Economic Development, Risky Sexual Behavior, and AIDS Epidemics--Theory and Evidence

In this paper, we present a simple theoretical model to investigate how economic development affects AIDS epidemics through its influence on individuals＇ sexual behavior, building on the literature on economic growth with endogenous mortality concern. We employ provincial data from China on the incidence rate of AIDS between 2002 and 2008 to test the theoretical predictions. The findings are： （1） a rise in personal income/wealth induces more safe sexual activities and reduces the prevalence of AIDS; and （2） increases in public health expenditure do not have a significant positive impact on individuals＇ preference of risky sexual activity over safe sexual activity.

Prevalence and Incidence of HIV and Sexual Risk Behaviors in Crack Users in the San Salvador Metropolitan Area, El Salvador

Objective: It is in order to estimate the prevalence and incidence of HIV, the frequency of sexual risk behaviors, and perceptions of available resources to prevent and treat HIV among crack users in the San Salvador Metropolitan Area. Methods: We conducted a survey of 420 crack users by using respondent-driven sampling to measure demographic characteristics, the quantity and frequency of drug use, history of STIs, including HIV, and experiences with organizations which provide prevention and treatment of HIV. Each participant offered a free and voluntary HIV test and was asked permission to share the results of the test with the study. Bernoullian modeling was used to estimate the prevalence and incidence of HIV among heterosexual males in this population. Results: The estimated prevalence was 7% (95% CI: 2.3% -9.8%) among participants who agreed to take the test and share the results, and 4.9% (95% CI: 2.8% -7.8%) assuming that those who did not take the test or share results were seronegative. Participants reported a high frequency of sexual risk behaviors. In addition, participants were reported to have little knowledge of organizations to prevent or treat HIV/AIDS;58% had never taken an HIV test prior to survey administration. Conclusions: Crack users in San Salvador are at high risk for HIV acquisition. HIV prevention interventions are urgently needed, especially interventions increasing access to HIV testing and prevention.

Relationship between Sexual Risk Behaviors and HIV Counseling and Testing (HCT) Uptake among Young People in Nigeria

This study examined the relationship between sexual risk behavior and HIV counselling and testing uptake among young people in Nigeria. Probability sampling technique was used to obtain a sample of 10,091 respondents (ages 15 to 24 years) for the study. The multistage cluster sampling was used to select suitable young people with known probability. Data were collected throughout Nigeria between September and December 2012 from 32,543 households (rural = 22,192;urban = 10,351) using structured and semi-structured questionnaires. The data were summed using descriptive statistics. Frequencies and percentages;measures of central tendencies were used to answer the research question while nonparametric test such as chi-square was used to analyze non-normally distributed data at 0.5 level of significance. Results of data analysis indicated that sexual risk behaviors comprised three variables: sex with multiple partners, intergenerational sex (sex with partners 10 years older), and transactional sex. The results of the chi-square test of association between sex with multiple partners and HCT uptake showed that there was no statistically significant relationship between sex with multiple partners and HCT uptake among young people ages 15 to 24 years in Nigeria. It was among others recommended that sexually active young people in Nigeria should use protection against HIV infection.

Parenting Skills Determinant in Preventing Adolescents’ Sexual Health Risk Behavior

Parenting skill is one of the crucial needs that parents must have in caring adolescents’ sexual health risk behavior. Present study aims to determine predictors of parenting skills in preventing adolescents’ sexual health risk behavior. A cross sectional study was conducted among adolescents’ parents who attended government health clinics in a semi-urban district, West Malaysia. Data were collected by systematic random sampling using validated questionnaire from eight government health clinics based on routine daily out-patient services. There were 386 respondents participated with 98.9% of response rate. Parental skill is categorized as appropriate or inappropriate based on Trans-Theoretical Model (TTM) staging. Eighteen independent variables were used: parental socioeconomic status, adolescent characteristic, parenting style, parent-adolescent communication, parental stress, perception on adolescent sexual risk, comfortable in discussing sexual issues, knowledge in sexual reproductive health (SRH) and knowledge in HIV/AIDS. Assessment of parenting skills using the TTM stage showed 139 respondents (36%) had inappropriate parenting skills, in which they were in pre contemplation, contemplation or preparedness stages, while 247 respondents (64%) showed appropriate parenting skills when they were in action and maintenance stages of TTM. Older parent, late adolescent, low parental education level, extended family living arrangement, comfortable in discussing sexual issues, good parent-adolescent communication and higher knowledge in HIV/AIDS were found significant in bivariate analysis. Multivariate logistic regression analysis identified older parent (AOR = 1.927, 95% CI = 1.889 - 1.966, p < 0.001), lower parental education (AOR = 2.394, 95% CI = 1.348 - 4.254, p = 0.003), comfortable in discussing sexual issues (AOR = 3.810, 95% CI = 1.622 - 8.948, p = 0.002), good parent-adolescent communication (AOR = 4.741, 95% CI = 2.478 - 9.071, p ≤ 0.001) and having higher knowledge on HIV/AIDS (AOR = 2.804, 95% CI = 1.528 - 5.147, p = 0.001) as significant predictors for appropriate parenting skills in preventing adolescent sexual health risk behavior. In conclusion, more than one third of parents were still not ready in preventing adolescent sexual risk behavior. Targeting the young parents and those having difficulty in communicating sexual issues with theirs adolescents should be emphasized in early intervention program for parents. Self-assessment using TTM stage questionnaire will help parents to identify their parenting skills in preventing adolescent sexual health risk behavior.

Epidemiology of Sexual Behaviour with Risk of Sexually Transmissible Infection (STI) among Students in Africa: The Case of the University of Ouagadougou

Objective: To study the sexual risk behaviors and their determining role in sexually transmissible infection (STI) and HIV among students of the University of Ouagadougou. Methodology: It was a descriptive and analytical single pass cross-sectional study from June 22 to July 21 2010 at the University of Ouagadougou. A cluster sampling in two stages was adopted to form a population of 762. Data were collected using a standardized written questionnaire completed by individual interview after informed consent. Results: The average age of students was 24.2 ± 2 years old for men and 23.7 ± 2 years old women. Singles represented 95.1% of students. The students were not scholarship grantees in 90.6% of the sample. Knowledge about STIs was average in 60.2% of cases. In total 33.65% of the students admitted to having had multiple sexual partners, 19.57% had sex with prostitutes, 34.62% had unprotected sex, 4% practiced sodomy without condoms and 3.1% of students had sex in group with one partner. In multivariate analysis, male gender was the determining factor associated with multiple sexual partner (OR = 3.30 95% CI = 2.19 to 4.95) and relations with prostitutes with an odds ratio of 16.13 (95 = 6.87% to 37.8%). The female gender was the determining factor associated with not using a condom with odds ratio of 1.5 (95% CI = 1.01 to 2.16). Conclusion: There are many risk behaviors for HIV transmission among students of the University of Ouagadougou. The urgent implementation of specific prevention programs to benefit this population is essential.

2013—2022年重庆市巴南片区新发现HIV/AIDS病例特征分析

目的:了解重庆市巴南片区2013—2022年新发现人类免疫缺陷病毒(HIV)/艾滋病(AIDS)病例的变化趋势和流行病学特征,为相关部门制定防控策略提供参考依据。方法:在重庆市艾滋病检测系统及巴南区艾滋病确证信息报告系统中,收集2013—2022年巴南片区新发现HIV/AIDS病例的流行病学特征信息,并进行统计学分析。结果:2013—2022年重庆市巴南片区新发现HIV/AIDS病例6077例,病例数呈逐年上升趋势,年均增长率为13.21%;45岁以上人群新发现病例的占比呈明显上升趋势,年均增长率为24.97%;病例以男性为主,男女性别比为2.43∶1;婚姻状况以已婚为主,占51.69%;文化程度以小学及文盲为主,占39.66%;职业为农民最多,占35.54%;有55.29%的新发现HIV/AIDS病例是在医疗机构就医时被发现的;主要感染途径是通过异性性传播,占95.06%。结论:目前,重庆市巴南片区防控AIDS最有效的方法是减少人群高危性行为发生。相关部门应加强安全性教育,全面普及宣传AIDS的防治知识,提升居民特别是中老年群体AIDS防治、性健康意识、自我保护能力及风险意识,减少人群高危性行为的发生,增强人群的主动检测意识,扩大检测人群及检测量,从而进一步提升AIDS防治水平。

基于IMB模型的某医科大学大学生危险性行为中介效应分析

目的 了解大学生艾滋病预防知识和能力,探索危险性行为发生的关键作用因素。方法 通过多阶段PPS-整群抽样,对某医科大学在校生进行问卷调查。基于信息-动机-行为技巧模型(IMB模型)构建问卷,采用中介效应模型验证行为技巧在动机对行为影响中的中介作用。结果 共回收有效问卷1424份,有效回收率99.37%。信息和动机是两个独立因素,通过行为技巧影响行为,信息对行为无直接作用。行为技巧在动机对行为的影响中起部分中介作用[a^(std)*b^(std)/(c'+a^(std)*b^(std))=15.24%]。结论 要根据大学生的特征从更贴近行为层面的作用因素制定针对性干预措施。

敬畏与遵守社会规范行为的关系——有调节的中介模型

探讨公众遵守社会规范行为的影响因素是当下研究的重要主题之一.在疫情背景下,以遵守防疫行为准则为例,采用问卷法(被试805名)和实验法(被试105名),考察敬畏与公众遵守社会规范行为的关系,以及风险感知在其中的中介作用和心理控制源的调节作用.结果发现:特质敬畏与状态敬畏对公众的风险感知、遵守防疫行为准则均有正向预测作用;风险感知在特质敬畏和特定情景敬畏条件下与遵守防疫行为准则之间起部分中介作用,而在一般自然景观敬畏条件下,风险感知在其中起完全中介作用;敬畏与风险感知的关系受到心理控制源的调节,且在特质敬畏与状态敬畏条件下调节效果有所不同,但在外控倾向条件下,敬畏对风险感知的预测作用更强.研究结果有助于理解敬畏促进公众遵守社会规范行为的作用机制,对促进公众遵守社会规范行为的政策制定具有借鉴意义.

我国城、乡高中生性行为发生的比较

目的:了解中国城、乡高中生性行为发生现状,为制定适宜的性教育提供依据。方法:采取无记名自填问卷方式,按照分层整群抽样方法,对28个省级单位224 770名高中生进行中国青少年健康危险行为问卷调查。结果:我国高中生性行为的报告率为5.9%,城、乡分别为6.2%和5.2%(χ2=83.290,P<0.01),男、女生分别为8.8%和3.3%(χ2=2944.456,P<0.01)。在发生过性行为的学生中,被迫性行为报告率为44.6%,城、乡分别为43.5%和47.5%(χ2=16.237,P<0.01),男、女生分别为39.7%和55.8%(χ2=285.089,P<0.01)。Logistic回归分析发现,无论城、乡,男生、高年级、职业高中、长期不与父母同住、生活在西部地区都是高中生发生性行为的危险因素。城、乡被迫性行为发生的模式略有不同,但女生、普通高中、长期不与父母同住和生活在西部地区是高中生发生被迫性行为的危险因素。结论:为高中生,尤其是职业中学学生、长期不与父母同住的学生和西部地区学生进行科学、系统的性教育是十分必要的。

静脉吸毒人群HIV感染危险因素研究

目的 了解四川省凉山地区静脉吸毒人群艾滋病病毒感染危险因素。方法 以社区为基础 ,调查静脉吸毒人群艾滋病病毒感染危险因素。结果 静脉吸毒人群艾滋病病毒感染率为 11 3 % (43 / 3 79)。在多因素Logistic回归模型分析中 (P <0 0 5) ,共用注射器具 10次及以上的OR值为 2 0 3 4。在多因素Logistic回归模型分析中 (P <0 10 ) ,共用注射器具 10次及以上和近 6个月有新的性伙伴是艾滋病病毒感染的危险因素。

深圳市流动人口艾滋病相关性行为及影响因素分析

目的了解深圳市流动人口的艾滋病相关行为及影响因素,为后续干预活动提供政策性建议。方法在深圳市盐田、罗湖、福田三区开展问卷调查。统计分析方法主要包括χ2检验和Logistic回归分析,统计软件采用SAS 8.02软件包。结果本次研究共调查1 014名对象,86.79%的调查对象年龄集中在20～40岁之间,812名对象有性生活。流动人口多性伴比例为47.41%,女性多性伴的危险性低于男性(OR=0.40,95%CI:0.28-0.56),首次性行为对象为非配偶的对象其多性伴的可能性高于首次性行为对象为配偶的对象(OR=3.87,95%CI:2.72-5.51)。有52.46%的研究对象近一年性生活中使用安全套,单因素分析显示不同性别、不同学历、不同收入、不同户口性质、不同艾滋病知识总分、不同的首次性行为对象以及不同性伴数量的对象,其安全套使用的比例有统计学差异。多因素结果显示性别、知识总分是安全套使用的主要影响因素。与男性相比,女性使用安全套的比例较低(OR=0.47,95%CI:0.34-0.65);与知识总分在60分以下的研究对象相比,知识总分在60分以上的研究对象使用安全套的比例高(OR=2.49,95%CI:1.84-3.36)。结论流动人口中普遍存在艾滋病相关高危行为,建议多部门协调合作,加强流动人口群体的艾滋病防治知识和保护意识的宣传,特别是对男性、首次性行为为非配偶的对象、艾滋病知识较低的对象进行干预。

四川省西昌市静脉吸毒人群梅毒感染状况研究

[目的]了解四川省西昌市静脉吸毒人群梅毒感染情况及其影响因素。[方法]于2005年10～11月在西昌市对静脉吸毒人群进行调查,调查内容包括社会人口学、毒品使用、共用注射器具静脉吸毒以及性行为情况等,同时采集血样进行梅毒抗体检测。[结果]在招募的325名静脉吸毒者中,梅毒感染率为17.2%(56/325),其中男性和女性的梅毒感染率分别为12.8%(35/273)和40.4%(21/53)。多因素Logistic回归模型分析结果显示,女性(OR:4.95;95%CI:2.49～9.83)、彝族(OR:2.44;95%CI:1.25～4.76)和近1个月与临时性伴发生非保护性性交(OR:2.61;95%CI:1.30～5.24)与静脉吸毒人群梅毒感染的关系有统计学意义。[结论]四川省西昌市静脉吸毒人群梅毒感染率高,迫切需要采取措施来提高该地区静脉吸毒人群中安全套的使用。

男男性行为者艾滋病知识及高危性行为调查

目的了解男男性行为者（MSM）艾滋病相关知识状况以及与高危性行为之间的关系,为在该人群中开展行为干预提供依据。方法对同志吧经营者和服务人员进行培训,由他们对到同志吧消费的MSM进行匿名问卷调查。结果了解艾滋病知识的主要来源是报纸、杂志、网站、电视和广播,MSM对传播途径知识掌握的较好,正确率为78.1%～98.9%。而基本知识情况较差,正确率只有12.6%～67.8%。经常登陆同性恋网站、25岁年龄组性取向为同性、居住本市超过6个月的MSM艾滋病传播途径得分均高于不经常登陆网站、25岁年龄组和31岁年龄组、非同性和居住时间少于6个月MSM,差异有统计学意义（P〈0.01）。经常登陆同性恋网站的MSM艾滋病基本知识得分高于不经常登陆网站的MSM,差异有统计学意义（P〈0.01）。艾滋病基本知识性传播途径得分在高危性行为和多性伴中的分布差异无统计学意义。结论该人群中有关HIV知识水平总体不高,知识得分水平与多性伴和高危性行为无关联。

男男性接触者焦虑、抑郁与艾滋病高危性行为的关系

目的:探讨男男性接触者(Men who have sex with men,MSM)心理症状与艾滋病高危性行为的关系。方法:采用无记名方式,运用焦虑自评量表(SAS)和抑郁自评量表(SDS),对在酒吧中活动的MSM 进行焦虑、抑郁症状评定,并对其性取向、性行为和性伴特征进行问卷调查。结果:焦虑、抑郁心理症状检出率分别为45.5%和57.5%。已婚、非同性恋和有过性病史的人比未婚、同性恋和没有性病史的MSM 符合焦虑的比例高(分别为62.5%/41.5%,54.1%/62.5%,72.2%/42.3%,x^2=4.61,3.91,5.81,P<0.05);受教育程度为高中及以下、非同性恋和有过性病史的MSM 抑郁症状检出率较受教育程度为大专以上者、同性恋和没有性病史者高(分别为76.9%/48.7%,70.3%/47.3%,83.3%/54.4%,x^2=11.67,8.89,5.52,P<0.01)。焦虑、抑郁症状与多性伴和艾滋病高危性行为相关联(r=0.19～0.28,P<0.01)。经Logistic 回归分析表明,进入焦虑症状方程的变量为一生中异性性伴数、近2个月同性商业性伴和近6个月无保护阴道性交,进入抑郁症状方程的变量为为受教育程度、性取向和近2个月同性商业性伴。结论:在MSM 人群中进行行为干预时,应当注意他们的心理健康方面的问题。

甘肃泡型包虫病流行与人行为危险因素

目的 泡型包虫病的流行一般呈散发状态 ,甘肃省漳县、岷县局部地区泡球蚴病高度流行。对流行区人群进行影象学和血清流行病学调查的同时 ,进行当地人行为和生活方式的调查。探讨与疾病传播有关的因素。方法 对甘肃省漳县和岷县泡型包虫病 (AE)流行区 2 4 85人 ,经B超和泡球蚴抗原的血清流行病学调查 ,以血清学和影像学检查均为阳性者诊断为泡型包虫病感染者。并对所有对象进行 11项有关问题的询问调查。得出人群相应项目下包虫感染者和未感染人数之间构成比的组成 ,应用完全随机秩和H检验 ,由 χ2 界值表 ,确定与流行有关的因素。结果 确诊为泡型包虫病感染者有 86名 ,绝大部分是农民 ,经统计处理 ,发现AE流行与养狗、猎狐、接触狐皮、生食蔬菜、食用自产蔬菜等活动无关 (P >0 0 5 ) ;与用狗粪作肥料 ,和狗的密切接触有关 (P <0 0 5 )。与养狗的数量、时间 ,自由放养的方式高度相关 (P <0 0 1)。结论 多房棘球绦虫卵对环境污染是最主要的危险因素。少养狗或改变放养犬的不卫生习惯 ,应是防治当地泡型包虫病的重要措施。

保护动机对农村流动人口性病艾滋病高危性行为的预测

农村流动人口已经成为我国性病艾滋病预防干预的重点人群。为了探讨流动人口所存在的性病艾滋病高危性行为,以及保护动机(Protection Motivation)对性病艾滋病高危性行为的预测作用,研究选取2201名从农村到北京打工已有3个月的流动人口为被试,采用问卷调查的形式,要求其自己报告初始性行为发生的时间、性伙伴的数量、商业性行为、性伙伴的性行为、安全套的使用,对我国性病艾滋病严重程度的评估,以及所拥有的性病艾滋病症状知识和传播知识。对904名已发生性行为的流动人口的统计分析发现:(1)农村流动人口存在较多的高危性行为,男性流动人口的高危性行为明显多于女性流动人口;(2)保护动机对农村流动人口的性病艾滋病高危性行为具有明显的预测作用,其中的外在奖励、内在奖励、反应效能和反应代价与农村流动人口的性病艾滋病高危性行为的关系更为密切。研究揭示,保护动机理论可以作为我国今后开展农村流动人口性病艾滋病高危性行为预防干预工作的一个基础。

男男性接触者艾滋病感染危险因素调查

目的了解深圳市男男性接触者的艾滋病高危行为及相关情况,为实施有效的干预措施和制定预防控制对策提供信息和依据。方法采用匿名问卷形式进行横断面调查和血标本采集。结果(1)调查对象以青壮年为主,多数人对自己的患病机会认识不足,在安全套使用上存在着认识和行为分离的现象；广泛存在双性性行为和多性伴现象,持续使用安全套比例低,肛交行为普遍。(2)梅毒感染率为12．3%；HIV感染率为1．75%。结论深圳的MSM已经具备了艾滋病流行的条件,应全面深入进行行为干预,以阻断AIDS的二代传播。

计划行为模型在HIV性风险行为领域的应用与发展

整理和回顾了计划行为模型在HIV性风险行为领域的应用与进展。该模型在不同文化背景、不同样本中,对于HIV性风险行为呈现良好的解释力,但是其整体预测力及内部变量的显著程度仍不时波动。21世纪以来,通过核心变量操作化、新变量引入和结构关系调整,模型获得了较大的扩展和完善。但在模型效度再检验、纳入社会性别视角、克服个体行为模型缺陷,以及强化模型的干预适用性方面仍有较大的发展空间。

婚姻状况对男男性行为者的艾滋病高危性行为影响研究

目的探讨中国男男性行为者(MSM)中,在婚与非在婚亚人群艾滋病高危性行为状况。方法采用定向抽样方法,对9个城市2250名MSM进行匿名问卷调查,比较在婚与非在婚亚人群的高危行为。结果在婚组累计同性性伴数、同性口交性伴数、同性肛交性伴数、近1年内向男性"买"性次数,均明显高于非在婚组(P均<0.01);在婚组与男女性交及最近1次与女性性交时安全套使用率、近6个月内"买"性时安全套使用频率,明显低于非在婚组(P<0.05或0.01);在婚组近6个月内在男同性爱者活动场所与陌生男性性交、最近1次与不熟悉或陌生男性性交、曾经向男性"买"性及有过肛交行为的百分率,明显高于非在婚组(P<0.05或0.01);在婚组近6个月女性性伴数、是男性性工作者、最近1次与男性性工作者性交、有固定的男性伴侣、近1年内性交时曾出血、近1年内在外地与男性性交的百分率,明显低于非在婚组(P<0.05或0.01)。结论MSM中,在婚与非在婚亚人群的高危行为存在诸多差异。婚姻不能制约其高危性行为,为有效阻断艾滋病病毒的传播,应对不同的MSM亚人群选择不同的艾滋病干预措施。