Shrader Cho-Hee, Jovanovski Straso, Saito Suzue, Reed Domonique, Ndagije Felix, Greenleaf Abigail
Cho-Hee Shrader, PhD, MPH, is a Postdoctoral Research Scholar and MS Nursing Student, Arizona State University, College of Nursing and Health Innovation, Phoenix, Arizona, USA.
Straso Jovanovski, PhD, is a Data Analyst, ICAP at Columbia University, New York, New York, USA.
J Assoc Nurses AIDS Care. 2025 Jan 9. doi: 10.1097/JNC.0000000000000520.
Adolescent girls and young women ages 15-29 years (AGYW) living in Lesotho experience a disproportionate HIV burden. Using a household-based national survey in Lesotho, we conducted a three-step latent class analysis to identify typologies of AGYW most vulnerable to HIV infection. We first classified AGYW into HIV vulnerability groups based on self-reported sexual behaviors, then identified associations between typology and HIV diagnosis. HIV vulnerability behaviors included early sexual debut, condomless sex, multiple sexual partners in the past year, sex with partners they do not know the status of or are living with HIV, age disparate sex, use of contraceptives, and having children. Across all age groups, we found that HIV vulnerability typologies could be described as low vulnerability, high vulnerability, and parous. As AGYW age, they engage in more types of higher vulnerability sexual behaviors; interventions to reduce this risk should start at a younger age. Our findings emphasize the importance of implementing and scaling up biomedical strategies such as pre-exposure prophylaxis.
生活在莱索托的15至29岁少女和年轻女性（AGYW）承受着不成比例的艾滋病毒负担。我们利用莱索托一项基于家庭的全国性调查，进行了三步潜在类别分析，以确定最易感染艾滋病毒的AGYW类型。我们首先根据自我报告的性行为将AGYW分为艾滋病毒易感染群体，然后确定类型与艾滋病毒诊断之间的关联。艾滋病毒易感染行为包括初次性行为过早、无保护性行为、过去一年中有多个性伴侣、与不知其感染状况或感染艾滋病毒的伴侣发生性行为、年龄差距较大的性行为、使用避孕药具以及生育。在所有年龄组中，我们发现艾滋病毒易感染类型可描述为低易感性、高易感性和已生育。随着AGYW年龄增长，她们会参与更多类型的高易感性性行为；降低这种风险的干预措施应从更年轻的时候开始。我们的研究结果强调了实施和扩大暴露前预防等生物医学策略的重要性。
