乌干达卡普里拉贫民窟青年自报艾滋病病毒感染的社会心理相关因素。
Psychosocial correlates of self-reported HIV among youth in the slums of Kampala.
机构信息
Department of Population Health Sciences, School of Public Health, Georgia State University, P.O. Box 3984, Atlanta, GA, 30302-3984, USA.
Department of Respiratory Therapy, Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, P.O. Box 3995, Atlanta, GA, 30302-3995, USA.
出版信息
BMC Public Health. 2019 Aug 27;19(1):1176. doi: 10.1186/s12889-019-7480-z.
BACKGROUND
Human immunodeficiency virus (HIV) rates are high in Uganda (6.7%), and rates are especially high among at-risk groups such as youth living in the slums of Kampala, Uganda. The objective of this study was to assess the psychosocial correlates, particularly alcohol use, associated with HIV among youth living in the slums of Kampala, Uganda.
METHODS
Analyses are based on cross-sectional survey data collected in Spring of 2014. Participants comprised a convenience sample (N = 1134) of urban service-seeking youth living on the streets or in the slums, 12-18 years of age who were participating in a Uganda Youth Development Link drop-in center (56.1% female and 43.9% male). Chi-Square Tests were used to determine differences in the proportions of alcohol use patterns between self-reported HIV-positive and HIV-negative youth. Bivariate and multivariable logistic regression were conducted to determine the associated risk factors with self-reported HIV. Institutional Review Board approvals were obtained from the Georgia State University and the Uganda National Council for Science and Technology.
RESULTS
Among the total sample of youth (N = 1103), 10.5% (n = 116) reported being HIV-positive. There were statistically significant differences between HIV-positive and HIV-negative youth on ever living on the streets (χ =10.14, df = 1, p = 0.002), past 12-month alcohol use (χ =16.38, df = 1, p < .0001), ever having sexual intercourse (χ =14.52, df = 1, p = 0.0001), ever engaging in sex work (χ =13.19, df = 1, p = 0.0003), inconsistent condom use in the past 3 months (χ =5.03, df = 1, p = 0.03), and ever being raped (χ =15.29, df = 1, p < 0.0001). A higher percentage of HIV-positive youth were classified as problem drinkers, defined by the CAGE scores (21.6% vs. 13.9%, respectively). In the multivariable analysis, previously being raped (OR: 1.70; 95% CI: 1.02, 2.83) and alcohol use without problem drinking (OR: 2.14; 95% CI: 1.24, 3.69) was associated with HIV.
CONCLUSION
Youth living in the slums of Kampala, Uganda have a high prevalence of HIV. These youth are in dire need of interventions which address both alcohol use behaviors and sexual risk behaviors to reduce further complications of their existing health conditions, including HIV.
背景
在乌干达，艾滋病毒（HIV）感染率很高（6.7%），在高危人群中尤其如此，例如生活在乌干达坎帕拉贫民窟的青年。本研究的目的是评估与坎帕拉贫民窟青年感染 HIV 相关的社会心理因素，特别是饮酒行为。
方法
分析基于 2014 年春季收集的横断面调查数据。参与者是一个便利样本（N=1134），由在街头或贫民窟寻求服务的城市青年组成，年龄在 12-18 岁之间，他们正在参加乌干达青年发展联系（Uganda Youth Development Link）的一个外展中心，其中 56.1%为女性，43.9%为男性。卡方检验用于确定自我报告 HIV 阳性和 HIV 阴性青年之间饮酒模式比例的差异。采用单变量和多变量逻辑回归来确定与自我报告 HIV 相关的风险因素。格鲁吉亚州立大学和乌干达国家科学技术委员会获得了机构审查委员会的批准。
结果
在总样本（N=1103）中，有 10.5%（n=116）报告 HIV 阳性。HIV 阳性和 HIV 阴性青年在以下方面存在统计学差异：曾在街头生活（χ=10.14，df=1，p=0.002）、过去 12 个月饮酒（χ=16.38，df=1，p<0.0001）、曾发生过性行为（χ=14.52，df=1，p=0.0001）、曾从事性工作（χ=13.19，df=1，p=0.0003）、过去 3 个月避孕套使用不规范（χ=5.03，df=1，p=0.03）、曾被强奸（χ=15.29，df=1，p<0.0001）。更高比例的 HIV 阳性青年被归类为有问题的饮酒者，这是通过 CAGE 评分定义的（分别为 21.6%和 13.9%）。在多变量分析中，曾被强奸（OR：1.70；95%CI：1.02，2.83）和无问题饮酒行为（OR：2.14；95%CI：1.24，3.69）与 HIV 相关。
结论
生活在乌干达坎帕拉贫民窟的青年 HIV 感染率很高。这些青年迫切需要干预措施，既要解决饮酒行为，又要解决性风险行为，以减少他们现有健康状况的进一步并发症，包括 HIV。
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