Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada.
Women's College Research Institute, Women's College Hospital, Toronto, Canada.
AIDS Care. 2021 Jul;33(7):897-903. doi: 10.1080/09540121.2020.1861181. Epub 2020 Dec 21.
HIV prevention needs among urban refugee and displaced youth engaged in transactional sex are understudied. We examined associations between transactional sex and the HIV prevention cascade among urban refugee/displaced youth in Kampala, Uganda. We conducted a cross-sectional survey with a peer-driven sample of refugee/displaced adolescent girls and young women (= 324) and adolescent boys and young men (= 88) aged 16-24 living in Kampala's informal settlements. We conducted gender-disaggregated multivariable linear and logistic regressions to examine associations between past 12-month transactional sex and: lifetime HIV testing, condom self-efficacy, and recent [past 3-month] consistent condom use. Among the 27% of young women reporting transactional sex, 63% reported HIV testing. In multivariable analyses with young women, transactional sex was associated with higher condom self-efficacy, increased consistent condom use, but not HIV testing. Among the 48% of young men reporting transactional sex, 50% reported HIV testing. In multivariable analyses with young men, transactional sex was associated with lower HIV testing but not with condom self-efficacy or consistent condom use. Young men were 68% less likely to report HIV testing if transactional sex engaged. Findings point to urgent HIV testing gaps among transactional sex engaged urban refugee/displaced youth and a need for gender-tailored HIV prevention strategies.
城市难民和流离失所青年从事商业性性行为的艾滋病毒预防需求研究不足。我们研究了乌干达坎帕拉从事商业性性行为的城市难民/流离失所青年与艾滋病毒预防环节之间的关联。我们对居住在坎帕拉非正规住区的年龄在 16-24 岁的难民/流离失所少女和年轻女性（=324 人）和青年男孩和年轻男性（=88 人）进行了一项同伴驱动的横断面调查。我们进行了性别分类的多变量线性和逻辑回归分析，以研究过去 12 个月商业性性行为与以下方面之间的关联：终身艾滋病毒检测、 condom 自我效能和最近[过去 3 个月] condom 的一致性使用。在报告有商业性性行为的 27%年轻女性中，有 63%报告进行了艾滋病毒检测。在对年轻女性进行的多变量分析中，商业性性行为与 condom 自我效能更高、 condom 的一致性使用增加有关，但与艾滋病毒检测无关。在报告有商业性性行为的 48%年轻男性中，有 50%报告进行了艾滋病毒检测。在对年轻男性进行的多变量分析中，商业性性行为与较低的艾滋病毒检测有关，但与 condom 自我效能或 condom 的一致性使用无关。如果从事商业性性行为，年轻男性报告艾滋病毒检测的可能性降低 68%。研究结果表明，从事商业性性行为的城市难民/流离失所青年中存在迫切需要进行艾滋病毒检测的情况，需要制定针对性别差异的艾滋病毒预防策略。
