Visser Maretha
a PhD, is a professor in Psychology at the Department of Psychology , University of Pretoria , Pretoria , South Africa.
SAHARA J. 2017 Dec;14(1):64-76. doi: 10.1080/17290376.2017.1376704.
The aim of the research was to gain increased knowledge regarding the sexual risk behaviour of school-going young people in South Africa after two decades of HIV-education in schools, to contribute to the development of improved HIV prevention strategies. In collaboration with the Department of Education, a sample of 5305 learners (between 10 and 18 years in Grades 5-12) from high-risk communities were identified. They completed a survey that assessed self-reported sexual risk behaviour and variables that potentially underlie sexual risk, such as attitudes towards preventive behaviour, perceived social norms and self-efficacy (based on the theory of planned behaviour [TPB]) and social factors like caregiver relationships and gender norms (based on the social ecological theory). Lifetime sex was reported by 49.4% of boys and 30.5% of girls in Grades 8-12, while 56% of the sexually active young people reported consistent condom use. Accurate knowledge about HIV transmission was low (37.8%). Regression analysis showed that risk behaviour was more prominent among older male youths, who perceived social norms as encouraging sexual activity, who use alcohol excessively, and who have negative attitudes towards abstinence. Perceived traditional community gender norms and negative relationships with caregivers were also associated with sexual risk behaviour. This research showed that the TPB can be used in planning HIV prevention interventions for young people. It also revealed that HIV-prevention strategies should focus beyond educating the individual, to address community factors such as improving caregiver relationships, the culture of substance abuse, peer group norms and inequality in community gender norms. These community processes influence young people's behaviour and need to be addressed to allow the youth to make healthy behavioural choices.
这项研究的目的是，在学校开展了二十年艾滋病病毒教育之后，增进对南非在校青少年性风险行为的了解，以推动制定更有效的艾滋病病毒预防策略。与教育部合作，从高风险社区抽取了5305名学习者（年龄在10至18岁之间，就读于5至12年级）作为样本。他们完成了一项调查，该调查评估了自我报告的性风险行为以及可能构成性风险的潜在变量，例如对预防行为的态度、感知到的社会规范和自我效能感（基于计划行为理论[TPB]），以及诸如照顾者关系和性别规范等社会因素（基于社会生态理论）。8至12年级的男生中有49.4%、女生中有30.5%报告有过终生性行为，而在有性行为的青少年中，56%报告一直使用避孕套。对艾滋病病毒传播的准确知识知晓率较低（37.8%）。回归分析表明，风险行为在年龄较大的男性青少年中更为突出，他们认为社会规范鼓励性行为，酗酒，并且对禁欲持消极态度。感知到的传统社区性别规范以及与照顾者的负面关系也与性风险行为有关。这项研究表明，计划行为理论可用于规划针对青少年的艾滋病病毒预防干预措施。研究还表明，艾滋病病毒预防策略不应仅关注个体教育，还应关注社区因素，例如改善照顾者关系、药物滥用文化、同伴群体规范以及社区性别规范中的不平等现象。这些社区因素会影响年轻人的行为，需要加以解决，以便年轻人能够做出健康的行为选择。
