Price Joan T, Rosenberg Nora E, Vansia Dhrutika, Phanga Twambilile, Bhushan Nivedita L, Maseko Bertha, Brar Savvy K, Hosseinipour Mina C, Tang Jennifer H, Bekker Linda-Gail, Pettifor Audrey
Division of Global Women's Health, Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, NC.
Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC.
J Acquir Immune Defic Syndr. 2018 Jan 1;77(1):53-63. doi: 10.1097/QAI.0000000000001567.
Adolescent girls and young women (AGYW) in sub-Saharan Africa have high HIV prevalence and incidence. We sought to understand which HIV risk factors individually and in combination contribute to risk, and whether these factors are associated with HIV worry and risk perception.
This study is ongoing at 4 public health centers in Lilongwe, Malawi (2016-2017).
AGYW of 15-24 years old were recruited to participate in a study assessing 4 models of service delivery. At each health center, participants completed a baseline survey assessing socioeconomic, behavioral, biomedical, and partnership characteristics; self-reported HIV status; and, if HIV-uninfected, HIV risk perception (high versus low or none) and HIV worry (any versus none). We analyzed associations between baseline characteristics and HIV prevalence, risk perception, and worry.
Among 1000 AGYW, median age was 19 years (IQR: 17-21). Thirty-three participants reported being HIV-infected. Fifteen characteristics were associated with HIV infection. Having more risk factors was associated with higher HIV prevalence (≤4 factors, 0.5%; 5-8 factors, 6%; >8 factors, 21%). Having more risk factors was also associated with higher risk perception (P < 0.001) and higher worry (P < 0.001). However, among those with ≥8 risk factors, 52% did not consider themselves to be at high risk and 21% did not report any HIV worry.
Most AGYW perceive little risk of HIV acquisition, even those at highest risk. As a critical gap in the HIV prevention cascade, accurate risk perception is needed to tailor effective and sustained combination prevention strategies for this vulnerable population.
撒哈拉以南非洲地区的青春期女孩和年轻女性（AGYW）艾滋病毒感染率和发病率很高。我们试图了解哪些艾滋病毒风险因素单独或综合起来会导致风险，以及这些因素是否与艾滋病毒担忧和风险认知相关。
本研究正在马拉维利隆圭的4个公共卫生中心进行（2016 - 2017年）。
招募15 - 24岁的AGYW参与一项评估4种服务提供模式的研究。在每个卫生中心，参与者完成一项基线调查，评估社会经济、行为、生物医学和伙伴关系特征；自我报告的艾滋病毒感染状况；如果未感染艾滋病毒，则评估艾滋病毒风险认知（高风险与低风险或无风险）和艾滋病毒担忧（有担忧与无担忧）。我们分析了基线特征与艾滋病毒感染率、风险认知和担忧之间的关联。
在1000名AGYW中，中位年龄为19岁（四分位间距：17 - 21岁）。33名参与者报告感染了艾滋病毒。15种特征与艾滋病毒感染相关。风险因素越多，艾滋病毒感染率越高（≤4个因素，0.5%；5 - 8个因素，6%；>8个因素，21%）。风险因素越多，风险认知也越高（P < 0.001），担忧程度也越高（P < 0.001）。然而，在有≥8个风险因素的人群中，52%的人不认为自己处于高风险，21%的人未报告有任何艾滋病毒担忧。
大多数AGYW认为感染艾滋病毒的风险很小，即使是那些风险最高的人。作为艾滋病毒预防链条中的一个关键缺口，需要准确的风险认知来为这一脆弱人群量身定制有效且持续的综合预防策略。
