少女和年轻女性的男性性伴侣是谁？在 DREAMS 推出之前三个环境中的人群数据分析比较。
Who are the male sexual partners of adolescent girls and young women? Comparative analysis of population data in three settings prior to DREAMS roll-out.
机构信息
MRC Tropical Epidemiology Group, Department of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom.
African Health Research Institute, KwaZulu- Natal, South Africa.
出版信息
PLoS One. 2018 Sep 28;13(9):e0198783. doi: 10.1371/journal.pone.0198783. eCollection 2018.
BACKGROUND
The DREAMS (Determined Resilient Empowered AIDS-free, Mentored and Safe) Partnership aims to reduce HIV incidence among adolescent girls and young women (AGYW,15-24y) with a core package of evidence-based interventions. Some interventions, including voluntary HIV counselling and testing and circumcision, will be targeted at the male sexual partners of AGYW. A priority of DREAMS is to characterise the male partners for effective targeting.
METHODS
Using population-based data (2010-2015) in three DREAMS impact evaluation settings in Kenya and South Africa, we describe the demographic characteristics and sexual behaviour of male partners reported by AGYW, and the characteristics of males who report sexual activity with AGYW.
RESULTS
In all settings, over 90% of recent male partners reported by AGYW were aged <35 years. Median ages of spousal and non-spousal partners were 29 and 23 years respectively in uMkhanyakude (rural South Africa) and 21 and 20 years respectively in Nairobi (urban Kenya). Most males reporting an AGYW partner had never been married (89%) and many were in school (39%). Most male partners reported only 1 AGYW partner in the past year; in Gem (rural Kenya) and Nairobi 25%-29% reported 2+(AGYW or older female) partners. Concurrent partners were reported by 16% of male partners in Gem and 3-4% in uMkhanyakude. Two thirds of male partners in Gem reported testing for HIV in the past 6 months and under half in uMkhanyakude reported testing for HIV in the past year. Almost all (96%) partners in Nairobi were circumcised, compared to 45% in Gem and 43% in uMkhanyakude.
CONCLUSIONS
With almost all AGYW's sexual partners aged 15-34 years, this is an appropriate target group for DREAMS interventions. Encouraging young men to reduce their number of partners and concurrency, and uptake prevention and treatment services such as HIV testing, circumcision and ART is crucial in the effort to reduce HIV among both AGYW and young men.
背景
“梦想（坚定、有韧性、赋权、无艾滋、受指导和安全）”伙伴关系旨在通过一整套基于证据的干预措施来降低青少年女孩和年轻妇女（AGYW，15-24 岁）的艾滋病毒感染率。一些干预措施，包括自愿艾滋病毒咨询和检测以及割礼，将针对 AGYW 的男性性伴侣。“梦想”的一个重点是确定有效的目标男性伴侣。
方法
利用肯尼亚和南非三个“梦想”影响评估地点的基于人群的数据（2010-2015 年），我们描述了 AGYW 报告的男性伴侣的人口统计学特征和性行为，以及报告与 AGYW 发生性行为的男性的特征。
结果
在所有地点，AGYW 报告的最近男性伴侣中，超过 90%的年龄<35 岁。乌姆坎夸德（南非农村）和内罗毕（肯尼亚城市）中配偶和非配偶伴侣的中位年龄分别为 29 岁和 23 岁，21 岁和 20 岁。大多数报告有 AGYW 伴侣的男性从未结婚（89%），许多人还在上学（39%）。大多数男性伴侣报告在过去一年中只有一个 AGYW 伴侣；在 Gem（肯尼亚农村）和内罗毕，25%-29%的男性报告有 2+（AGYW 或年龄较大的女性）伴侣。16%的 Gem 男性伴侣和 3-4%的 uMkhanyakude 男性伴侣报告有同时性伴侣。过去 6 个月内，60%的 Gem 男性伴侣接受了艾滋病毒检测，而过去一年中，uMkhanyakude 只有不到一半的男性伴侣接受了艾滋病毒检测。近 96%的内罗毕男性伴侣接受了割礼，而 Gem 为 45%，uMkhanyakude 为 43%。
结论
由于几乎所有 AGYW 的性伴侣年龄在 15-34 岁之间，因此这是“梦想”干预措施的适当目标群体。鼓励年轻男性减少性伴侣数量和同时发生性行为，并接受艾滋病毒检测、割礼和 ART 等预防和治疗服务，对于减少 AGYW 和年轻男性中的艾滋病毒至关重要。
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