乌干达东北部卡兰多亚地区冲突后牧民社区中，10-19 岁青少年（10-19 岁）先前从事高危性行为的相关因素。
Factors associated with prior engagement in high-risk sexual behaviours among adolescents (10-19 years) in a pastoralist post-conflict community, Karamoja sub-region, North eastern Uganda.
机构信息
Directorate of Research, Monitoring and Evaluation, Baylor College of Medicine Children's Foundation, P.O. Box 72052, Kampala, Uganda.
Department of Disease Control and Environmental Health, School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda.
出版信息
BMC Public Health. 2019 Jul 31;19(1):1027. doi: 10.1186/s12889-019-7352-6.
BACKGROUND
Adolescent sexual risky behaviours continue to be significant drivers of the HIV epidemic globally. The objective of this study was to determine factors associated with prior engagement in high-risk sexual behaviours among adolescents (10-19 years) in Karamoja sub-region, a pastoralist and post-conflict community in North-eastern Uganda.
METHODS
Between August and September 2016, we conducted a cross-sectional study among 1439 adolescents receiving primary healthcare services at nine public health facilities located in five of the seven districts that make up Karamoja sub-region. High-risk sexual behaviour was defined as engaging in sex with two or more (2+) sexual partners in the 6 months preceding the survey or exchanging sex for money or gifts with no or inconsistent use of condoms over the same period of time. Factors associated with prior engagement in high-risk sexual behaviours were analysed using a modified Poison regression model with log-link and Poisson-family via a generalized linear model.
RESULTS
Eighty-two percent (81.8%, n = 1177) of the respondents had ever tested for HIV while 62 % (61.5%, n = 885) had ever had sex. Of those that had ever had sex, 11.4% (n = 101) reported prior engagement in high-risk sexual behaviours. Prior engagement in high-risk sexual behaviours was lower among men than women (adjusted prevalence ratio (adj. PR) = 0.46; 95% Confidence Interval (95% CI): 0.33, 0.62) and those whose sex debut was above 14 years (adj.PR = 0.63; 95% CI: 0.57, 0.69). However, prior engagement in high-risk sexual behaviours was significantly higher in adolescents who were not aware of their recent sexual partner's HIV status (adj.PR = 2.43; 95% CI: 1.68, 3.52) and those who used illicit drugs (adj.PR = 2.76; 95% CI: 1.88, 4.05).
CONCLUSION
Prior engagement in high-risk sexual behaviours was significantly associated with having sex with partners of unknown HIV sero-status and use of illicit drugs. These findings suggest a need for targeted interventions to improve mutual HIV status disclosure between sexual partners while minimizing their use of illicit drugs/substances.
背景
青少年的性行为风险持续成为全球艾滋病流行的主要驱动因素。本研究的目的是确定与乌干达东北部卡拉莫贾地区（一个牧民和冲突后社区）10-19 岁青少年（青少年）先前参与高危性行为相关的因素。
方法
2016 年 8 月至 9 月，我们在卡拉莫贾地区的五个区中的七个区的九家公共卫生机构中接受初级医疗保健服务的 1439 名青少年中进行了一项横断面研究。高危性行为的定义是在调查前 6 个月内与两个或更多（2+）性伴侣发生性行为，或者在同一时期内为了金钱或礼物而发生性行为，而没有或不经常使用避孕套。使用修正后的泊松回归模型（对数链接和泊松家族）通过广义线性模型分析与先前参与高危性行为相关的因素。
结果
82%（81.8%，n=1177）的受访者曾接受过 HIV 检测，而 62%（61.5%，n=885）曾有过性行为。在那些有过性行为的人中，有 11.4%（n=101）报告曾参与过高危性行为。与女性相比，男性（调整后的患病率比（adj.PR）=0.46；95%置信区间（95%CI）：0.33，0.62）和性初为 14 岁以上的青少年（adj.PR=0.63；95%CI：0.57，0.69）中，先前参与高危性行为的比例较低。然而，对于那些不知道最近性伴侣 HIV 状况的青少年（adj.PR=2.43；95%CI：1.68，3.52）和使用非法药物的青少年（adj.PR=2.76；95%CI：1.88，4.05），先前参与高危性行为的比例显著更高。
结论
先前参与高危性行为与与 HIV 血清学状况未知的性伴侣发生性行为和使用非法药物显著相关。这些发现表明，需要有针对性的干预措施，以改善性伴侣之间的 HIV 状况相互披露，同时减少他们对非法药物/物质的使用。
Zotero 插件