Boothe Makini A S, Semá Baltazar Cynthia, Sathane Isabel, Raymond Henry F, Fazito Erika, Temmerman Marleen, Luchters Stanley
Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
National Institute of Health, Maputo, Mozambique.
PLoS One. 2021 Dec 31;16(12):e0261943. doi: 10.1371/journal.pone.0261943. eCollection 2021.
The first exposure to high-risk sexual and drug use behaviors often occurs during the period of youth (15-24 years old). These behaviors increase the risk of HIV infection, especially among young key populations (KP)-men how have sex with men (MSM), female sex workers (FSW), and people who inject drugs (PWID). We describe the characteristics of young KP participants in the first Biobehavioral Surveillance (BBS) surveys conducted in Mozambique and examine their risk behaviors compared to adult KP.
Respondent-driven sampling (RDS) methodology was used to recruit KP in three major urban areas in Mozambique. RDS-weighted pooled estimates were calculated to estimate the proportion of young KP residing in each survey city. Unweighted pooled estimates of risk behaviors were calculated for each key population group and chi-square analysis assessed differences in proportions between youth (aged less than 24 years old) and older adult KP for each population group.
The majority of MSM and FSW participants were young 80.7% (95% CI: 71.5-89.9%) and 71.9% (95% CI: 71.9-79.5%), respectively, although not among PWID (18.2%, 95% CI: 13.2-23.2%). Young KP were single or never married, had a secondary education level or higher, and low employment rates. They reported lower perception of HIV risk (MSM: 72.3% vs 56.7%, p<0.001, FSW: 45.3% vs 24.4%, p<0.001), lower HIV testing uptake (MSM: 67.5% vs 72.3%, p<0.001; FSW: 63.2% vs 80.6%; p<0.001, PWID: 53.3% vs 31.2%; p = 0.001), greater underage sexual debut (MSM: 9.6% vs 4.8%, p<0.001; FSW: 35.2% vs 22.9%, p<0.001), and greater underage initiation of injection drug use (PWID: 31.9% vs 7.0%, p<0.001). Young KP also had lower HIV prevalence compared to older KP: MSM: 3.3% vs 27.0%, p<0.001; FSW: 17.2% vs 53.7%, p<0.001; and PWID: 6.0% vs 55.0%, p<0.001. There was no significant difference in condom use across the populations.
There is an immediate need for a targeted HIV response for young KP in Mozambique so that they are not left behind. Youth must be engaged in the design and implementation of interventions to ensure that low risk behaviors are sustained as they get older to prevent HIV infection.
首次接触高风险性行为和吸毒行为通常发生在青年时期（15 - 24岁）。这些行为会增加感染艾滋病毒的风险，尤其是在年轻的关键人群中，即男男性行为者（MSM）、女性性工作者（FSW）和注射吸毒者（PWID）。我们描述了在莫桑比克进行的首次生物行为监测（BBS）调查中年轻关键人群参与者的特征，并将他们与成年关键人群的风险行为进行比较。
采用应答驱动抽样（RDS）方法在莫桑比克的三个主要城市地区招募关键人群。计算RDS加权汇总估计值，以估计居住在每个调查城市的年轻关键人群的比例。计算每个关键人群组风险行为的未加权汇总估计值，并通过卡方分析评估每个年龄组中年轻人（年龄小于24岁）和成年关键人群之间比例的差异。
大多数男男性行为者和女性性工作者参与者较为年轻，分别为80.7%（95%置信区间：71.5 - 89.9%）和71.9%（95%置信区间：71.9 - 79.5%），不过注射吸毒者群体并非如此（18.2%，95%置信区间：13.2 - 23.2%）。年轻关键人群单身或从未结婚，具有中等及以上教育水平，就业率较低。他们报告的艾滋病毒风险认知较低（男男性行为者：72.3%对56.7%，p<0.001；女性性工作者：45.3%对24.4%，p<0.001），艾滋病毒检测接受率较低（男男性行为者：67.5%对72.3%，p<0.001；女性性工作者：63.2%对80.6%；p<0.001，注射吸毒者：53.3%对31.
