恢复力因素作为缓冲对坦桑尼亚男同性恋者艾滋病毒风险和感染的综合条件的影响

A. Adeboye, M. Ross, M. Wilkerson, A. Springer, H. Ahaneku, Rafeek A. Yusuf, T. Olanipekun, S. McCurdy
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引用次数: 3

摘要

背景:在坦桑尼亚和撒哈拉以南非洲其他国家极度恐同的情况下,与男性发生性关系的男性(MSM)经历了不成比例的艾滋病毒感染和心理健康问题,但尚未进行任何研究来检验这些逆境对其经历的协同或相加影响。虽然主要基于赤字的研究方法已经确定了各种艾滋病毒风险和脆弱性,但这些男性对这些与健康相关的逆境自然采用的任何自然发生的保护性和恢复力因素仍不确定。目的:本研究考察了心理社会健康问题对HIV感染和HIV风险的综合征影响,同时试图确定任何可能缓冲高危坦桑尼亚男男性行为者HIV感染和风险行为综合征产生的恢复力或保护因素。这些综合性健康问题被称为SAVID(无公寓性行为期间的药物滥用、儿童和青少年性虐待、暴力、内化的同负性和抑郁)方法:使用居住在达累斯萨拉姆和坦噶的坦桑尼亚男男性行为者的人口特征、艾滋病毒流行率和风险的横断面数据来检查艾滋病毒是否按比例增加随着综合征数量的增加,感染和风险增加。使用Logistic回归分析来测试综合征条件之间的相互作用,并确定任何潜在的恢复力因素,作为在这些男性中建立预防综合征产生的HIV感染和风险的一种方法。在保护性恢复力因素(调节因子)——支持、年龄可见性——与新冠肺炎综合征之间的相互作用水平上;与熟人中社会知名度较低的人相比,熟人中社会关注度较高的人感染艾滋病毒的几率较低。结果:结果显示,SAVID综合征成分数量的增加与艾滋病毒感染率和风险的增加之间存在显著的加性关联。在各种已确定的潜在复原力因素中,发现三种功能性社会支持、性取向自我意识年龄和熟人的正式社会知名度与感染艾滋病毒的几率较低直接相关。在保护性恢复力因素(调节因子:功能性社会支持、性取向意识年龄和熟人之间的正式社会可见性)与新冠肺炎综合征之间的相互作用水平上,只有那些在熟人中社会知名度较高的MSM样本与在熟人中正式社会知名度较低的MSM相比,感染艾滋病毒的几率较低成本效益高,是一种适用于极端恐同环境中男男性行为者的新型健康促进策略。
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Resilience Factors as a Buffer against the Effects of Syndemic Conditions on HIV Risk and Infection among Tanzanian MSM
Background: In the extremely homophobic conditions in Tanzania and other countries in sub-Saharan Africa (SSA), men who have sex with men (MSM) experience disproportionate amounts of both HIV infection and psychosocial health problems, but no research has been conducted to examine the synergistic or additive effects of these adversities on their experiences. While the predominantly deficit-based research approach has identified various HIV risks and vulnerabilities, any naturally occurring protective and resilience factors that these men naturally employ to these health-related adversities remain undetermined. Purpose: This study examined the syndemic effects of psychosocial health problems on HIV infection and HIV risk and simultaneously sought to identify any resilience or protective factors that may buffer against the syndemic production of HIV infection and risk behavior among high-risk Tanzanian MSM. These syndemic health problems were coined as SAVID (Substance abuse during condomless sex, childhood and adolescent sexual abuse, violence, internalized homonegativity and depression) Methods: Cross-sectional data on demographic characteristics and HIV prevalence and risks among Tanzanian MSM residing in Dar es Salaam and Tanga were used to examine whether there is a proportional increase in HIV infection and risk as the number of syndemic conditions increases. Logistic regression analysis was used to test for interactions between syndemic conditions and to identify any potential resilience factors as a way of establishing protection against the syndemic production of HIV infection and risk among these men. At the level of interaction between protective resilience factors (moderators)-support, age visibility- and SAVID syndemic; those that reported high social visibility among Acquaintance have lower odds of contracting HIV infection when compared to those that have lower social visibility among acquaintances Results: The results revealed significant additive associations between increasing numbers of SAVID syndemic components and higher rates of HIV infection and risk. Among a variety of identified potential resilience factors, three-functional socio-support, age at self-awareness of sexual orientation and formal social visibility among acquaintances-were found to directly associated with lower odds of contracting HIV infection. At the level of interaction between protective resilience factors (moderators: functional social support, age at awareness of sexual orientation, and formal social visibility among acquaintances) and SAVID syndemics, only those sampled MSM that reported high social visibility among acquaintances had lower odds of contracting HIV infection when compared to sampled MSM that had lower formal social visibility among acquaintances Conclusion: Harnessing naturally-occurring resilience factors through strength-based research approach and innovatively disseminate them through existing secrete social network may be a cost effective and a novel health promotion strategy suitable for MSM in extreme homophobic environment.
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