Discipline of Public Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.
HIV/AIDS/STIs and TB Research Programme, Human Sciences Research Council, Cape Town, South Africa.
BMC Infect Dis. 2020 Aug 1;20(1):563. doi: 10.1186/s12879-020-05302-1.
Despite several intervention programmes in South Africa, risky sexual behaviours among women of reproductive age remain a public health concern, making them vulnerable to unintended pregnancies and/or sexually transmitted infections (STIs), including human immunodeficiency virus (HIV) infection. The aim of this study was to investigate the predictors of risky sexual behaviours among women of reproductive age in a high HIV-burden township in KwaZulu-Natal, South Africa.
In a cross-sectional study, 471 women of reproductive age (18-49 years, mean: 25.83) in 10 public health clinics in Umlazi Township, responded to a structured questionnaire. Data were coded, entered into Epi Data Manager and exported to Stata for analysis. A Pearson Chi-square tests and logistic regression models (bivariate and multivariate) were employed to assess the level of the association between the predictor and outcome variables and the p-value < 0.05 was considered statistically significant.
More than half (51.80%) of the women were aged 18-24 years and only a handful (18.26%) had a tertiary qualification. The majority were single (88.96%) and the unemployed accounted for 53.50%. This study found that women who had talked about condoms with their partner in the past 12 months were more likely (p = < 0.0001) to have used condoms during their last sexual intercourse. Older women (p = 0.035) were more likely to have used a condom at last sex, compared to younger women. However, women who were exposed to physical partner violence (hitting and/or slapping), those who had been diagnosed with HIV and those whose sexual partners were diagnosed with HIV, did not show a significant association with condom use at last sex.
Exposure to physical partner violence and poor partner discussions about condoms are key deterrents to condom usage. Holistic interventions are required in order to address the risky behaviours, and consequently reduce sexually transmitted infections and/or unintended pregnancies.
尽管南非实施了多项干预措施，但育龄妇女的危险性行为仍然是一个公共卫生关注点，使她们容易意外怀孕和/或感染性传播感染（STIs），包括人类免疫缺陷病毒（HIV）感染。本研究旨在调查南非夸祖鲁-纳塔尔省一个高 HIV 负担城镇中育龄妇女危险性行为的预测因素。
在一项横断面研究中，乌姆拉齐镇 10 个公共卫生诊所的 471 名育龄妇女（18-49 岁，平均年龄：25.83 岁）回答了一份结构化问卷。数据经过编码，输入 EpiData 管理器并导出到 Stata 进行分析。采用 Pearson 卡方检验和逻辑回归模型（双变量和多变量）评估预测因素与结局变量之间的关联水平，p 值<0.05 被认为具有统计学意义。
超过一半（51.80%）的妇女年龄在 18-24 岁之间，只有少数（18.26%）具有高等教育资格。大多数是单身（88.96%），失业者占 53.50%。本研究发现，过去 12 个月中与伴侣谈论过避孕套的妇女在过去一次性交中更有可能使用避孕套（p<0.0001）。与年轻妇女相比，年龄较大的妇女（p=0.035）更有可能在上一次性交中使用避孕套。然而，遭受身体伴侣暴力（殴打和/或拍打）、被诊断患有 HIV 以及性伴侣被诊断患有 HIV 的妇女，在最后一次性交中使用避孕套与未使用避孕套之间没有显著关联。
遭受身体伴侣暴力和缺乏有关避孕套的讨论是阻碍避孕套使用的关键因素。需要采取整体干预措施，以解决危险行为，从而减少性传播感染和/或意外怀孕。
