School of Public Health, University of Zambia, Lusaka, Zambia.
Ministry of Health in Zambia, Lusaka, Zambia.
PLoS One. 2024 Jun 5;19(6):e0294545. doi: 10.1371/journal.pone.0294545. eCollection 2024.
In Zambia, 3.8% of young women and men aged 15-24 are HIV positive. However, like in most developing nations, HIV prevalence is higher among young women than young men (5.6% versus 1.8%). Despite the recognition of the rights of young people to sexual reproductive health (SRH) information and services, adolescent and young people (AYP) still face challenges in accessing healthcare in public health institutions including access to comprehensive knowledge on HIV/AIDs, HIV testing and contraceptives. The overall objective of the study was to collect baseline HIV, SRH and gender based violence (GBV) data at district level to inform the design of interventions targeting adolescent girls and young women (AGYW) aged 10-24 years in 20 districts of Zambia.
A cross-sectional, mixed-methods study was conducted in 20 districts of Zambia with the highest incidence of HIV. Data was collected between August and October 2022 with a total response rate of 92% (12,813/13960), constituting 5979 (46.7%) in-school and 6834 (53.3%) out-of-school participants.
Overall, Mwinilunga, Chinsali, Chisamba and Chembe districts had the highest number of respondents, while Sinazongwe and Mungwi districts contributed the least. The overall age distribution was such that 12.6% (n = 1617) of those interviewed were aged 10 to 14 years, 35.4% (n = 4536) were aged 15-19 years, and 52.0% (n = 6660) were aged 20-24 years. The overall mean age at first sex among AGYW interviewed was 16.6 years which was broken down as follows: 16.2 years for in-school and 16.8 years for out of school. Overall, most of the respondents had first time sex with either their boyfriend (80.4%) or husband (15.6%), with 2.4% of the in-school participants reporting to have had their sexual debut in marriage compared to 21.0% among out-of-school AGYW. Prevalence of HIV was higher in the out-of-school compared to the in-school participants (5.5% vs 2.0%), Similarly, the prevalence of syphilis was higher in the out-of-school than the in-school participants (4.1% vs 1.5%).
The study focused on assessing the prevalence and vulnerability of HIV, syphilis, GBV, and SRH services uptake among adolescent girls and young women, and exploring factors affecting girls' stay-in-school and re-engagement. The study found that HIV and syphilis are still significant public health problems among adolescent girls and young women in Zambia, emphasizing the need for increased efforts to prevent and manage these infections.
在赞比亚，15-24 岁的年轻女性和男性中有 3.8%呈 HIV 阳性。然而，与大多数发展中国家一样，HIV 在年轻女性中的流行率高于年轻男性（5.6%对 1.8%）。尽管年轻人享有性生殖健康（SRH）信息和服务的权利得到了承认，但青少年和年轻人（AYP）在获得公共卫生机构的医疗保健方面仍然面临挑战，包括获得关于艾滋病毒/艾滋病、HIV 检测和避孕药具的全面知识。该研究的总体目标是在赞比亚 20 个地区收集 HIV、SRH 和基于性别的暴力（GBV）的基线数据，为针对 10-24 岁的少女和年轻女性（AGYW）设计干预措施提供信息。
在赞比亚 HIV 发病率最高的 20 个地区进行了一项横断面、混合方法研究。数据于 2022 年 8 月至 10 月收集，总响应率为 92%（12813/13960），其中 5979 人（46.7%）在校，6834 人（53.3%）辍学。
总体而言，姆温利朗加、钦萨利、钦巴萨和切姆贝地区的受访者最多，而西纳宗韦和蒙圭地区的受访者最少。总体年龄分布情况如下：接受采访的人中，12.6%（n=1617）年龄在 10-14 岁，35.4%（n=4536）年龄在 15-19 岁，52.0%（n=6660）年龄在 20-24 岁。接受采访的 AGYW 中首次发生性行为的平均年龄为 16.6 岁，具体情况如下：在校者为 16.2 岁，辍学者为 16.8 岁。总体而言，大多数受访者的第一次性行为是与他们的男朋友（80.4%）或丈夫（15.6%）发生的，而 2.4%的在校参与者报告说他们的性初体验是在婚姻中，而辍学者的比例为 21.0%。与在校参与者相比，辍学者的 HIV 感染率更高（5.5%比 2.0%），同样，与在校参与者相比，梅毒的感染率在校外参与者中更高（4.1%比 1.5%）。
该研究重点评估了 HIV、梅毒、GBV 和青少年女孩和年轻女性获得性健康服务的流行率和脆弱性，并探讨了影响女孩留（辍）学和重新入学的因素。研究发现，HIV 和梅毒仍是赞比亚青少年女孩和年轻女性的重大公共卫生问题，这强调了需要加大努力预防和管理这些感染。
