Forsberg A D, King G, Delaronde S R, Geary M K
New England Hemophilia Center, Medical Center of Central Massachusetts, Worcester 01605, USA.
AIDS Care. 1996 Dec;8(6):629-40. doi: 10.1080/09540129650125353.
Adolescents with haemophilia comprise 44% of the reported AIDS cases in teenagers. Unprotected sexual intercourse among this group increases the risk of HIV transmission. Understanding the influences which others may have on the sexual behaviour of adolescents with HIV and haemophilia may lead to the development of effective risk reduction strategies. An evaluative instrument, administered to 307 HIV-infected adolescents with haemophilia, assessed their behavioural stage of change (Prochaska & DiClemente), attitudes, beliefs and behaviours about safer sex practices. The influence of parents, peers and sexual partners on sexual behaviour was compared between (1) those who were sexually experienced and (2) and those who were sexually inexperienced. Barriers and facilitators to practising safer sex were identified. Although parents influenced the sexual behaviour of both groups, this influence was significantly greater in the sexually inactive group. Fewer than 20% reported that their peers impacted their decisions about sexual behaviour. Eighty-six per cent of the sexually active indicated that partners significantly impacted their sexual decisions, while 60% of the sexually inactive indicated that future partners would affect their decisions about sex. Most participants agreed that disclosure of HIV status before intercourse was desirable, but only 31% of the sexually active said they told every partner. Fear of rejection or a negative reaction from the partner, and lack of communication skills were the greatest barriers to disclosure of HIV status and practising safer sex. This study indicates that behavioural interventions for both groups should focus on developing communication skills and self-efficacy. Interventions should include the key influences for each group--parents for the sexually inactive and partners for the sexually active.
血友病青少年占青少年艾滋病报告病例的44%。该群体中的无保护性行为会增加艾滋病毒传播的风险。了解他人可能对感染艾滋病毒和血友病的青少年性行为产生的影响，可能会促成有效的风险降低策略的制定。一项评估工具应用于307名感染艾滋病毒的血友病青少年，评估他们的行为改变阶段（普罗查斯卡和迪克莱门特）、对安全性行为的态度、信念和行为。比较了父母、同伴和性伴侣对性行为的影响，比较对象为（1）有性经验者和（2）无性经验者。确定了实行安全性行为的障碍和促进因素。虽然父母对两组的性行为都有影响，但这种影响在性不活跃组中明显更大。不到20%的人报告说同伴影响了他们关于性行为的决定。86%的性活跃者表示伴侣对他们的性决定有重大影响，而60%的性不活跃者表示未来的伴侣会影响他们关于性的决定。大多数参与者同意在性交前披露艾滋病毒感染状况是可取的，但只有31%的性活跃者说他们告诉了每一个伴侣。害怕被伴侣拒绝或有负面反应以及缺乏沟通技巧是披露艾滋病毒感染状况和实行安全性行为的最大障碍。这项研究表明，针对两组的行为干预都应侧重于培养沟通技巧和自我效能感。干预应包括对每组的关键影响因素——对性不活跃者来说是父母，对性活跃者来说是伴侣。
