Department of Epidemiology and Biostatistics, Indiana University School of Public Health, 1025 E. 7th Street, Bloomington, IN, 47405, USA.
Fonkoze Foundation, Port-au-Prince, Haiti.
AIDS Behav. 2019 Sep;23(9):2375-2385. doi: 10.1007/s10461-019-02511-x.
Sexual health education interventions have generally yielded modest impact, but may be more successful when integrated into programs designed to alleviate poverty and empower women. Between December 2017 and February 2018, we interviewed 304 Haitian female microfinance clients, 75 of whom had received health education training delivered within their regular meetings. Participants reported six key sexual health outcomes. We used log-binomial models to estimate the association between health education training and each outcome, and tested for interaction by age and literacy status. Women with health education training reported more condom use with unfaithful partners [PR (95% CI) 1.78 (1.04, 3.02)], more HIV testing [PR (95% CI) 1.56 (1.28, 1.90)], and fewer STI symptoms [PR (95% CI) 0.37 (0.19, 0.73)], compared to women with no training. Some of the associations were stronger among older women [e.g. HIV testing: PR (95% CI) 2.09 (1.49, 2.82)] and illiterate women [e.g. condom use: PR (95% CI) 3.46 (1.05, 11.38)]. These findings add to the growing body of evidence demonstrating the potential to use microfinance programs as platforms for health education delivery, and provide the first evidence for the association in Haiti.
性健康教育培训的效果通常较为有限，但如果将其纳入旨在减轻贫困和增强妇女权能的方案中，可能会更加成功。2017 年 12 月至 2018 年 2 月期间，我们对 304 名海地女性小额信贷客户进行了访谈，其中 75 人接受了在例会中提供的健康教育培训。参与者报告了 6 项关键的性健康结果。我们使用对数二项式模型来估计健康教育培训与每种结果之间的关联，并按年龄和读写能力状况检验交互作用。接受健康教育培训的女性与不忠实伴侣发生性行为时使用安全套的可能性更高 [比值比 (95%置信区间) 1.78 (1.04, 3.02)]，接受 HIV 检测的可能性更高 [比值比 (95%置信区间) 1.56 (1.28, 1.90)]，性病症状更少 [比值比 (95%置信区间) 0.37 (0.19, 0.73)]，与未接受培训的女性相比。在年龄较大的女性 [例如 HIV 检测：比值比 (95%置信区间) 2.09 (1.49, 2.82)]和不识字的女性 [例如安全套使用：比值比 (95%置信区间) 3.46 (1.05, 11.38)]中，一些关联更为强烈。这些发现增加了越来越多的证据，证明可以利用小额信贷方案作为健康教育的平台，并且是海地境内首次对此关联的证明。
