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Gender-Based Power and Couples’ HIV Risk In Uttar Pradesh and Uttarakhand, North India

机译:印度北部北方邦和北阿坎德邦基于性别的权力和夫妻的艾滋病毒风险

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CONTEXT Gender inequality is a long-recognized driver of the HIV epidemic. However, few studies have investigated the association between gender-based power and HIV risk in India, which has the world’s third largest HIV epidemic. METHODS Population-based data collected in 2003 from 3,385 couples residing in Uttar Pradesh and Uttarakhand, North India, were used to examine associations between gender-based power (wife’s autonomy and husband’s inequitable gender attitudes) and indicators of couples’ HIV risk (whether the husband had had premarital sex with someone other than his eventual spouse, extramarital sex in the past year or STI symptoms in the past year). Structural equation modeling was used to create composite variables for the gender-based power measures and test their associations with HIV risk measures. RESULTS Twenty-four percent of husbands had had premarital sex, 7% had had extramarital sex in the past year and 6% had had STI symptoms in the past year. Structural equation models indicated that wives who reported higher levels of autonomy were less likely than other wives to have husbands who had had extramarital sex in the past year (direct association) or STI symptoms in the past year (indirect association). Moreover, husbands who endorsed more inequitable gender attitudes were more likely than others to report having had premarital sex with someone other than their spouse, which in turn was associated with having had extramarital sex and STI symptoms in the past year. CONCLUSIONS If the associations identified in this study reflect a causal relationship between gender-based power and HIV risk behavior, then HIV prevention programs that successfully address inequitable gender roles may reduce HIV risks in North India. International Perspectives on Sexual and Reproductive Health , 2014, 40(4):196–205, doi: 10.1363/4019614
机译:背景性别不平等是艾滋病毒流行的长期公认的驱动因素。但是,很少有研究调查基于性别的权力与印度的HIV风险之间的关系,印度是世界第三大HIV流行病。方法2003年从北方印度北方邦和北阿坎德邦居住的3,385对夫妇中收集的基于人口的数据用于检验基于性别的权力(妻子的自主权和丈夫的不平等的性别态度)与夫妇的HIV风险指标(无论丈夫与他的配偶以外的人发生过婚前性行为,在过去一年中发生过婚外性行为或在过去一年中出现了性传播感染症状。结构方程模型被用来为基于性别的权力衡量指标创建复合变量,并测试它们与艾滋病毒风险衡量指标的关联。结果在过去的一年中,有24%的丈夫有婚前性行为,有7%的人有婚外性行为,而在过去的一年中,有6%的人患有性病。结构方程模型表明,具有较高自治能力的妻子比其他妻子更容易有过去一年发生过婚外性行为(直接关联)或过去一年中出现性传播感染症状(间接关联)的丈夫。此外,支持更不公平的性别态度的丈夫比其他人更有可能报告与配偶以外的人发生婚前性行为,而这又与过去一年发生过婚外性行为和性传播感染症状有关。结论如果本研究中确定的关联反映了基于性别的权力与HIV风险行为之间的因果关系,那么成功解决性别不平等角色的HIV预防计划可能会降低北印度的HIV风险。性与生殖健康国际观点,2014,40(4):196-205,doi:10.1363 / 4019614

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