理解性别转换干预如何影响青少年的性行为：跨文化视角。

Understanding How Gender Transformative Interventions Affect Adolescent Sexuality: A Cross-Cultural Perspective.

机构信息

Department of Population and Family Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland.

出版信息

J Adolesc Health. 2023 Jul;73(1S):S65-S73. doi: 10.1016/j.jadohealth.2023.02.030.

DOI:10.1016/j.jadohealth.2023.02.030

PMID:37330823

Abstract

PURPOSE

Early adolescence is a critical period for developing healthy sexual and reproductive health (SRH) knowledge, attitudes, and behaviors. However, a gap exists in interventions targeting very young adolescents that encompass the multilevel influences impacting healthy sexuality. This examination of two SRH programs in Indonesia and the Democratic Republic of Congo will elucidate facilitators and barriers to improving young adolescent sexuality.

METHODS

The Growing Up Great! (GUG) intervention in the Democratic Republic of Congo and Semangat Dunia Remaja or Teen Aspirations intervention in three districts in Indonesia were evaluated using the Global Early Adolescent Study survey. Adolescents were interviewed in 2017 and one year later in Kinshasa (n = 2,519). In Indonesia, baseline in 2018 was follow-up in 2020 in Bandar Lampung (n = 948), Denpasar (n = 1,156), and Semarang (n = 1,231). Outcomes included SRH knowledge and communication, awareness of SRH services, and attitudes about sexuality. Analysis followed a difference-in-difference approach to compare changes in each outcome over time between interventions and controls.

RESULTS

Both interventions improved pregnancy and HIV knowledge, while Semangat Dunia Remaja or Teen Aspirations also improved SRH communication. Results differed by site in Indonesia, with Semarang, the site that adhered most closely to intervention design, observed the most improvements. Differential effects were also seen by gender, especially in Kinshasa where girls advanced in SRH communication and knowledge but not boys. Girls in Semarang shifted normative SRH attitudes, and boys in Denpasar improved knowledge.

DISCUSSION

Interventions targeting very young adolescents can improve SRH knowledge, communication, and attitudes, though impact depends on context and implementation. Future programs should incorporate the community and environment influencing adolescent experiences with sexuality.

摘要

目的

青春期早期是培养健康的性和生殖健康（SRH）知识、态度和行为的关键时期。然而，针对非常年轻的青少年的干预措施存在差距，这些措施涵盖了影响健康性行为的多层次影响。本研究对印度尼西亚和刚果民主共和国的两项 SRH 计划进行了考察，以阐明改善青少年性行为的促进因素和障碍。

方法

在刚果民主共和国实施的“成长快乐！”（GUG）干预措施和印度尼西亚三个地区实施的“Semangat Dunia Remaja 或青少年抱负”干预措施，均采用全球早期青少年研究调查进行评估。2017 年对青少年进行了访谈，一年后在金沙萨（n=2519）进行了访谈。在印度尼西亚，2018 年进行了基线调查，2020 年在班达楠榜（n=948）、登巴萨（n=1156）和三宝垄（n=1231）进行了随访。结果包括 SRH 知识和沟通、对 SRH 服务的认识以及对性行为的态度。分析采用差异-差异方法，比较干预组和对照组在每个结果上随时间的变化。

结果

两项干预措施均提高了妊娠和 HIV 知识，而“Semangat Dunia Remaja 或青少年抱负”也提高了 SRH 沟通。印度尼西亚的结果因地点而异，最接近干预设计的三宝垄观察到的改善最多。在金沙萨也观察到了性别差异效应，女孩在 SRH 沟通和知识方面有所进步，而男孩则没有。三宝垄的女孩改变了对 SRH 的规范态度，登巴萨的男孩提高了知识。