Population Council, 4301 Connecticut Ave, Suite 280, Washington, DC, USA.
Independent Consultant, Washington, DC, USA.
Int J Public Health. 2020 May;65(4):399-411. doi: 10.1007/s00038-020-01350-1. Epub 2020 Apr 9.
To stem the HIV epidemic among adolescent girls and young women (AGYW, 15-24 years), prevention programs need to reach AGYW who are most at risk. We examine whether individual- and household-level factors could be used to define HIV vulnerability for AGYW.
We surveyed out-of-school AGYW in urban and peri-urban Kenya (N = 1014), in urban Zambia (N = 846), and in rural Malawi (N = 1654) from October 2016 to 2017. LCA identified classes based on respondent characteristics, attitudes and knowledge, and household characteristics. Multilevel regressions examined associations between class membership and HIV-related health outcomes.
We identified two latent classes-high and low HIV vulnerability profiles-among AGYW in each country; 32% of the sample in Kenya, 53% in Malawi, and 51% in Zambia belonged to the high vulnerability group. As compared to AGYW with a low-vulnerability profile, AGYW with a high-vulnerability profile had significantly higher odds of HIV-related outcomes (e.g., very early sexual debut, transactional sex, sexual violence from partners).
Out-of-school AGYW had differential vulnerability to HIV. Interventions should focus on reaching AGYW in the high HIV vulnerability profiles.
为了遏制青少年女孩和年轻妇女（AGYW，15-24 岁）中的艾滋病毒流行，预防计划需要覆盖到处于最大风险的 AGYW。我们研究了个体和家庭层面的因素是否可以用来定义 AGYW 的艾滋病毒易感性。
我们于 2016 年 10 月至 2017 年期间在肯尼亚城市和城郊地区（N=1014）、赞比亚城市（N=846）和马拉维农村（N=1654）对失学的 AGYW 进行了调查。潜在类别分析（LCA）根据受访者特征、态度和知识以及家庭特征确定了类别。多水平回归分析了类别成员身份与艾滋病毒相关健康结果之间的关联。
我们在每个国家的 AGYW 中确定了两个潜在类别——高和低艾滋病毒易感性特征；肯尼亚有 32%的样本、马拉维有 53%的样本和赞比亚有 51%的样本属于高易感性组。与低易感性特征的 AGYW 相比，高易感性特征的 AGYW 更有可能出现与艾滋病毒相关的结果（例如，性经历过早、性交易、来自伴侣的性暴力）。
失学的 AGYW 对艾滋病毒的易感性存在差异。干预措施应侧重于针对高艾滋病毒易感性特征的 AGYW。
