Dipartimento di Sanità Pubblica e Malattie Infettive, Sapienza Università di Roma, Rome, Italy.
Centro Nazionale per la Salute Globale, Istituto Superiore di Sanità, Rome, Italy.
Ann Ist Super Sanita. 2023 Jan-Mar;59(1):80-92. doi: 10.4415/ANN_23_01_12.
Kenya is home to one of the worst HIV/AIDS epidemics, with higher prevalence rates in youths in urban slums. We conducted a cross-sectional mixed-methods study in Nairobi informal settlements. The aim was to investigate knowledge, attitudes and behaviours of this marginalized community, and to identify, with a bottom-up approach, the most appropriate interventions to increase the utilization of HIV/STIs services. Preliminary qualitative research was used to draw questionnaires, which assessed: STIs/HIV/AIDS knowledge, attitudes, and behaviours; access and barriers to STIs/HIV/AIDS services; perceived quality of services; the impact of COVID-19. One thousand and fifty-four respondents completed the questionnaire. 48.3% were youth in the community, 23% youth in school, 16.8% young mothers, 6.9% drug users and 5% people attending a technical-vocational training. We found unsatisfactory knowledge of STIs/HIV/AIDS transmission and prevention, and low condom use, mainly due to difficult access, poverty, and gender-based violence. We also found limited use of health services, and lack of trust due to poor attitude of the staff. COVID-19 has widened barriers to access to health services. To reach this population, it is necessary to implement educational interventions, facilitate access to free condoms, and train health centre staff to be more welcoming. Respondents found proximity strategies more efficient, including door-to-door testing and community outreach.
肯尼亚是艾滋病疫情最严重的国家之一，城市贫民窟中的年轻人感染率更高。我们在内罗毕的非正规住区进行了一项横断面混合方法研究。目的是调查这个边缘化社区的知识、态度和行为，并通过自下而上的方法确定最适合的干预措施，以增加艾滋病毒/性传播感染服务的利用。初步的定性研究用于制定调查问卷，评估了以下内容：性传播感染/艾滋病毒/艾滋病的知识、态度和行为；获得性传播感染/艾滋病毒/艾滋病服务的机会和障碍；对服务质量的看法；新冠肺炎的影响。1054 名受访者完成了问卷。48.3%是社区中的年轻人，23%是在校青年，16.8%是年轻母亲，6.9%是吸毒者，5%是参加技术职业培训的人。我们发现，对性传播感染/艾滋病毒/艾滋病传播和预防的知识了解不足，而且避孕套使用率低，主要原因是难以获得、贫困和性别暴力。我们还发现，卫生服务的利用有限，而且由于工作人员的态度不佳，导致缺乏信任。新冠肺炎加大了获得卫生服务的障碍。为了接触到这一人群，有必要实施教育干预措施，方便获得免费避孕套，并培训卫生中心工作人员，以提高他们的服务意识。受访者发现，上门检测和社区外展等接近策略更有效。
