risk subpopulations of youth. The results further suggest that these initiatives would be strengthened by including strategies to increase HIV comprehensive knowledge.
引言
尽管撒哈拉以南非洲地区的青少年和青年中艾滋病毒感染率很高，但该地区青年接受艾滋病毒检测和咨询的情况仍不理想。本研究的目的是评估影响撒哈拉以南非洲15至24岁青年接受艾滋病毒检测和咨询的因素。
方法
本研究使用了代表撒哈拉以南非洲四个地理区域的国家的人口与健康调查（DHS）数据：刚果（布拉柴维尔），代表中非（2011 - 2012年DHS）；莫桑比克，代表南部非洲（2011年DHS）；尼日利亚，代表西部非洲（2013年DHS）；以及乌干达，代表东部非洲（2011年DHS）。分析仅限于23367名年龄在15至24岁之间、在感兴趣变量上有完整数据的男性和女性受访者。使用卡方检验和逻辑回归模型来评估艾滋病毒检测的预测因素。统计学显著性设定为p < 0.01。
结果
分析显示，大多数受访者为女性（78.1%），年龄在20至24岁之间（60.7%）。只有有限比例的受访者（36.5%）曾经接受过艾滋病毒检测，甚至更少（25.7%）对艾滋病毒/艾滋病有全面的了解。在汇总样本中，艾滋病毒检测与受访者的性别、年龄、首次性行为年龄以及对艾滋病毒的全面了解之间存在显著关联。年龄较大的青年（调整后的比值比（aOR）= 2.19；99%置信区间 = 1.99 - 2.40）和那些对艾滋病毒有全面了解的人（aOR = 1.98；1.76 - 2.22）分别比年轻受访者和艾滋病毒/艾滋病知识有限的人接受艾滋病毒检测的几率显著更高。此外，男性接受艾滋病毒检测的几率低于女性（aOR = 0.32；0.28 - 0.37）。
结论
让撒哈拉以南非洲的青年接受艾滋病毒检测仍然是一项挑战。旨在增加青年艾滋病毒咨询和检测的公共卫生项目应特别关注针对青年高危亚人群的努力。结果进一步表明，通过纳入增加艾滋病毒全面知识的策略，这些举措将得到加强。
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