Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9 SH, UK.
Department of Social Science, UCL Institute of Education, University College London, London, UK.
AIDS Behav. 2019 Jun;23(6):1471-1483. doi: 10.1007/s10461-019-02406-x.
Friends could be influential on young women's sexual health via influences on sexual behaviours and as connections to sexual partners, but are understudied in sub-Saharan Africa. We cross-sectionally surveyed 2326 13-20 year-old young women eligible for grades 8-11 in rural South Africa about their sexual behaviour and up to three sexual partners. Participants each described five specific but unidentified friends and the relationships between them in an 'egocentric' network analysis design. We used logistic regression to investigate associations between friendship characteristics and participants' reports of ever having had sex (n = 2326) and recent condom use (n = 457). We used linear regression with random effects by participant to investigate friendship characteristics and age differences with sexual partners (n = 633 participants, 1051 partners). We found that it was common for friends to introduce young women to those who later became sexual partners, and having older friends was associated with having older sexual partners, (increase of 0.37 years per friend at least 1 year older, 95% CI 0.21-0.52, adjusted). Young women were more likely to report ever having had sex when more friends were perceived to be sexually active (adjusted OR 1.85, 95% CI 1.72-2.01 per friend) and when they discussed sex, condoms and HIV with friends. Perception of friends' condom use was not associated with participants' reported condom use. While this study is preliminary and unique in this population and further research should be conducted, social connections between friends and sexual partners and perceptions of friend sexual behaviours could be considered in the design of sexual health interventions for young women in South Africa.
朋友可以通过对性行为的影响以及与性伴侣的联系对年轻女性的性健康产生影响，但在撒哈拉以南非洲地区的研究较少。我们对南非农村地区 2326 名 13-20 岁符合 8-11 年级条件的年轻女性进行了横断面调查，了解她们的性行为和最多 3 个性伴侣的情况。在“自我中心”网络分析设计中，参与者分别描述了五个特定但未识别的朋友以及他们之间的关系。我们使用逻辑回归调查了友谊特征与参与者报告的有过性行为（n=2326）和最近使用避孕套（n=457）之间的关联。我们使用具有参与者随机效应的线性回归来调查友谊特征与性伴侣的年龄差异（n=633 名参与者，1051 名性伴侣）。我们发现，朋友将年轻女性介绍给后来成为性伴侣的人很常见，并且拥有年长的朋友与拥有年长的性伴侣有关（每个至少年长 1 岁的朋友增加 0.37 岁，95%CI 0.21-0.52，调整后）。当更多的朋友被认为性行为活跃时（每个朋友调整后的 OR 1.85，95%CI 1.72-2.01），当年轻女性与朋友讨论性、避孕套和 HIV 时，她们更有可能报告曾经有过性行为。朋友使用避孕套的看法与参与者报告的避孕套使用情况无关。虽然这项研究在该人群中是初步的和独特的，应该进行进一步的研究，但在南非年轻女性的性健康干预措施设计中，可以考虑朋友和性伴侣之间的社会联系以及对朋友性行为的看法。
