Laver S M, van den Borne B, Kok G, Woelk G
Department of Community Medicine, Medical School, University of Zimbabwe, Harare, Zimbabwe.
AIDS Educ Prev. 1997 Feb;9(1):94-110.
A cumulative total of 41,298 AIDS cases have been reported in Zimbabwe as of March 1995. Of concern is the growing evidence of high levels of seroprevalence among rural farm workers. A pre-intervention survey was conducted by interview in one district to examine behavioral factors likely to place farm workers in marginalized rural communities at risk for sexually transmitted diseases (STD) and HIV infection. Seven hundred seventy commercial farm workers from 17 randomly selected commercial farm participated in the study. We found that farm worker communities, which are characterized by educationally disadvantaged women when compared with men (p < .001), have had little exposure to AIDS prevention activities. Beliefs that AIDS is brought about by divine or ancestral retribution were upheld by less education women (p < .001). A significant association was found with respect to perceived risk to HIV and low self-efficacy among uneducated women who articulated helplessness and an inability to protect themselves from HIV infection. Among more educated men, we found acknowledgment about multipartnering and that changes in behavior are more likely to develop as a result of changes in normative values (p = .075). Condom use among men, which is probably the most effective barrier against STD infection, was shown to be associated with age (p < .01) and education (p < .01). The study concludes with recommendations for an appropriate intervention.
截至1995年3月，津巴布韦共报告了41298例艾滋病病例。令人担忧的是，越来越多的证据表明农村农场工人中的血清阳性率很高。在一个地区进行了一项干预前调查，通过访谈来研究可能使边缘化农村社区的农场工人面临性传播疾病（STD）和艾滋病毒感染风险的行为因素。来自17个随机挑选的商业农场的770名商业农场工人参与了这项研究。我们发现，与男性相比，以受教育程度较低的女性为特征的农场工人社区很少接触到艾滋病预防活动（p < 0.001）。受教育程度较低的女性更坚信艾滋病是由神罚或祖先报应引起的（p < 0.001）。在表达无助感且无法保护自己免受艾滋病毒感染的未受过教育的女性中，发现她们对艾滋病毒的感知风险与自我效能感低之间存在显著关联。在受教育程度较高的男性中，我们发现他们承认有多个性伴侣，并且行为改变更有可能因规范价值观的改变而发生（p = 0.075）。男性使用避孕套可能是预防性病感染最有效的屏障，结果显示这与年龄（p < 0.01）和教育程度（p < 0.01）有关。该研究最后提出了适当干预的建议。
