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首页> 外文期刊>AIDS care. >Sexual risk among orphaned adolescents: is country-level HIV prevalence an important factor?
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Sexual risk among orphaned adolescents: is country-level HIV prevalence an important factor?

机译：孤儿青少年的性风险：国家一级的艾滋病毒感染率是否是重要因素？

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Previous studies from sub-Saharan Africa have found that orphans experience increased sexual risk compared to non-orphans. We developed a theoretical framework for the investigation of determinants of HIV risk and used it to generate specific hypotheses regarding the effect of country-level HIV prevalence on the sexual risk experience of orphans. We expected that countries with high HIV prevalence would experience a higher prevalence of orphanhood. We further hypothesised that orphans in countries with high HIV prevalence would experience increased sexual risk, compared to non-orphans, due to pressure on the extended family network, which is primarily responsible for the care of orphans in sub-Saharan Africa, resulting in poorer standards of care and guidance. We used hierarchical logistic regression models to investigate this hypothesis using cross-sectional, Demographic and Health Survey data from 10 sub-Saharan African countries. We found that countries with high HIV prevalence did indeed have higher prevalence of orphanhood. We also found that, amongst female adolescents, maternal and double orphans were significantly more likely to have started sex than non-orphans in countries with high HIV prevalence but were not at increased risk in low HIV prevalence countries. This effect of country-level HIV prevalence on the sexual risk of orphans was not explained by household level factors such as wealth, overcrowding or age of the household head. The same pattern of risk was not observed for male adolescents - male orphans were not more likely to have started sex than non-orphans. This suggests that orphaned adolescent women are an important target group for HIV prevention and that efforts should be made to integrate prevention messages into existing support programmes for orphans and vulnerable children.
机译：先前来自撒哈拉以南非洲的研究发现，与非孤儿相比，孤儿经历的性风险增加。我们开发了一个理论框架来调查HIV风险的决定因素，并用它来生成关于国家一级HIV流行对孤儿性风险经历的影响的特定假设。我们预计，艾滋病毒感染率较高的国家将患孤儿病的比例更高。我们进一步假设，与非孤儿相比，艾滋病毒高发国家的孤儿会遭受更大的性风险，这是由于家庭网络受到压力，家庭网络主要负责撒哈拉以南非洲孤儿的照料，从而导致贫困状况更加恶化。护理和指导标准。我们使用分层Logistic回归模型，使用来自10个撒哈拉以南非洲国家的横断面，人口统计和健康调查数据来研究此假设。我们发现，艾滋病毒感染率很高的国家确实确实有更高的孤儿患病率。我们还发现，在艾滋病毒感染率高的国家中，女性青少年中，与非孤儿相比，孕产妇和双重孤儿发生性行为的可能性要高得多，但在艾滋病毒感染率低的国家中，未发生这种情况的风险并不高。国家一级的艾滋病毒流行率对孤儿性风险的影响没有通过家庭层面的因素来解释，例如财富，人满为患或户主的年龄。男性青少年未观察到相同的风险模式-男性孤儿比非孤儿更不可能开始性行为。这表明，孤儿是预防艾滋病毒的重要目标群体，应努力将预防信息纳入现有的孤儿和弱势儿童支助方案。

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