Saaka Sulemana Ansumah, Pienaah Cornelius K A, Stampp Zakara, Antabe Roger
Department of Geography and Environment, University of Western Ontario, London, Canada.
Department of Health and Society, University of Toronto Scarborough, Toronto, Canada.
PLOS Glob Public Health. 2024 Apr 24;4(4):e0003134. doi: 10.1371/journal.pgph.0003134. eCollection 2024.
Women are biologically more susceptible to the Human Immunodeficiency Virus (HIV) and other sexually transmitted Infections (STIs) because receptive sex is riskier than insertive. Despite condom use being the staple preventive method for HIV infection (over 80% efficacy), in Sub-Saharan African countries like Burkina Faso, a high burden of HIV and the unmet need for condom use coexist. Moreover, even though women in SSA are disproportionately HIV positive, they are reportedly less capable of negotiating condom use for HIV risk reduction. Thus, using the Health Believe Model (HBM), this study explored the factors that influence condom use among women within the context of HIV prevention, with a key interest in condom use negotiation. Using the women's dataset of the 2021 Burkina Faso Demographic and Health Survey and applying logistic regression models, this study examined the factors associated with condom use for HIV risk reduction. Women who had confidence to negotiate condom use with their partners (OR = 1.57, P<0.001, 95%CI: 1.29, 1.91), those with secondary education (OR = 1.38, P<0.05, 95%CI: 1.07 1.77), from richest households (OR = 1.64, P<0.05, 95%CI: 1.08, 2.47), the employed (OR = 1.23, P<0.05, 95%CI: 1.02, 1.49), women with knowledge of sexually transmitted infections (OR = 1.58, P<0.001, 95%CI: 1.26, 1.97), those who have ever been tested for HIV (OR = 1.85, P<0.001, 95%CI: 1.52 2.24), as well as those who knew that a healthy-looking person can have HIV (OR = 2.64, P<0.001, 95%CI: 2.15, 3.24) were all significantly more likely to practice condom use for HIV risk reduction. Also, religion and geographical location of participants significantly predicted condom use for HIV risk reduction in the study context. The ability to negotiate condom use, knowledge of HIV and STIs, the socioeconomic status of women, as well as their geographical location, influence their practice of safer sex for HIV risk reduction in Burkina Faso.
从生物学角度来看，女性更容易感染人类免疫缺陷病毒（HIV）和其他性传播感染（STIs），因为接受性行为比插入性行为风险更高。尽管使用避孕套是预防HIV感染的主要方法（有效率超过80%），但在布基纳法索等撒哈拉以南非洲国家，HIV感染负担沉重与避孕套使用需求未得到满足的情况并存。此外，尽管撒哈拉以南非洲地区的女性HIV阳性比例过高，但据报道她们在协商使用避孕套以降低HIV感染风险方面的能力较弱。因此，本研究运用健康信念模型（HBM），在HIV预防背景下探究了影响女性使用避孕套的因素，尤其关注避孕套使用的协商情况。本研究利用2021年布基纳法索人口与健康调查中的女性数据集，并应用逻辑回归模型，考察了与为降低HIV感染风险而使用避孕套相关的因素。那些有信心与伴侣协商使用避孕套的女性（比值比[OR]=1.57，P<0.001，95%置信区间[CI]：1.29，1.91）、接受过中等教育的女性（OR = 1.38，P<0.05，95%CI：1.07，1.77）、来自最富裕家庭的女性（OR = 1.64，P<0.05，95%CI：1.08，2.47）、有工作的女性（OR = 1.23，P<0.05，95%CI：1.02，1.49）、了解性传播感染知识的女性（OR = 1.58，P<0.001，95%CI：1.26，1.97）、曾经接受过HIV检测的女性（OR = 1.85，P<0.001，95%CI：1.52，2.24），以及那些知道外表健康的人也可能感染HIV的女性（OR = 2.64，P<0.001，95%CI：2.15，3.24），都显著更有可能为降低HIV感染风险而使用避孕套。此外，在本研究背景下，参与者的宗教信仰和地理位置也显著预测了为降低HIV感染风险而使用避孕套的情况。在布基纳法索，协商使用避孕套的能力、对HIV和性传播感染的了解、女性的社会经济地位以及她们的地理位置，都会影响她们为降低HIV感染风险而采取更安全性行为的做法。
