International Centre for Reproductive Health (ICRH), Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
Department of Health Policy Planning and Management, Makerere University School of Public Health, Kampala, Uganda.
BMJ Open. 2023 May 29;13(5):e065239. doi: 10.1136/bmjopen-2022-065239.
Venues where people socialize, such as bars, play a significant role in HIV transmission risk. However, little research has been done that identifies characteristics of high-risk venues, to inform HIV prevention efforts. This study identified clusters of social venues in Uganda and their relationship with HIV vulnerability of young venue workers (15-24 years). We also assessed availability of HIV prevention services at the venues.
This was a secondary analysis of data from a larger cross-sectional survey of social venues in 25 districts of Uganda.
A total of 480 venues that employed young workers were included in this study.
Hierarchical cluster and mixed-effects regression analyses were conducted.
Four clusters were adopted: cluster 1 represented 127 venues (mainly alcohol-serving sex work venues with a provision of on-site sex); cluster 2 represented 80 venues (mainly alcohol-serving sex work venues without a provision of on-site sex); cluster 3 represented 113 venues (mainly alcohol-serving venues without sex work or on-site sex); and cluster 4 represented 160 venues (non-alcohol-serving venues). We found a positive correlation between venue clusters and HIV vulnerability. Workers who belonged to cluster 1 (alcohol-serving sex work venues with a provision of on-site sex) had a 0.15 increase in HIV vulnerability compared with those in alcohol-serving venues without sex work or a provision of on-site sex (cluster 3) (coefficient: 0.15, 95% CI: 0.030 to 0.287) after adjusting for age, sex and marital status. Thirty-seven per cent of cluster 1 venues reported any HIV prevention services in the past 12 months.
Alcohol-serving sex work venues with a provision of on-site sex (cluster 1) appeared to reinforce vulnerability to HIV in this study and should be targeted with HIV prevention interventions. Such venues can amplify HIV transmission by facilitating sexual partner coupling and on-site sex.
人们社交的场所，如酒吧，在艾滋病毒传播风险中起着重要作用。然而，很少有研究确定高风险场所的特征，以告知艾滋病毒预防工作。本研究确定了乌干达社交场所的集群及其与年轻场所工作人员（15-24 岁）艾滋病毒脆弱性的关系。我们还评估了场所提供艾滋病毒预防服务的情况。
这是对乌干达 25 个地区更大的社交场所横断面调查数据的二次分析。
共有 480 个雇用年轻工人的场所纳入本研究。
进行了层次聚类和混合效应回归分析。
采用了四个聚类：聚类 1 代表 127 个场所（主要是提供现场性服务的含酒精性工作场所）；聚类 2 代表 80 个场所（主要是提供现场性服务的含酒精性工作场所，没有提供现场性服务）；聚类 3 代表 113 个场所（主要是提供现场性服务的含酒精性工作场所）；聚类 4 代表 160 个场所（非含酒精性工作场所）。我们发现场所聚类与艾滋病毒脆弱性呈正相关。与在没有性工作或没有现场性服务的含酒精性工作场所（聚类 3）工作的工人相比，属于聚类 1（提供现场性服务的含酒精性性工作场所）的工人艾滋病毒脆弱性增加了 0.15（系数：0.15，95%CI：0.030 至 0.287），调整年龄、性别和婚姻状况后。37%的聚类 1 场所报告在过去 12 个月内提供了任何艾滋病毒预防服务。
本研究中，提供现场性服务的含酒精性性工作场所（聚类 1）似乎加剧了对艾滋病毒的脆弱性，应该成为艾滋病毒预防干预的目标。这些场所可以通过促进性伴侣结合和现场性行为来放大艾滋病毒的传播。
