Department of Environmental Health, Faculty of Natural Sciences, Mangosuthu University of Technology, Durban, South Africa.
Department of Basic Medical Science, Faculty of Health Sciences, Durban University of Technology, Durban, South Africa.
Res Nurs Health. 2023 Aug;46(4):436-444. doi: 10.1002/nur.22328. Epub 2023 Jun 29.
Socioeconomic determinants of risky sexual behaviors in sub-Saharan Africa are well known. The socioeconomic determinants of the sexual behaviors of university students, however, remain unclear. This case control study aimed to investigate the socioeconomic determinants of risky sexual behavior and HIV seropositivity among university students in KwaZulu-Natal (KZN), South Africa. Participants (N = 500; 375 HIV uninfected and 125 HIV infected) from four public higher educational institutions in KZN were recruited, using a non-randomized strategy. Socioeconomic status was assessed by food insecurity, access to the government loan scheme, and sharing of the bursary/loan with family. The findings of this study suggest that students reporting food insecurity were 1.87 times more likely to have multiple sexual partners; 3.18 times more likely to engage in transactional sex for money; and presented a fivefold higher risk of engaging in transactional sex for basic needs other than money. Accessing the government financing for education and sharing of the bursary/loan with family was also significantly associated with an increased risk of having an HIV seropositive status. A significant association between socioeconomic measures, risky sexual behavior, and HIV seropositivity is demonstrated in this study. Moreover, the socioeconomic risks and drivers when determining and/or developing HIV prevention interventions, including preexposure prophylaxis use, should be considered by healthcare providers based at campus health clinics.
撒哈拉以南非洲的性行为风险的社会经济决定因素是众所周知的。然而，大学生性行为的社会经济决定因素仍不清楚。本病例对照研究旨在调查南非夸祖鲁-纳塔尔省（KZN）大学生性行为风险和 HIV 血清阳性的社会经济决定因素。使用非随机策略，从 KZN 的四所公立高等教育机构招募了 500 名参与者（N=500；375 名 HIV 未感染者和 125 名 HIV 感染者）。社会经济地位通过粮食不安全、获得政府贷款计划以及与家庭分享助学金/贷款来评估。这项研究的结果表明，报告粮食不安全的学生发生多个性伴侣的可能性增加了 1.87 倍；从事性交易以获取金钱的可能性增加了 3.18 倍；从事非金钱基本需求的性交易的风险增加了五倍。获得政府教育资助和与家庭分享助学金/贷款也与 HIV 血清阳性状态的风险增加显著相关。本研究表明，社会经济措施、性行为风险和 HIV 血清阳性之间存在显著关联。此外，医疗保健提供者应考虑在校园健康诊所确定和/或制定 HIV 预防干预措施时的社会经济风险和驱动因素，包括使用暴露前预防。
