E phatlalalitsoe: Pherekhong ea 25, 2016
inahaneloang
maikemisetso
Re ile ra lekola boholo ba lintlha tsa kahisano le setsoalle tse amanang le ho lula le thobalano le basali ba etsang thobalano le basali ba batšehali. Re boetse re hlalositse litšobotsi tsa bacha ba tlalehileng ts'ebeliso e sa lumellaneng ea ts'ebeliso ea likhohlopo le li-FSW.
mekhoa
Ena ke thuto ea sefapano (tekanyetso ea karabelo: 73%) ea lilemong tsa bocha tse sebetsang tsa 300 tsa monna ea neng a le lilemong tsa 16 ho isa lilemong tsa 19 li ea tleliniking ea naha ea STI naheng ea Singapore lipakeng tsa 2009 le 2014. Re ile ra lekola lintlha tsa tikoloho (motho ka mong, motsoali, thaka, sekolo le litšusumetso tsa bophelo bo botle) le boits'oaro bo botle ba thobalano re sebelisa lipotso tse itlhalositseng. Poisson regression e sebelisitsoe ho fumana litekanyetso tse fetotsoeng tsa ho ata ha sekhahla (aPR) le mekhahlelo ea kholiseho (CI).
Results
Karolo ea bacha ba batona ba kileng ba kopanela liphate le batho ba kileng ba kopanela liphate le FSWs e ne e le 39%. Tlhatlhobo ea Multivariate e bonts'itse hore lintlha tsa bohlokoa tse amanang le ho ba le thobalano le FSWs e ne e le ts'ebetso ea thobalano pele ho lilemo tsa 16 (aPR 1.79 CI: 1.30-2.46), ha ho mohla ho kileng ha ba le kharebe e neng e kopanela thobalano (aPR 1.75 CI 1.28-2.38), e tlalehileng boikoetliso bo tlase- lintlha tsa boleng (aPR 0.96 CI: 0.93-0.98), lintlha tsa borabele tse phahameng (aPR 1.03 CI: 1.00-1.07) le ho shebella khafetsa ka litšoantšo tsa bootsoa (aPR 1.47 CI: 1.04-2.09). Tšebeliso ea likhohlopo ka nako eohle e sa lumellaneng le li-FSWs e ne e le 30%.
Nahanisisa
Karolo e kholo ea bacha ba batona le ba batšehali ba kenang tliliniking ea STI ea sechaba e kile ea etsa thobalano le li-FSW. Ho kenella ho tsebisoang. Ho joalo le ho feta hobane karolo e kholo ea bacha e tlaleha tšebeliso e sa lumellaneng ea likhohlopo le li-FSW, ba ka sebetsang e le borokho ba phetisetso ea STI sechabeng. Patlisiso ea lefats'e mabapi le bophelo ba bocha e lokela ho kenyelletsa tlhahlobo ea khafetsa ea ketelo ea thobalano ea thobalano le tšebeliso ea likhohlopo le li-FSW bakeng sa ho lekola le ho beha leihlo nako e telele.
lipalo
Tlhaloso: Ng JYS, Wong ML (2016) Lits'ebetso tsa Bacha ba Heterosexual Bacha ba Kopanang le Banana ba Basebetsi ba Bong ba Basali ho la Singapore. PloS ONE 11 (1): e0147110. Doi: 10.1371 / journal.pone.0147110
mohlophisi: Jesse Lawton Clark, David Geffen Sekolo sa Bongaka UCLA, UNITED STATES
Re amohetse: June 26, 2015; E amohetse: December 29, 2015; E phatlalalitsoe: January 25, 2016
Copyright: © 2016 Ng, Wong. Ena ke sengolo se bulehileng sa phihlello se tsamaisitsoeng tlasa maemo a License ea Boikarabelo ba Creative Commons, e lumellang hore ho sebelisoe, ho abeloa, le ho beleha ho sa sebelisetsoe, ho fana ka moqapi le mohloli oa pele.
Ho fumaneha ha Data: Ka lebaka la litlhoko tsa boitshwaro tse mabapi le boits'oaro ba motho ea nkang karolo, data e nyane haholo e tla fumaneha ha e kopuoa. Likopo tsa data li ka romelloa ho sengoli se lumellanang ([imeile e sirelelitsoe]).
Lithuso: Boithuto bona bo tšehelitsoe ke Lekhotla la Naha la Lipatlisiso tsa Bongaka (NMRC), Singapore. Ha ho na likhohlano tsa phaello. NMRC ha e kopanele ho 1) moralo oa ho ithuta; (2) pokello, sekaseka, le ho toloka litaba; (3) mongolo oa tlaleho; le (4) qeto ea ho tlisa pampiri hore e phatlalatsoe.
Lithahasello tse tsitsitseng: Bangoli ba boletse hore ho na le lithahasello tsa tlhōlisano tse teng.
Selelekela
Bareki ba basebetsi ba thobalano le basali ke ba sehlopha sa mantlha phetisetsong ea tšoaetso ea thobalano le mafu a likobo a tsoang Asia. [1] Chaena, bareki ba FSW ba fumanoe ba na le linako tsa 12 le makhetlo a 6 menyetla ea ho ts'oaroa ke tšoaetso ea HIV le syphilis ka ho fapana ha e bapisoa le kakaretso ea batho ba baholo. [2] Leha ho na le likotsi, tokelo ea ho ba le thobalano le batho ba bang ka thobalano e nkuoa e le mosebetsi oa boikhathollo Asia. [3, 4]
Tlhahlobo ea naha ea banna ba nang le thobalano ea 46,961 India e tlalehiloe hore banna ba banyenyane ba na le tekanyo e phahameng ea ho reka litšebeletso tsa thobalano ha li bapisoa le batho ba baholo. [5] Thutong ena, bana ba lilemo li 15 ho isa ho 24 ba ne ba le menyetla e habeli ho feta ea ba tsofetseng ba 45 le kaholimo ho etsa thobalano le li-FSW selemong se fetileng. Ho ba pakeng tsa 15 ho isa ho 24 ea lilemo, 41% ha e a ka ea sebelisa likhohlopo ka mokhoa o ts'oanang le FSWs. Leha ho le joalo, karolo ea bacha, e hlalosoang e le 10 ho isa lilemong tsa 19 ke Mokhatlo oa Lefatše oa Bophelo, ea ileng a etsa thobalano le FSWs le mabaka a amanang le boitšoaro bona ha a tlaleheloa thutong ena. Ka tsebo ea rona, hajoale ha ho na ts'ebetso e tobileng e tobileng boitšoaro bona ho bacha ba Asia mohlomong hobane lisebelisoa li reretsoe ho kena lipuisanong tse lebisang banna ba baholo le li-FSW. Lebaka le leng le ka 'nang la hlaha e ka ba lebaka la ho phahama ha tlhahisoleseling ka boholo ba boitšoaro bona le lintho tse amanang le eona, tse ka fuoang lithibelo tsa molao le tsa boitšoaro tse joalo ka tumello ea motsoali ea ho bokella data ena e bohloko. [6] Leha ho le joalo, ho tsepamisa sehlopha sena ho bohlokoa haholo hobane ho ka susumetsa boits'oaro ba bona ba thobalano hantle nakong ea bongoana. [7] Ho feta moo, Asia e na le palo ea bobeli e kholo ea tšoaetso e ncha ea HIV har'a bacha ba baholo. [8] Leha ho le joalo, ho na le khaello ea khatelo-pele ho thibela ts'oaetso ea HIV e ncha bakeng sa sehlopha sena ka lebaka la data e sa lekaneng. [6]
Ha lithuto tse ngata mabapi le li-correlates tse amanang le ho reka thobalano li kenyeletsa disampole tsa batho ba baholo tsa banna [2, 5, 9-11], ke ba fokolang ba neng ba sheba likamano tse khethehileng har'a bacha. [12, 13] Liphetho tsa tšusumetso ea tlhekefetso ea thobalano le boits'oaro bo kotsing ea ho reka thobalano le bacha le tsona li kopantsoe. Phuputso ea naha naheng ea United States e hlahlobile mabaka a neng a le lilemong tsa bocha ba bongoana (ea lilemo li 12 ho isa lilemong tsa 17) tse neng li amahanngoa le ho reka thobalano lilemong tsa morao (18 ea lilemo li lilemo tsa 26). [13] Ho fumanoe hore nalane ea tlhekefetso ea thobalano, tšebeliso ea lithethefatsi le ho baleha lapeng hangata e ne e le mabaka a kotsi. Ho fapana le hoo, phuputsong e thehiloeng sekolong Canada, tlhekefetso ea thobalano le tšebeliso ea lithethefatsi li ne li sa amane le ho reka litšebeletso tsa thobalano. Thutong ena, 3% ea ba pakeng tsa 15 ho isa ho 18 ba ne ba kile ba reka thobalano mme ba na le monyetla oa ho shebella liketso tsa thobalano hape ba na le maikutlo a ho amohela botekatse. [12] Le ha thuto ena e ikemiselitse ho ntlafatsa kutlwisiso holima mabaka a amanang le ho reka litšebeletso tsa thobalano har'a bacha, re boetse re rata ho tlatsa leseli la tlhaiso-leseling e mabapi le boits'oaro bo bobe ba thobalano bo amanang le ho ba le thobalano le FSWs Sena se lebisa pakong ea mantlha ea thuto ena, e leng ho hlalosa karolo ea bacha ba batona ba etsang thobalano ba etelang tleliniking ea sechaba ea STI naheng ea Singapore ba kileng ba etsa thobalano le li-FSW, hammoho le mabaka a bophelo le boitšoaro ba ho kopanela likobo bo amanang le sena. boits'oaro. Morero oa bobeli ke ho hlalosa litšobotsi tsa bacha ba neng ba sa sebelise likhohlopo ka mokhoa o ts'oanang le li-FSW. Liphumano li ka thusa ho tsebisa mananeo a bacha ba batona ba kopanelang liphate, a hoholo le ho feta naheng ea Singapore ha bacha ba ntse ba qheleloa ka thoko boits'oarong ba boitšoaro ba botona le botšehali.
Lisebelisoa le mekhoa
Barupeluoa le ho hira
Lintlha tsa tlhatlhobo ena li nkuoe ho tsoa tlhahlobo ea litlhoko tsa motheo bakeng sa ts'ebetso ea bophelo bo botle ba thobalano (e ngolisitsoeng le ClinicalTrials.gov, nomoro NCT02461940) bakeng sa bacha ba kenang tliliniking ea Lefapha la STI Control (DSC), ke eona feela tleleniki ea STI naheng ea Singapore. Lintlha li ile tsa bokelloa pakeng tsa November 2009 le December 2014. Lebaka la ho etsa tlhahlobo tleliniking ena e habeli. Taba ea pele, hoo e ka bang 80% ea bacha ba nang le mafu a likobo a hlahelletseng a Singapore ba ile tleliniking ena selemo le selemo. [14Taba ea bobeli, ba kenang lilemong tsa bocha le bona ke sehlopha sa mantlha sa phetiso ea mafu a likobo har'a bacha ba Singapore. Mekhoa ea ho kenyelletsa phuputso ena e ne e le: ha ho mohla ho nyaloang bacha ba batona ba tlalehileng hore ke batho ba bong bo fapaneng, ba hlalosoang e le ho ba le likamano tsa botona le botšehali le mosali ea lilemo li 16 ho 19 ea tlang tliliniking ka lekhetlo la pele. Ha lilemo tsa molao tsa thobalano naheng ea Singapore li le lilemo tsa 16, ha rea ka ra hira bacha lilemong tse ka tlase tsa 16, ba neng ba tlameha ho beoa tlasa lipatlisiso tsa mapolesa bakeng sa peto e molaong.
Boithuto bona bo amohetsoe ke Boto ea Naha ea Tlhahlobo ea Bophelo bo Botle ba Naha ea Domain. Bacha ba nkileng karolo thutong ba saena foromo ea tumello kamora ho fumana tlhaloso ea thuto, ba bala leqephe la tlhaiso le ho hlakisa lipotso le motho ea buisanang. Liforomo tsa tumello tse saennweng li ne li bolokiloe ka khabineng e notletsoeng tleliniking ea DSC, ho fapana le ho khutlisetsoa ho barupeluoa. Lebaka ke hore, ho latela mofuta oa thuto ea rona le lilemo tsa bankakarolo, ba ne ba sa khone ho tlisa hae liforomo tse bonts'ang ketelo ea bona tliliniking ea DSC. Sebakeng seo, ba ka lahla liforomo tse saenneng tse nang le mabitso le linomoro tsa bona tsa libaka libakeng tsa sechaba. Ka hona, ho ne ho se bohlale ho khutlisa liforomo tse saennoeng ho litho tsa sehlopha. Leha ho le joalo, foromo e saennoeng ea tumello e ile ea fumaneha ea nkang karolo ea tleliniking haeba morupeluoa a ka batla ho e fumana. E le karolo ea thuto, litšenyehelo tsa liteko tsa laboratori tsa STI (ho fihlela ho US $ 50) li ile tsa tlosoa bakeng sa barupeluoa ba ngolisitseng.
Ho na le likarolo tse peli ho potso. Karolo ea pele ho tsa demographic le ea botsoali e ne e laoloa ka sefahleho ke basebetsi ba lehae le barupeluoa ba thuto sebakeng se ikemetseng sa kliniki. Karolo ea bobeli, e neng e ipusa, e ne e na le lipotso tsa tlhaho e tebileng joalo ka kotsi le boits'oaro ba thobalano mme e behiloe qetellong ea tlhahlobo. Ho fokotsa khethollo ea kahisano sechabeng, barupeluoa ba ile ba tiisetsoa ho boloka lekunutu le ho se tsejoe. Ba ile ba tsebisoa ka sepheo sa ho ithuta, e neng e le ho utloisisa boits'oaro ba bona le ho sebelisa liphetho ho ba rala.
Ho bacha ba tšoanelehang ba 409 ba kileng ba etela tliliniking nakong ea thuto, 300 (73%) e amohetse le ho phethela tlhahlobo ea motheo. Lebaka le ka sehloohong la ho se amohele tumello e ne e le ho se khone ho etsa tlhahlobo ea bophelo bo botle ba thobalano. Ho ne ho se na phapang lipakeng tsa ba arabelang le ba sa arabeleng ho ea ka lilemo (p = 0.320) le morabe (p = 0.704).
Mehato
Phello e fapaneng.
Ena e ne e le phapang e atamelaneng ea ho ba le thobalano le FSWs, e neng e thehiloe ho potso e reng: "Ke ka makhetlo a makae o ileng oa robala le letekatse ho tloha pele o ne o etsa thobalano?" Ba neng ba araba "1" kapa ho feta ba thathamisitsoe e le " o kile oa kopanela thobalano le FSWs athe ba neng ba supa "0" ba ne ba arotsoe ka hore "ha ho mohla ba kileng ba robala le FSW".
Lintho tse amanang le ho etsa thobalano le li-FSW.
Re fetole mohlala oa mefuta-futa ea lihloliloeng [15] ho lekola lintlha tse amanang le ho ba le thobalano le FSWs ka linako tsohle, ho kenyelletsang litšupiso tse lekanyang tšusumetso ea motho ka mong, motsoali, thaka, sekolo le media. Bakeng sa lihlahisoa tse thehiloeng nthong, ntho ka ngoe e ile ea hlahlojoa ho sebelisoa sekala sa Likert mme lintho li ile tsa buloa ho theha lintlha.
Boemo ba motho ka mong: Re lekotse litšobotsi tsa sechaba le sechaba (lilemo, mofuta oa bolulo, morabe, tumelo, sekolo le boemo ba mosebetsi le boemo ba thuto), boitšoaro bo kotsing, nalane ea tlhekefetso ea thobalano le litšobotsi tsa motho. Boitšoaro bo kotsi bo ne bo kenyelletsa ho tsuba, ho itlopa joala, ho loana le sehlopha sa lithethefatsi. Litšobotsi tsa botho li kenyelletsa tse latelang: Bofetoheli ba 7-ntho (Cronbach's alpha = 0.62) [16], Ho batla ha maikutlo a 6-ntho (Cronbach's alpha = 0.78) [16], 4-ntho e lemohuoa taolo ea kantle (Cronbach's alpha = 0.72) [17] le sekhahla sa ho itšepa sa 10-Rosenberg (Cronbach's alpha = 0.66) [18]. Ntho e 'ngoe le e' ngoe e etselitsoeng sebopeho sa botho e ile ea hlahlojoa ho sebelisoa sekhechana sa 4-Likert sa "Eseng nna", "Mofuta o tšoanang le nna", "o joalo ka nna" le "joalo ka nna".
Boemo ba motsoali: Tšusumetso ea botsoali e ile ea hlahlojoa ho sebelisoa 7-ente e hlokang botsoali (Cronbach's alpha = 0.79) le 8-factor Authoritative Parement (Cronbach's alpha = 0.72) indices [19] ka likarabo bakeng sa ntho e ngoe le e ngoe e lekantsoeng sethaleng sa 4-point, le polelo e reng "Ke utloa eka nka ea ho batsoali / batsoali ka lipotso ka thobalano".
Boemo ba lithaka: Tšusumetso ea lithaka e ile ea hlahlojoa ho ipapisitsoe le likarolo tse peli: khokahanyo ea lithaka tsa 6-sebelisa XRUMX-point Likert wadogo (Cronbach's alpha = 4) [20] le potso e reng "Ho na le khatello e kae ea metsoalle ea hau ea hore u kopanele thobalano?"
Boemo ba sekolo: STs'ebetso ea k'hoaere e ile ea hlahlojoa ke lipotso tse "U ka ipehela maemong a phahameng sekolong?" le "U ka ipehela maemong a kopaneng a lithuto joang sekolong?"
Boemo ba media: Litaba tsa thobalano tse phatlalalitsoeng ka bongata li ile tsa hlahlojoa ho ipapisitsoe le mefuta ea 3 ea ho pepeseha: 1) mecha ea phatlalatso e fihlellang sechabeng, 2) mecha ea phatlalatso e thibetsoeng ho Singapore, ke hore, litaba tsa bootsoa le 3). Mecha ea phatlalatso e fihlellang sechabeng e bua ka mananeo a TV / libaesekopo / livideo / lipina tse bontšang litšoantšo tsa thobalano kapa tsa thobalano. Khafetsa ho senoloa ho ile ha hlahlojoa ho sebelisoa lintlha tsa karolo ea 3-ente mecheng ea litaba tsa thobalano, [21] le ntho e ngoe le e ngoe e maemong a 4-point (ho hang, hang ka nako, hangata, hoo e ka bang ka linako tsohle). Ho pepesehela litšoantšo tse manyala tse hlephisang boitšoaro ho entsoe ka ho botsa, "Ke hangata hakae u balang kapa u shebeletse litšoantšo tse litšila tse tsosang takatso?" Mohlala oa polelo ea "e" kapa che ke "Ke balile koranteng kapa makasineng ka motho ea tšoaelitsoeng ke mafu a tšoaetsanoang ka thobalano."
Boitšoaro ba thobalano.
Barupeluoa ba tlaleha lilemo tsa thobalano ea pele (e neng e hlalosoa e le thobalano ea molomo, ea botšehali kapa ea maiketsetso) mme re hlalositse qaleho ea thobalano e le ka tlasa lilemo tsa 16. Kakaretso ea bophelo ba likhohlopo ka tšebeliso ea thobalano ho batho bohle balekane e thehiloe ho "Na uena kapa molekane oa hau u kile ua sebelisa khohlopo bakeng sa thobalano ea setho sa botšehali?" Ka likhetho tsa "Kamehla", "Ka linako tse ling", "ho hang" le "O ka se hopole" . Ho ile ha sebelisoa potso le likhetho tse tšoanang tšebelisong ea likhohlopo bakeng sa thobalano ea molomo le ea anal. Ntle le moo, ba ile ba botsoa hore ba bonts'e balekane ba bona ba pele ba thobalano ka likhetho tsa "kharebe, sefebe, moreki, motho eo ba ratanang le eena kapa ba bang". Barupeluoa ba ne ba hlokoa ho supa palo ea balekane ba bona ba thobalano bophelong le palo ea batho ba latelang: “Metsoalle (banana), Prostitute (bareki, bareki), Stranger / Acquaintance le ba bang”.
Mafu a tšoaelitsoeng a tšoaelitsoe ka liteko tsa laboratori ka nako ea ho ngolisa thupelong. Tsena li kenyeletsa syphilis e tšoaetsanoang, (cervical, urethral, pharyngeal, rectal) gonorrhea, chlamydia, non-gonococcal urethritis, herpes ea genital, warts war, molluscum contagiosum, lice tsa pubic le HIV.
Maikutlo le maikutlo.
Boikutlo mabapi le ts'ebeliso ea likhohlopo bo ne bo ipapisitse le lintlha tse akaretsang tsa polelo ea 7. Polelo e 'ngoe le e' ngoe e ile ea hlahlojoa ka tekanyo ea 5-point Likert ea "Ha ke lumellane haholo", "Ha ke lumellane", "Ha ho na letho", "Lumellana" le "Kea lumellana". Tsena li kenyelelitsoe: (1) Condom ke tsela e sebetsang ea ho itšireletsa khahlanong le mafu a likobo. (2) Likhondomo li senyeha habonolo. (3) Ke fumana ho le boima kapa ho le thata ho sebelisa likhohlopo. (4) Likhondomo li fokotsa thabo ea thobalano. (5) Likhondomo li etsa thobalano e nyenyefatse. (6) Likhondomo li theko e boima. (7) Ho bonolo / ho bonolo ho fumana khohlopo ha ke e hloka. Lintho tsa 2, 3, 4 le 6 li ne li khutlisitsoe ka cod. Re sebelisitse "U nahana hore ke monyetla oa hau oa ho fumana mafu a likobo?" Ho lekola monyetla oa bona oa ho fumana mafu a likobo. Barupeluoa ba boetse ba koptjoa ho khetha polelo e hlalosang hantle kamoo ba ikutloang ka teng mabapi le thobalano pele ho lenyalo.
Liketelo tsa khoebo ea thobalano le tšebeliso ea likhohlopo.
Babuelli ba tlalehileng ba kileng ba kopanela liphate le FSW le bona ba ile ba botsoa hore ba fane ka leseli le eketsehileng ka boitšoaro bona. Tšebeliso ea likhohlopo tse amanang le li-FSW li ile tsa hlahlojoa li sebelisa "Na u kile oa nahana ho sebelisa likhohlopo le matekatse selemong se fetileng sa 1?" Khetho ea "Ke sebelisa likhohlopo ka linako tsohle le matekatse" e ile ea nkuoa e le tšebeliso e sa fetoheng ea khohlopo le likhetho tse ling " Ha ke e-so nahane ho e sebelisa "," Ke nahanne ka hona empa ha ke e-so qale ho e sebelisa "," Ke batla ho sebelisa likhohlopo empa ha ke tsebe "," Ke ne ke kile ka sebelisa likhohlopo empa eseng hona joale "le" Ke ntse ke sebelisa likhohlopo ka linako tse ling ”li hlophisitsoe e le tšebeliso ea likhohlopo tse sa lumellaneng. Ba boetse ba botsoa, ka khetho ea ho khetha likarabo tse fetang e le 'ngoe, naha (ke hore, Singapore, Thailand, Indonesia, Cambodia, Malaysia, China, linaha tse ling tsa Asia kapa Bophirima) le mofuta (ke hore brothel, literata, li-massage parlors, li-bar / li-pubs kapa lihotele) tsa maeto a ho etsa thobalano ka thobalano. Re hlophisitse mebila, li-parlour tsa massage, li-bar / li-pubs le lihotele joalo ka litlhophiso tse sa thehoeng ho brothel.
Lipatlisiso tsa sethathamo
Ha ho hlahlojoa bivariate, mefuta e fapaneng ea likarolo e ile ea hlahlojoa ho sebelisoa li-chi-square kapa liteko tsa moetlo, athe mefuta e tsoelang pele e ile ea hlahlojoa ka tlhahlobo ea boemo ba Wilcoxon. Bakeng sa tlhahlobo ea li-multivariate, khatello ea Poisson e nang le phapang e matla e sebelisitsoe ho fapana le khatello ea thepa ka lebaka la karolo e phahameng (> 10%) ea bacha ba tlalehang ba kile ba kopanela liphate le FSWs. Re sebelisitse mokhoa o tsoelang pele mohato oa ho aha mofuta. Mofuta o mong le o mong o ikemetseng o ikemetseng o ikemetseng o nang le p <0.1 ho tsoa tlhahlobisong ea bivariate e kentsoe ka har'a mofuta, ho sebelisoa khetho ea pele. Tsena li ne li kenyelletsa tšebeliso ea joala, borabele, boitšepo, taolo ea kantle e lemohuoang, ts'ebetso ea thuto, mesebetsi e kopanetsoeng, ho shebella litšoantšo tsa bootsoa, lilemo tsa thobalano ea pele pele ho lilemo tse 16 ebile o kile a ba le kharebe ea thobalano. Mofuta oa pele o neng o ikarabella bakeng sa mefuta e fapaneng ea mofuta ona o ile oa khethoa, 'me ha khethoa oa bobeli ka bobeli. Mefuta e latelang e ile ea eketsoa ho fihlela ho se na phapang e kholo ponong ea sephetho se fapaneng ho fumana mofuta o hlakileng ka ho fetesisa. Moetso o ile oa fetoloa bakeng sa mefuta-futa ea batho (ke hore, lilemo, morabe, mofuta oa bolulo, boemo ba thuto) le selemo sa ho hiroa. Molemo oa ho lekana mohlala oa hoqetela o bonts'itse hore mofuta o kentse data hantle (p = 1.00). Bohlokoa ba lipalo-palo bo behiloe ho p <0.05 mme ho tlalehiloe likhaolo tsa bongata ba bongata (aPR). Re sebelisitse sephutheloana sa software Stata 14.0 (Stata Corp, College Station, Tex) ho etsa lipatlisiso tsa lipalo.
Results
Litšobotsi tsa demographic le boits'oaro
Ka kakaretso, lilemo tsa batsamaisi ba barupeluoa e ne e le lilemo tsa 18 (mefuta e arohaneng ea [IQR]: 18-19). Hoo e ka bang halofo (57%) e ne e le Machaena, 33% e ne e le Semalay mme ba bang kaofela e ne e le Maindia le Maasia. Ho ne ho se na lipuisano tsa bohlokoa lipalo pakeng tsa morabe le mefuta e ikemetseng ea ho ba le thobalano le li-FSWs. Liperesente tse mashome a mane a metso e supileng tsa batho ba neng ba nka karolo ba ne ba sa kene sekolo. Hoo e ka bang 40% ea bacha ba ne ba le lilemo tse ≤10 tsa ho kena sekolo. Ho ba 140 ba neng ba sa kene sekolo mothating oa lipatlisiso, 66 (47%) e ne e le likolo tse sieo sekolong. Boitšoaro ba sechaba le boits'oaro bo kotsi bo akaretsitsoe ho Lethathamo 1. Nako ea pele ea thobalano e ne e le lilemo tsa 16 (IQR: 15-18) 'me palo ea balekane ba botona le botšehali nakong ea bophelo e ne e le 3 (IQR: 2-6). Ha ho le ea mong oa karolo ea kileng a lefuoa ka thobalano. Liperesente tse mashome a mane a metso e supileng li ne li le ntle le mafu a likobo. Ho ne ho se na linyeoe tsa tšoaetso ea HIV.
Karolelano ea bacha ba batona le ba bong bo fapaneng ba ileng ba robala le li-FSW le mabaka a amanang le ho lula ho etsa thobalano le li-FSWs
Ba lekholo le leshome le metso e robeli (39%, 95% CI: 34% -45%) ba tlalehile ba kile ba kopanela liphate le li-FSW, ka China haholo (44%) ho feta Malays (29%) (p = 0.02). Liphuputsong tsa bivariate, ba tlalehileng bofetoheli bo phahameng (p = 0.002), boitšepo bo tlase (p = 0.02) le lintlha tse phahameng tsa taolo ea kantle (p = 0.01), mme ba lekantse ts'ebetso ea bona ea thuto ka karolelano kapa ka tlase (p = 0.02) ) ba ne ba ka ba le thobalano le li-FSW. Makhetlo a phahameng haholo a ho shebella litšoantšo tse manyala tse hlephisang boitšoaro (p <0.001) e ne e atile haholo hara batho ba kileng ba etsa thobalano le li-FSW. Boemo ba thuto (p = 0.62), tšusumetso ea batsoali [Ho batla index ea botsoali: p = 0.20; Index ea matla: p = 0.49] le tšusumetso ea lithaka [Khokahano ea lithaka: p = 0.85] li ne li sa amane le boitšoaro bona.
Joalokaha ho bontšitsoe ho Lethathamo 2, banna ba kileng ba etsa thobalano le li-FSW ba ne ba na le monyetla oa ho etsa thobalano pele ho lilemo tse 16 (p = 0.01) mme ba be le balekane ba bangata ba thobalano (p <0.001). Leha ho le joalo, ba ne ba se na monyetla o moholo oa hore ba kile ba ba le kharebe ea thobalano (p <0.001) mme ba na le monyetla oa ho tlaleha ts'ebeliso e sa fetoheng ea likhohlopo le balekane bohle ba basali (p <0.001), molomo (p <0.001) le thobalano ea ka morao ( p = 0.048) le mefuta eohle ea balekane.
Thutisong ea multivariate (Lethathamo 3), bacha ba qalileng ho etsa thobalano pele a le lilemo tsa 16 (aPR 1.79 CI: 1.30-2.46), eo ho seng mohla a kileng a ba le kharebe e neng e kopanela thobalano (aPR 1.75 CI 1.28-2.38), e tlalehiloe boemo bo tlase ba boitšepo (aPR 0.96 CI: 0.93-0.98) , lintlha tse phahameng tsa borabele (aPR 1.03 CI: 1.00-1.07) mme o shebelletse litšoantšo tsa bootsoa khafetsa (aPR 1.47 CI: 1.04-2.09) ba ne ba na le monyetla oa ho etsa thobalano le FSWs.
Liketelo tsa botona le botšehali tsa khoebo, tšebeliso ea likhohlopo le mafu a likobo
Har'a ba kileng ba etsa thobalano le FSWs, 38% e tlaleha hore ba ile le thobalano ea bona ea pele le FSW, athe ba bang kaofela ba ne ba lula le kharebe e mong (41%) kapa molekane ea neng a sa kopane le bona (14%). Palo ea bophelo ba bohareng ba likamano tsa botona le botšehali le FSWs e ne e le 2 (IQR: 1-3). Sebaka se tloaelehileng haholo sa ho reka litšebeletso tsa thobalano e ne e le Singapore (51%), e lateloe ke Thailand (40%) le Indonesia (17%). Ka kakaretso, 30% (n = 35) ha ea ka ea sebelisa likhohlopo ka mokhoa o ts'oanang le li-FSW selemong se fetileng. Halofo ea batho ba arabetseng (51%) o kile a ba le thobalano le li-FSW tse thehiloeng ho brothel le 35% le basebetsi ba seterateng.
Re fumane hore bacha ba Malay ba na le menyetla e fokolang ea ho sebelisa likhohlopo le li-FSW ha li bapisoa le bao e seng Malays (59% vs. 20%, p <0.001). Ho ne ho se na phapang e kholo palong ea likamano tsa botona le botšehali le li-FSW lipakeng tsa ba sebelisang likhohlopo khafetsa le FSW le ba sa e sebeliseng (Mediian (IQR): 2 (1-3) vs. 2 (2-3), p = 0.54 ). Basebelisi ba likhohlopo ba sa fetoheng le bona ba ne ba sa fapana le basebelisi ba likhohlopo ba sa tsitsang maemong a bona a boits'oaro mabapi le ts'ebeliso ea likhohlopo (Median (IQR): 23 (20-25) vs. 23 (21-25), p = 0.80).
Karolo ea li-STI tse fumanoeng nakong ea ho hira e fumanoe e ts'oana le ba ileng ba etsa thobalano le li-FSW le ba sa kang ba etsa joalo (41.9% vs. 49.7%, p = 0.19). Leha ho le joalo, har'a bacha ba kileng ba etsa thobalano le li-FSW, mafu a likobo a fumanoe a le holimo haholo ho ba neng ba sa sebelise likhohlopo khafetsa le li-FSW le balekane ba bang bohle ha ba bapisoa le ba sebelisang likhohlopo khafetsa (59% vs. 17%, p <0.001). Likokoana-hloko tse fumanoeng le tsona li ne li phahame, leha e se tsa bohlokoa lipalo, har'a ba kileng ba robala le FSW e seng malala feela ha ba bapisoa le ba kileng ba etsa thobalano le li-FSW tse thehiloeng ho matekatse feela (46% vs. 32%, p = 0.27). Lifeiga 1 'me 2 ka ho latellana bontša liperesente tsa ba neng ba sebelisa likhohlopo ka mokhoa o sa lekanyetsoang ke naha le mofuta oa li-FSW. Tekanyetso e phahameng ka ho fetisisa ea tšebeliso ea likhohlopo e sa lumellaneng (53%) e tlalehiloe har'a ba neng ba reka litšebeletso tsa thobalano Indonesia. Barupeluoa ba neng ba kopanela thobalanong le basebetsi ba seterateng ba tlalehile liperesente tse phahameng tsa tšebeliso ea likhohlopo tse sa lumellaneng (39%) ha ba neng ba etsa thobalano le barekisi ba thobalano le batho ba amanang le thobalano ba tlalehile ba tlase haholo (23%).
* Bapisa 10 China, 6 Malaysia, 2 Cambodia, 10 linaha tse ling tsa Asia le linaha tsa Bophirima tsa 2.
Puisano
Karolo e kholo ea (banna ba 39%) ea banna ba lilemong tsa bocha ba sebetsang ka thobalano ba kenang tleliniking ea STI ea sechaba sa Singapore thutong ea rona e tlaleha hore o kile a ba le thobalano le FSWs. Sena se tlase ho feta se tlalehiloeng phuputsong e 'ngoe litleliniking tsa STI Vietnam, moo 84% ea bacha ba lilemo tse 14 ho isa lilemong tsa 19 ba kileng ba etela FSWs selemong se fetileng. [9] Re boetse re fumane maemo a fapaneng a susumetsang boitšoaro bona. Mohlaleng o fetotsoeng oa likamano tsa rona ka bongata, re fumane hore bacha ba tlalehileng bonyenyaneng ba ho qala thobalano, lintlha tse tlase tsa boitšepo, lintlha tse phahameng tsa borabele, ha ho mohla ho kileng ha ba le kharebe e amanang le thobalano, le ho shebella litšoantšo tse litšila tse tsosang takatso hangata ho ka tlaleha hore o kile a ba le thobalano le FSWs.
Ho ea kamoo re tsebang, ho na le thuto e le 'ngoe feela e shebaneng le boitšoaro ba ho etsa thobalano le batho ba etsang thobalano har'a bacha' me sena se entsoe har'a baithuti ba sekolo se phahameng sa Canada ba lilemo li 16 ho ea 18. [12] Boithuto bona bo amanang le likarolo tse ling bo shebile lintlha tse kang boits'oaro ba thobalano (eo ke lilemo tsa 13 kapa ka tlase), ho ba le balekane ba tloaetsoeng, ho shebella litšoantšo tsa bootsoa marang-rang le ho shebella liketso tsa thobalano tse kang ho hlobola. Kamora liphetoho tse nang le likamano tse ngata, ho shebella feela liketso tsa thobalano ho hlahile e le karolo ea bohlokoa. Sena se fapana le seo re se fumaneng thutong, mohlomong ka lebaka la mekhoa e fapaneng ea tlhahlobo le litlhahlobo. Leha ho le joalo, liphetho tsa rona li lumellana hantle le lithuto tsa banna ba baholo ba etsang thobalano. Phuputso e mabapi le palo ea banna ba Spain ba lilemo li 18 ho 49 e fumane hore bao e neng e le masoha le ba qalileng thobalano pele ba lilemo tsa 16 ba na le monyetla o moholo oa ho reka thobalano. [11] Tlaleho ea Australia e hlalositse hore banna ba baholo bao e leng masoha ha ba na bokhoni ba ho kopanela likamano tsa botona le botšehali le ho retelehela ho li-FSW bakeng sa kamano e haufi. [22] Ho ekelletsa moo, ho shebella litšoantšo tsa bootsoa e ne e le lebaka la bohlokoa le amanang le ho reka litšebeletso tsa thobalano har'a basebetsi ba Maindia ba nang le lilemo tse pakeng tsa 27, 'me ho ne ho nahanoa hore litšoantšo tsa bootsoa li ba etsa hore ba be le maikutlo a nepahetseng mabapi le thobalano e lefuoang. [23]
Seo re se fumaneng se boetse se bonts'itse lintlha tse ikhethang ho bacha, tse lumellanang le khopolo ea Jessor ea Bothata ea Beor. [24] E hlalosa hore boits'oaro ba mathata (joalo ka ho etsa thobalano le FSWs [5]) hlahella nakong ea bohlankana ka lebaka la ho se lekane taolong ea botho (joalo ka ho itšepa le bofetoheli), sistimi e lemohuoang (joalo ka mecha ea litaba le litšoantšo tse litšila tse tsosang takatso) le tsamaiso ea boitšoaro (joalo ka bongoana ba ho qala thobalano) . Ehlile, ho itšepa ho ne ho sa amane le boits'oaro bo kotsi ba thobalano (joalo ka thobalano ea thobalano le nalane ea mafu a likobo) har'a bacha lilemong tsa bocha. [25] Le ha ho le joalo, e ne e le lebaka le matla le amanang le ho ba le thobalano le FSWs thutong ea rona. Sena se ka 'na sa hlalosoa ke ba kopanelang liphate le li-FSW e le mokhoa oa ho itšepa haholoanyane, o hlahisitsoeng ke ho sitoa ho fumana kharebe. Sena se boetse se amana le lipatlisiso tse fumanoeng har'a bacha ba Maafrika ba Amerika ba fumane hore ba sebelisitse thobalano ho ntlafatsa boitšepo ba bona kapa ka mabaka a ithorisang. [26] Leha ho le joalo, re tla hloka ho etsa lipatlisiso tse ling ho utloisisa hantle kamano e lipakeng tsa boitšepo bo tlase le litšebeletso tsa thobalano. Ho kenella ha hoa lokela ho lebisa maemo a fapaneng feela a tšusumetso, empa hape ho sebetsana le boits'oaro ba bothata e le sesupo sa mathata ho fapana le ho a nka e le a ikhethileng ka bobeli.
Ha rea fumana tšoaetso ea mafu a likobo e amahanngoa le ho ba le thobalano le FSWs ka linako tsohle. Ho na le litlhaloso tse ka bang teng bakeng sa sena. Pele, mafu a likobo a ile a fumanoa a le mothating oa ho ingolisa thutong, athe sephetho sa rona sa thuto e ne e le bophelo bo atileng ba ho etsa thobalano le li-FSW. Ka hona, barupeluoa ba rekileng thobalano nakong e fetileng ba kanna ba ba le tšoaetso e matla ea mafu a likobo mme ba e nkile kae kae pele ba ea tliliniking ena. Taba ea bobeli, kotsi ea ho fumana tšoaetso ea mafu a likobo ho FSW e boetse e itšetlehile ka tšebeliso ea khohlopo le mosebeletsi oa thobalano le boemo ba hae ba thobalano nakong eo ea thobalano. Ebile, re fumane hore mafu a likobo a phahame haholo hara ba sa sebeliseng likhohlopo ka mokhoa o ts'oanang le li-FSW. Qetellong, halofo ea barupeluoa e ile ea reka thobalano ho barekisi ba Singapore. Li-brothel tsohle tsa Singapore li ngolisitsoe ka molao mme ts'ebeliso ea likhohlopo tsa 100% e se e thehiloe. Ntle le moo, bahokahanyi ba tsa thobalano, e leng tlasa ts'ebetso ea bongaka ea kalafo, ba tlameha ho hlahlobeloa lefu la nko ea mokokotlo le chlamydia, le tlhahlobo ea HIV le lefu la sethoathoa ka likhoeli tse 'ne. Basebetsi ba tsa thobalano ba nang le tšoaetso ea mafu a likobo ba alafuoa setsing sa bophelo mme ba tlameha ho emisa mosebetsi oa thobalano nakong ea kalafo.
Ho na le meeli lithutong tsena tse fokotsang ho akaretsa ha lipalo tse ling. Taba ea mantlha, leha e le mona feela kliniki ea mafu a likobo naheng ea Singapore e nkang likhato tse fetang tse tharo tsa linyeoe tsa STI tse tsebahalang har'a bacha, ke moemeli oa bacha ba etsang thobalano feela ba kenang tliliniking ena kapa ba kileng ba fetisoa ho eona ho ea hlahlojoa le ho phekoloa. Mafu a likobo. Ho hlakile hore ha se bacha bohle ba etsang thobalano ba nang le matšoao a STI ka hona, bacha ba kenang tliliniking ea STI ba ka se emetse bacha ba etsang thobalano ho bongata ka kakaretso. Ho feta mona, bacha ba etsang thobalano le FSWs ba ka se be le mafu a likobo, ka lebaka leo, ba kanna ba se ke ba batla tlhokomelo ea bongaka tleleniking ea STI. Kaha data e ne e le karolo ea tlhaho tlhahisong, re ka sitoa ho theha kamano ea nakoana lipakeng tsa mabaka a kotsi mme re kile ra ba le thobalano le li-FSW. Sebakeng sa tšebeliso ea likhohlopo bophelo bohle ka li-FSW, re ile ra lekola tšebeliso ea likhohlopo selemong se fetileng feela. Hape ha rea ka ra khona ho etsa litlatsetso mabapi le sepheo le maemo a ho reka ka thobalano har'a bacha, e leng se fanang ka lebaka la tlhoko ea lipatlisiso tsa boleng. Boholo ba sampole ea rona e fokolang bo boetse bo beha meeli ea rona ea lipalo ho lekola lintlha tse ikemetseng tse amanang le ts'ebeliso ea likhohlopo le li-FSW. Qetellong, liphetho li ke ke tsa akaretsoa ho bacha ba batona ba tlalehileng ba etsa thobalano le balekane ba banna kapa banna ba etsang thobalano le banna. Leha ho le joalo, thuto ea rona e na le tekanyo e phahameng ea karolo le mohlala oa merabe e mengata. Re sebelisitse mohlala oa tikoloho ho khetholla ka mokhoa o hlophisehileng likamano tse ka bang teng le boitšoaro bona bo rarahaneng. Habohlokoa le ho feta, liphetho tsa rona li fane ka leseli mabapi le boitšoaro ba ho reka thobalano ho bacha le litlamorao tsa bophelo ba sechaba.
Ho fumana ha rona karolo e phahameng ea ho reka thobalano ho bacha ba sebetsang ka bong bo fapaneng ba kenang tliliniking ea mafu a likobo ke taba ea bophelo bo botle ba sechaba. Hoo e ka bang karolo ea boraro ea bacha le bona ba ne ba sa sebelise likhohlopo ka mokhoa o ts'oanang le li-FSW. Ke mohloli o ka sebelisang konteraka le ho fetisetsa mafu a likobo ho batho ka kakaretso joalo ka balekane ba bona ba kamehla kapa bao ba sa tsebeng letho ka bona, bao ba ileng ba tlaleha monyetla o tlase oa tšebeliso ea likhohlopo. [27] Ho feta moo, bacha ba neng ba kopanela liphate le batho ba etsang thobalano ba sa laoloang ke molao joalo ka barekisi ba mebileng ba tlalehile karolo e phahameng ea tšebeliso ea likhohlopo e sa lumellaneng le ba neng ba etsa thobalano le bahokahanyi ba tsa bong bo amanang le botekatse naheng ea Singapore, moo ho thehiloe lenaneo la tšebeliso ea khohlopo ea 100%. [28] Ho boetse ho thata ho latela bacha ba Singapore ba rekang thobalano ho tsoa ho li-FSW ba sebetsa ka tsela e seng molaong literateng kapa mose ho maoatle. Lithuto tsa morao-rao tsa thobalano likolong tsa Singapore li ka ba tsa morao-rao ho ruta bacha ka ho reka ka thobalano le tšebeliso ea likhohlopo. Leha ho le joalo, ba tlohelang sekolo ba kanna ba se khone ho rua molemo lenaneong lena.
Lits'ebetso tse shebileng bareki ba lilemong tsa bocha ba tlang tleliniking e le 'ngoe feela ea STI ho sechaba sa Singapore e sebetsa e le leano le sebetsang la ho fana ka thuto ea thibelo ea mafu a tšoaetsanoang ka lefu la likobo, ho hlahlobisisa le ho alafa bacha ba rekang thobalano ka mekhoa ena, leha re lumela hore bacha ba ka batla tlhokomelo ea bophelo bo botle maemong a mang. Lebaka le leng hape la hore ho kenelletse ho lokela ho qala nakong ea bocha ke hore bacha ba na le ts'ebetso ea phetoho ea boitsoaro ho feta batho ba baholo. [29] Litšebelisano tse joalo tsa boits'oaro li lokela ho lumellana le bacha ba kenang thobalanong le li-FSW ka ho fetola maemo a fapaneng a tšusumetso joalo ka mabaka a motho a le mong le a litaba. Ha ho fanoa ka lipatlisiso tsa phuputso ena tleleniking ea STI, lipatlisiso tsa naha mabapi le boitšoaro ba thobalano li lokela ho kenyelletsa bacha le ho kenyelletsa lipotso mabapi le ho kopana le thobalano le li-FSW ho lumella ho shebella le ho lekola boitšoaro bona ka nako e telele. Lithuto tsa nako e tlang le palo e kholo ea bacha ba kenang thobalanong le li-FSW li ka fana ka leseli le eketsehileng ka boits'oaro ba bona ba ts'ebeliso ea likhohlopo.
Nahanisisa
Ho na le karolo e kholo ea bacha ba batona ba eang tleliniking ea STI ba tlalehileng ba etsa thobalano le li-FSW. Ha karolo e kholo ea bona e sa sebelise likhohlopo, ke borokho bo ka fetisetsang phetiso ea mafu a likobo ho basali ba bangata ba Singapore le ho feta. Ka hona, mananeo a thijoeng a thibelo a lokela ho qala nakong ea bohlankana e le ho beha metheo ea bophelo bo botle ba thobalano.
Ho tšehetsa Boitsebiso
lumela hore baa fokola
Re leboha batsamaisi le basebeletsi ba tleliniki ea DSC ba thusitseng thuto. Re boetse re leboha Dede Tham le Raymond Lim ba thusitseng ho bokella datha. Boithuto bona e ne e le karolo ea boithuto ba boithuto ba boits'oaro bakeng sa bacha ba tšehelitsoeng ke Lekhotla la Naha la Lipatlisiso tsa Bongaka.
Menehelo ea Mongoli
Rea tseba le ho hlophisa liteko: WLM. O entse liteko: JYSN. Hlahloba data: JYSN WLM. Ngola pampiri: JYSN WLM.
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