RESUMEN
(1) As of 2011, 38% of young Zimbabwean women have had sex by age 18, as have 23% of young men; this difference has widened over time. Females now first have sex nearly two years sooner than males. (2) One-quarter of 15-19-year-old women have started childbearing; one-third of all births to adolescents are unplanned (wanted later or not at all). (3) Favorable trends of rising modern contraceptive use in urban areas were likely interrupted by the worst of the economic crisis in 2008. Use among married adolescents declined in urban areas (from 50% in 2006 to 29% in 2011), even as it rose in rural areas (from 30% to 37%). (4) Patterns in unmet need for contraception followed suit: In urban areas, the proportion of married adolescents who wanted to postpone childbearing but were not using a method rose between 2006 and 2011(from 14% to 28%); among their counterparts in rural areas, unmet need fell from 20% to 15% over this period. (5) Single, sexually active adolescents have by far the greatest unmet need--62% as of 2011, compared with 19% among their married counterparts. (6) Existing policies need clarification to assure that no adolescent is illegally denied services because of age. Youth-friendly sexual and reproductive health programs should be prioritized so today's HIV-positive adolescents, many of whom have been infected since birth, do not transmit the virus to yet another generation.
Asunto(s)
Anticoncepción/estadística & datos numéricos , Necesidades y Demandas de Servicios de Salud , Embarazo en Adolescencia/etnología , Servicios de Salud Reproductiva/estadística & datos numéricos , Conducta Sexual/etnología , Adolescente , Condones/estadística & datos numéricos , Femenino , Infecciones por VIH/epidemiología , Infecciones por VIH/etnología , Política de Salud , Humanos , Ilegitimidad/etnología , Masculino , Matrimonio , Embarazo , Embarazo en Adolescencia/estadística & datos numéricos , Población Rural , Población Urbana , Zimbabwe/etnologíaRESUMEN
OBJECTIVES: This study represents a comprehensive assessment of differences between participants in an HIV/AIDS prevention program (SHAPE: Sustainability, Hope, Action, Prevention, Education) and non-participants in knowledge, attitudes and practices with a focus on cultural, sociological and economic variables. METHODS: We developed an eight-page questionnaire that was administered to 933 randomly selected students at the University of Zimbabwe. Survey items addressed sexual decision-making, condom use, limiting sexual partners, cultural power dynamics and access to HIV testing. RESULTS: Results show participants are statistically more likely to report being sexually abstinent, and understand the prevention benefits of condom use. SHAPE members had fewer sexual partners in the previous year than non-SHAPE members (1.4 vs. 2.2). SHAPE members were significantly more likely (67%) than non-SHAPE respondents (48%) to indicate that they knew their HIV sero-status and to state that they knew their status because they had been tested (85% vs. 71%). DISCUSSION: Though we found differences between the groups suggesting that program participation increases awareness concerning gender equity, there continue to be many intractable cultural attitudes in this age group. Findings suggest that the attitudes and practices of young men and women are changing, but that progress in some areas does not assure progress in all areas.
Asunto(s)
Países en Desarrollo , Infecciones por VIH/prevención & control , Conocimientos, Actitudes y Práctica en Salud , Estudiantes , Síndrome de Inmunodeficiencia Adquirida/prevención & control , Adolescente , Adulto , Estudios de Cohortes , Condones , Estudios Transversales , Toma de Decisiones , Transmisión de Enfermedad Infecciosa/prevención & control , Femenino , Infecciones por VIH/transmisión , Programas Gente Sana/tendencias , Humanos , Masculino , Sexo Seguro , Abstinencia Sexual , Encuestas y Cuestionarios , Universidades , ZimbabweRESUMEN
We assess gender differences in HIV prevention knowledge, attitudes and practices with a focus on cultural, sociological, and economic variables. A randomized cross-sectional study was used in order to achieve high participation and broad comparative assessment. An eight-page questionnaire was administered to 933 randomly selected students at the University of Zimbabwe. Survey items addressed sexual decision-making, condom use, limiting sexual partners, cultural power dynamics and access to HIV testing. We found marked gender differences with men reporting beliefs of entitlement to dominate women, an assumed leadership in decision-making concerning condom use and an attitude that when a woman says "no" to sex, really, "it depends." Women acknowledged gender-based cultural attitudes but are much more likely to support women's rights to sexual expression. A multi-faceted approach to gender equity training is needed to challenge men and women to change attitudes and increase social awareness that respects cultural traditions while still inspiring both men and women to champion justice and equality between genders.