資料載入中.....
|
請使用永久網址來引用或連結此文件:
http://libir.tmu.edu.tw/handle/987654321/63115
|
| 題名: | Association between risky sexual behaviours, sexual violence and HIV testing uptake among girls aged 15-24 years in Malawi: evidence from the MPHIA 2015-2016 survey |
| 作者: | CHIMPANGO, CHARITY |
| 貢獻者: | 全球衛生暨發展碩士學位學程
SANNA, MATTIA |
| 關鍵詞: | HIV testing;risky sexual behaviour;sexual violence;adolescent girls and young women |
| 日期: | 2023-05-30 |
| 上傳時間: | 2023-12-07 09:42:10 (UTC+8) |
| 摘要: | 簡介：愛滋病毒仍然是全球健康問題，估計到 2020 年將有 3,770 萬人感染該病毒。儘管取得了一些進展，但撒哈拉以南非洲地區仍然是全球愛滋病毒傳播中心，青少年中的新感染人數並沒有下降，因為與其他年齡段的人一樣快。馬拉維的情況也是如此，該國新增愛滋病毒感染總數的三分之一是 15-24 歲的少女和年輕女性 (AGYW)。
由於愛滋病毒檢測對於識別、聯繫和留住青少年接受治療以確保減少病毒傳播至關重要，聯合國艾滋病規劃署 (UNAIDS) 設定了一個目標，即到 2025 年讓 95% 的愛滋病毒感染者了解自己的狀況。不幸的是，馬拉維似乎無法實現這一目標，因為到 2021 年，只有 88.3% 的愛滋病毒感染者知道自己的狀況。由於持續存在危險性行為和遭受性暴力，馬拉維的 AGYW 更容易受到與性行為相關的健康風險包括 愛滋病毒 在內的活動（Machira、Maonga 和 Chirwa，2020；Nguyen 等人，2021）。因此，本研究旨在評估馬拉維 15-24 歲女孩的危險性行為、性暴力和艾滋病毒檢測率之間的關聯。
方法：本研究使用的數據集是馬拉維基於人口的愛滋病毒影響評估調查（MPHIA），這是衛生部於 2015-2016 年進行的一項全國代表性調查。對從 2,769 名 15-24 歲女性個體收集的有關危險性行為（首次性行為年齡、安全套使用、性伴侶數量、性交易和伴侶愛滋病毒狀況意識）和性暴力暴露的數據進行了分析。使用邏輯回歸分析來估計根據社會人口因素調整後的比值比及其 95% 置信區間。
結果：年齡、婚姻狀況、地區、宗教、安全套使用和性暴力暴露被確定為馬拉維 AGYW 愛滋病毒檢測的重要預測因素。 20-24 歲的女性比 15-19 歲的女性更有可能接受檢測（AOR=3.850，95% CI：2.395-6.190）。目前已婚和以前已婚的 AGYW 比從未結婚的人更有可能接受檢測（分別為 AOR=6.974，95% CI：3.935-12.360；AOR=5.074，95% CI：1.452-17.724）。中部地區的女孩參加檢測的可能性低於北部地區的女孩（AOR= 0.277，95% CI：0.107-0.717）。穆斯林女孩比基督教女孩更有可能接受測試（AOR=2.758，95% CI：1.125-6.763）。經常使用安全套的女孩比始終使用安全套的女孩更有可能接受檢測（AOR= 1.750，95% CI：1.030-2.972）。遭受過性暴力的 AGYW 比那些自稱從未經歷過性暴力的人更有可能接受過檢測（AOR=2.154，95% CI：1.097-4.229）。
結論：低檢測率可能對預防愛滋病毒傳播和到 2030 年結束這一流行病的努力構成挑戰。因此，這些結果強調需要製定更有針對性和基於風險的戰略和政策，並特別關注青少年、未婚、基督教女孩和來自中部地區的女孩，以確保 AGYW 免受愛滋病毒感染，並為國家發展做出貢獻。需要進一步研究來找出愛滋病毒檢測的所有障礙以及它們如何運作，以提出有針對性的干預措施來增加 AGYW 中的愛滋病毒檢測。
Introduction: HIV remains a global health concern with an estimate of 37.7 million people living with the virus in 2020. Despite some progress has been made, sub-Saharan Africa is still the global epicentre of HIV transmission and new infections among adolescents are not declining as quickly as among other age groups. Such is also the case in Malawi, where one third of the total new HIV infections are among adolescent girls and young women (AGYW) aged 15-24.
Since HIV testing is vital to identifying, linking and retaining adolescents in treatment to ensure reduced transmission of the virus, United Nations AIDS (UNAIDS) set a target of getting 95% of those living with HIV aware of their status by 2025. Unfortunately, Malawi does not appear to be on track to reach this goal, as only 88.3 % of people living with HIV knew their status in 2021. Due to persistent risky sexual practices and exposure to sexual violence AGYW in Malawi are more susceptible to health risks associated with sexual activity including HIV (Machira, Maonga, & Chirwa, 2020; Nguyen et al., 2021). This study therefore aims at assessing the association between risky sexual behaviours, sexual violence and HIV testing uptake among 15-24 years old girls in Malawi.
Method: The dataset used in this study is the Malawi Population- based HIV Impact Assessment survey (MPHIA), a nationally representative survey conducted in 2015- 2016 by the Ministry of Health. Data about risky sexual behaviours (age at first sex, condom use, number of sexual partners, transactional sex and awareness of partners’ HIV status) and sexual violence exposure collected from 2,769 female individuals aged 15-24 were analysed. Logistic regression analysis was used to estimate odds ratios adjusted for socio-demographic factors, along with their 95% confidence intervals.
Results: Age, marital status, region, religion, condom use and exposure to sexual violence, were identified as significant predictors of HIV testing among AGYW in Malawi. Women aged 20-24 years were more likely to have tested than those aged 15-19 years (AOR=3.850, 95% CI: 2.395-6.190). AGYW currently and previously married were more likely to have tested, than those never married (AOR=6.974, 95% CI: 3.935-12.360; AOR=5.074, 95% CI: 1.452-17.724, respectively). Girls from the Central region were less likely to have tested than those from the Northern region (AOR= 0.277, 95% CI: 0.107-0.717). Muslim girls were more likely to have tested than the Christian girls (AOR=2.758, 95% CI: 1.125-6.763). Girls who inconsistently used a condom were more likely to have tested than those who always used a condom (AOR= 1.750, 95% CI: 1.030-2.972). AGYW exposed to sexual violence were more likely to have tested than those who reported never experiencing sexual violence (AOR=2.154, 95% CI: 1.097-4.229).
Conclusion: Low testing rates may pose a challenge to the efforts to prevent the spread of HIV and ending the pandemic by 2030. Hence these results highlight the need for strategies and policies that are more targeted and risk-based with a specific focus on teenagers, unmarried, Christian girls and those from the central region to ensure that the AGYW live free of HIV and contribute to the development of the country. Further research is needed to find out all the barriers to HIV testing and how they operate to come up with targeted interventions to increase HIV testing among AGYW. |
| 描述: | 碩士
指導教授:SANNA, MATTIA
委員:高志文
委員:莊?智
委員: SANNA MATTIA |
| 資料類型: | thesis |
| 顯示於類別: | [全球衛生暨發展碩士學位學程] 博碩士論文
|
文件中的檔案:
| 檔案 |
描述 |
大小 | 格式 | 瀏覽次數 |
|---|
| index.html | | 0Kb | HTML | 88 | 檢視/開啟 |
|
在TMUIR中所有的資料項目都受到原著作權保護.
|
