博茨瓦纳18至49岁外来工人的HIV/AIDS知识，态度和性行为状况研究

摘要

目的:艾滋病毒/艾滋病是一个真正的紧急情况影响南部非洲，特别是博茨瓦纳，在2008的成年人口中，占主导地位的比例是17.1％。由于工作场所和他们的伴侣的长期分离，移民工人很容易感染艾滋病病毒。虽然已经做了很多在于工人和卡车司机的研究，没有太多的研究探讨移民工人的危险变量，然而移民工人构成在博茨瓦纳和非洲南部最大的职业。这项研究背后的动机是确定农民工参与性风险的行为因素，尊至他们有更大的风险感染艾滋病毒。
　　方法:一个横截面的解释性研究，分析博茨瓦纳的外来务工人员变量增加的性行为模式和扩展艾滋病病毒的危险。在博茨瓦纳的首都哈博罗内和第二大城市弗朗西斯敦，采用一个标准问卷形式的结构面试给900熟练和半熟练的农民工。从二元和多元回归分析，找出连接与受访者的性风险行为贡献因素。
　　结果:它是有趣地注意到艾滋病毒的传播课程的困惑不认可之间移徙工人，尤其是被蚊子叮咬（p=0.04;或0.593，95％ci[0.3540.993]），共享的器物，再到个人感染（p=0.01;或0.082，95％CI[0.011-0.602]）。参与者被要求他们是否认为艾滋病毒/艾滋病是一个为其他人如商业性工作者或同性恋者，而不是自己的问题。188的反应，28(14.9％)同意声明艾滋病毒是为他人解决问题，不是他们自己。多数，160受访者（分别为85.1％），不过，不同意声明，引用，艾滋病毒一个为大家盘点自己的问题。没保护下的性行为被观察到是最常见的性风险行为，移民工人估36.2％。显著地，百分之89.9的农民工与他们的长期伴侣进行无保护的性行为，而其中百分之10.1的人，与他们的临时伴侣进行没保护的性行为。其次最常见的性危险行为，是同时与多个性伴侶进行性行为。约百分之52的流徙民工被发现在采访的前六个月中，有多次的同时性行为。交易性行为，包括物质支持的交易有百分之72.1作为影响流徙民工参加同时关系的关键变量。商业性行为，尽管很少报道，仅占百分之10.8的农民工。在多变量分析中，利用逻辑回归模型对与在面试前的六个月内有一个不同的并发性关系进行了分析。有四个变量引至在采访六个月前的多种并发性关系。这些因素包括移徙工人的年龄，每月工资，工作环境和主要伴侣的分离。年龄较大的移民工人，不太愿意吸引到各种并发的关系（95％可信区间为0.79至1.21），[在危险与每一年的年龄（0.028岁））。农民工工资1000普拉（约108美元）或更高的被观察为3.66倍（95％可信区间:1.95，5.01）更容易与额外的临时性伴侣进行无保护的性行为(P=0.002)。在哈博罗内移徙民工有5.19倍(95％可信区间:2.21，8.72)更容易有并发性关系，与那些弗朗西斯敦成为对比(P＜0.001)。利用第二逻辑回归模型来看待交易性行为。约四个因素被发现有助于从事交易性的性。这些因素包括;（一）工人的教育水平;（二）与伴侣规律的访问;（三）工人的月薪（四）工人的工作场所。没有完成初中教育的受访者被观察到9.37倍(95％词:3.88至27.99更容易产生交易性行为(p=0.001)。工人呆了超过500公里远离他们的主要伴侣均是6.11倍(95％可信区间:2.43，9.12)相比在500公里内的工人更容易发生性交易的行为(P=0.014)。各种社会人口变量与性风险行为，包括工人的年龄，儿童的数量，职业地位，工资，工作地点，和教育水平的显着结盟。另一方面，更重要的是要注意流动工人的饮酒量和艾滋病的认知水平并没有显著影响他们的性行为。
　　结论:这些发现表明，劳动力迁移成为决定工人参与危险性行为的焦点部分。雇主应该给工人更多天的休假和场合。迁移的同时，其中起着关键的作用在于更多专注行为变化的教育，而不是专门的艾滋病毒/艾滋病的认识。

目录

声明

CONTENTS

LIST OF TABLES

LIST OF FIGURES

LIST OF APPENDICES

LIST OF ACRONYMS

摘要

ABSTRACT

CHAPTER 1 Introduction

1．1 Statement of the Problem

1．2 Research questions

1．3 Main Objective

1．3．1 Other objective

1．4 Significance of the Study

1．5 Operational definitions

1．6 Conceptual framework

CHAPTER 2 Literature Review

2．1 Overview about HIV／AIDS

2．2 Risk factors for HIV transmission

2．2．1 Biological factors

2．2．2 Behavioural factors

2．2．3 Social factors

2．3 Risk sexual behaviours in Migrants

2．4 Association between socio-demographic characteristics and risk behaviours

2．5 Association between Knowledge to health education and risk behaviours

2．6 Alcohol related risk behaviour

2．7 Drug-related risk behaviours

2．8 Migration as a contributing factor

2．9 Migrant labour

2．9．1 Truck drivers

2．10 Dissertation structure

CHAPTER 3：Methodology

3．1 Study Area

3．1．1 Profile of Botswana

3．1．2 Profile of Gaborone

3．1．3 AIDS in Gaborone

3．1．4 Profile of Francistown

3．1．5 Francistown demographic and health

3．2 Theoretical Framework

3．3 Study plan

3．4 Study Population

3．5 Sampling Technique

3．5．1 Exclusion criteria

3．5．2 Inclusion criteria

3．6 Data Collection Techniques and Research Instruments

3．7 Sample size

3．8 Data collection Procedure

3．8．1 Gain access to key respondents

3．8．2 Havmg sufficient resources for data collection

3．8．3 Procedure for assistance and guidance

3．8．4 Develop a clear data collection timeline

3．8．5 Provide for unanticipated events

3．9 The data analysis

3．10 Logistic Regression Model

3．11 Variables

3．12 Pilot study

3．13 Ethical Considerations

CH-APTER 4 Results

4．1 Socio-demographic characteristics

4．1．1 Age distribution

4．1．2 Education and training

4．1．3 Marital status

4．1．4 Gender

4．1．5 Number of children

4．1．6 Nature of work and employment position

4．1．7 Salary distribution

4．2 Living conditions

4．3 Migration patterns

4．4 Alcohol consumption

4．5 Access to health care

4．5．1 Empirical results and the economic interpretations

4．6 Knowledge about HIV／AIDS among Migrants

4．6．1 Knowledge about HIV／AIDS bivariate results

4．6．2 Knowledge about HIV／AIDS multivariate results

4．6．3 Knowledge of STI and AIDS

4．7 Attitude about HIV／AIDS among Migrants

4．7．1 Awareness of HIV infection and protection

4．7．2 Attitude about HIV／AIDS multivariate results

4．7．3 Multivariate analyses on knowledge and attitudes about HIV／AIDS

4．8 Sexual risk behaviour

4．8．1 Knowledge about sexual behaviour

4．8．1 Sex with multiple partners

4．8．2 Unprotected sex and condom use

4．8．3 Condom use behaviour of the patients who received treatments of STIs

4．8．4 Sexual Behaviour for commercial sex workers

4．9 Factors associated with having an extra partner in the last six months

4．10 Factors associated with having transactional sex

4．11 Bivariate factors associated with drinking alcohol

4．12 Bivariate factors associated with drug use

4．13 Multivariate factors associated with having an extra partner in the last six months

4．14 Multivariate factors associated with having transactional sex

4．15 Multivariate factors associated with having unprotected sex

CHAPTER 5 Discussion

5．1 Socio-demographic factors

5．1．1 Age distribution

5．1．2 Place of birth

6．1．3 Educational level and training

5．1．4 Marriage and partners

5．1．5 Employment and salary

5．2 Migration patterns

5．2．1 Migration to partners

5．3 Alcohol consumption

5．4 Knowledge about HIV／AIDS

5．5 Sexual transmitted infection awareness

5．6 Access to health

5．7 Sexual risk behaviours

5．7．1 Multiple partners

5．7．2 Migration and multiple partners

5．7．3 Living conditions and multiples partners

5．7．4 Socio-demographic Factors and multiple partners

5．8 Transactional sex

5．8．1 Socio-demographic factor and transactional sex

5．8．2 Migration and transactional sex

5．9 Commercial sex

5．10 Unprotected sex

5．11 Different levels of unprotected sex with main partners and additional partner

5．12 Association of unprotected sex with main partner’s long and casual partners

5．13 HIV／AIDS awareness and unprotected sex

CHAPTER 6 Conclusion and Recommendation

6．1 Conclusion

6．2 Recommendations

6．2．1 Recommendations for Service Providers and Policy Makers

6．2．2 Recommendations for Future Research

6．3 Limitations of the study

REFERENCES

DEDICATION

ACKNOWLEDGEMENTS

PUBLICATION

APPENDIX