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P
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S)
Vo
l.
14
,
No
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3
,
Sep
tem
b
er
2
0
2
5
,
p
p
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1
1
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Au
g
2
6
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2
0
2
4
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ev
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Dec
2
5
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4
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Ma
r
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se
s.
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v
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o
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a
n
d
c
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l
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v
o
lu
n
tary
c
o
u
n
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li
n
g
a
n
d
tes
ti
n
g
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e
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u
rp
o
se
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th
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e
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a
m
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e
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e
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c
to
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a
ss
o
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iate
d
with
th
e
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p
tak
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VCT
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m
o
n
g
a
d
o
les
c
e
n
ts
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th
e
g
e
n
e
ra
l
p
o
p
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lati
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t
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v
a
.
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c
ro
ss
-
se
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n
a
l
stu
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y
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e
sig
n
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a
q
u
a
n
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it
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ti
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h
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q
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e
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d
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o
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se
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l
m
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o
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o
l
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re
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ll
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se
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th
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h
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2
9
in
d
iv
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a
ls
in
to
tal,
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t
ra
n
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o
m
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o
k
p
a
rt
i
n
th
is
stu
d
y
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h
e
p
re
v
a
len
c
e
ra
ti
o
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R)
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h
a
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5
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o
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e
n
c
e
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t
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ll
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ra
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ters
th
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t
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d
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e
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c
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(P
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=
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1
3
3
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%
CI
1
.
2
9
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a
v
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b
sta
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t
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imp
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c
t
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VCT
fo
r
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.
Th
u
s,
it
'
s
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rit
ica
l
to
e
n
h
a
n
c
e
so
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ial
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a
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it
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d
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t
e
d
u
c
a
ti
o
n
a
l
in
it
iativ
e
s
o
n
VCT
fo
r
HIV
u
sin
g
so
c
ial
m
e
d
ia
in
o
rd
e
r
to
imp
ro
v
e
tee
n
a
g
e
rs'
fa
v
o
ra
b
le
p
e
rc
e
p
ti
o
n
s
o
f
t
h
e
trea
tme
n
t.
K
ey
w
o
r
d
s
:
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u
ir
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im
m
u
n
o
d
ef
icien
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s
y
n
d
r
o
m
e
Ad
o
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C
o
m
m
u
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le
d
is
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s
e
Hu
m
an
im
m
u
n
o
d
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f
icien
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v
ir
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s
Vo
lu
n
tar
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c
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test
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a
rticle
u
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CC B
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C
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A
uth
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Stu
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an
d
Hea
lth
Pro
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o
ti
o
n
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Facu
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o
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Pu
b
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lth
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Un
i
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s
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Air
lan
g
g
a
Su
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I
n
d
o
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y
.
q
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id
1.
I
NT
RO
D
UCT
I
O
N
An
in
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tio
n
with
th
e
h
u
m
an
im
m
u
n
o
d
e
f
icien
cy
v
ir
u
s
(
HI
V)
ca
u
s
es
an
in
f
ec
tio
u
s
im
m
u
n
e
s
y
s
tem
d
is
ea
s
e
th
at
h
as
th
e
p
o
ten
tial
t
o
b
e
f
atal
[
1
]
.
Glo
b
ally
,
1
.
6
5
m
illi
o
n
(
1
.
1
8
-
2
.
1
9
m
illi
o
n
)
teen
ag
er
s
b
etwe
en
th
e
ag
es
o
f
1
0
an
d
1
9
ar
e
p
r
o
jecte
d
to
h
av
e
HI
V
b
y
2
0
2
2
.
Ap
p
r
o
x
im
ately
4
%
o
f
HI
V
-
p
o
s
itiv
e
in
d
iv
id
u
als
ar
e
ad
o
lescen
ts
.
Asi
a
an
d
L
atin
Am
er
ica
h
av
e
th
e
h
ig
h
est
r
a
tes
o
f
HI
V
-
p
o
s
itiv
e
teen
a
g
er
s
[
2
]
.
T
h
e
h
ig
h
est
n
u
m
b
er
o
f
HI
V
p
o
s
itiv
e
ca
s
es
in
I
n
d
o
n
esia
is
r
an
k
ed
s
ec
o
n
d
in
th
e
ag
e
g
r
o
u
p
o
f
a
d
o
le
s
ce
n
ts
2
0
–
2
4
y
ea
r
s
(
1
6
.
9
%)
an
d
f
o
u
r
th
in
ad
o
lesc
en
ts
ag
ed
1
5
–
1
9
y
ea
r
s
(
3
.
1
%).
Me
an
wh
ile,
o
u
t o
f
3
4
I
n
d
o
n
e
s
ian
p
r
o
v
in
ce
s
,
E
ast
J
av
a
h
as
alwa
y
s
h
ad
th
e
h
ig
h
est
r
ate
o
f
n
ew
HI
V
ca
s
e
s
,
ev
en
th
o
u
g
h
th
e
tr
en
d
in
th
e
n
u
m
b
er
o
f
n
ew
ca
s
es
f
r
o
m
2
0
1
9
(
8
,
9
3
5
)
to
2
0
2
1
(
5
,
8
7
2
)
h
as
d
ec
r
ea
s
ed
.
T
h
e
teen
a
g
e
ag
e
g
r
o
u
p
s
o
f
1
5
–
1
9
an
d
2
0
–
2
4
y
ea
r
s
o
ld
h
ad
th
e
lar
g
est
n
u
m
b
er
o
f
HI
V
ca
s
es
in
E
ast
J
av
a
in
2
0
2
1
,
r
an
k
in
g
s
ec
o
n
d
in
ter
m
s
o
f
to
tal
HI
V
ca
s
es
[
3
]
.
T
h
e
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8
8
0
6
I
n
t J Pu
b
lic
Hea
lth
Sci
,
Vo
l.
14
,
No
.
3
,
Sep
tem
b
er
20
25
:
1
1
7
1
-
1
1
7
8
1172
n
u
m
b
er
o
f
n
ew
HI
V
ca
s
e
f
in
d
in
g
s
in
E
ast
J
av
a
in
2
0
2
2
i
n
cr
ea
s
ed
b
y
9
,
2
0
8
ca
s
es,
with
ad
o
lescen
ts
ag
ed
15
–
1
9
y
ea
r
s
in
f
o
u
r
th
p
lace
(
2
%),
wh
ile
2
0
–
2
4
y
ea
r
s
r
an
k
e
d
s
ec
o
n
d
(
1
1
%).
Ad
o
lescen
ts
ar
e
m
o
r
e
v
u
ln
e
r
a
b
le
to
HI
V
in
f
ec
tio
n
d
u
e
to
p
u
b
er
tal
d
ev
elo
p
m
en
t,
s
ex
u
al
m
atu
r
atio
n
,
au
to
n
o
m
y
,
an
d
s
o
cial
ch
an
g
es
[
4
]
-
[
6
]
.
HI
V
is
an
in
c
u
r
ab
le
in
f
ec
tio
n
,
b
u
t w
ith
s
tr
ict
a
d
h
er
en
ce
to
an
tire
tr
o
v
i
r
al
th
er
ap
y
(
AR
T
)
,
it
h
as
b
ec
o
m
e
a
m
an
ag
ea
b
le
ch
r
o
n
ic
d
is
ea
s
e,
an
d
HI
V
-
in
f
ec
ted
p
e
o
p
le
ca
n
n
o
w
liv
e
lo
n
g
,
h
ea
lth
y
,
a
n
d
p
r
o
d
u
ctiv
e
li
v
es
[
7
]
.
T
h
e
r
e
is
a
n
ee
d
t
o
in
c
r
ea
s
e
awa
r
en
ess
o
f
HI
V
p
r
ev
en
tio
n
an
d
ca
r
e
in
ad
o
lescen
ts
[
7
]
.
Ad
o
lesce
n
ts
a
r
e
less
lik
ely
th
an
ad
u
lts
to
b
e
d
iag
n
o
s
ed
with
HI
V,
to
p
ar
ti
cip
ate
in
ca
r
e
,
an
d
to
h
av
e
th
eir
v
ir
u
s
s
u
p
p
r
ess
ed
,
ev
en
with
th
e
wid
esp
r
ea
d
u
s
e
o
f
AR
T
m
ed
icatio
n
[
8
]
,
[
9
]
.
Acc
o
r
d
in
g
to
th
e
W
o
r
l
d
He
alth
Or
g
an
izatio
n
(
W
HO)
,
h
az
ar
d
o
u
s
co
n
d
u
ct,
in
ad
e
q
u
ate
a
cc
ess
to
r
ep
r
o
d
u
ctiv
e
h
ea
lth
s
er
v
ices,
an
d
a
lack
o
f
ac
cu
r
ate
h
ea
lth
i
n
f
o
r
m
atio
n
m
ak
e
y
o
u
n
g
p
eo
p
l
e
m
o
r
e
s
u
s
ce
p
tib
le
to
HI
V
in
f
ec
tio
n
.
Ad
o
lescen
ce
is
r
ec
o
g
n
ized
as
a
p
o
s
s
ib
le
b
ar
r
ier
to
s
to
p
p
in
g
th
e
s
p
r
ea
d
o
f
HI
V/
ac
q
u
ir
ed
im
m
u
n
o
d
ef
icien
cy
s
y
n
d
r
o
m
e
(
AI
DS
)
[
1
0
]
.
O
n
e
tactic
f
o
r
H
I
V
p
r
ev
en
tio
n
an
d
c
o
n
tr
o
l
is
v
o
lu
n
tar
y
c
o
u
n
s
elin
g
an
d
test
in
g
(
VC
T
)
[
1
1
]
.
Un
f
o
r
tu
n
ately
,
t
h
er
e
is
a
s
tig
m
a
ass
o
ciate
d
with
HI
V
th
at
m
ak
es
a
p
er
s
o
n
f
ee
l
u
n
ac
ce
p
ted
in
th
e
co
m
m
u
n
ity
.
T
h
is
s
tig
m
a
h
as
a
d
etr
im
en
t
al
im
p
ac
t
o
n
HI
V
test
in
g
,
tr
e
atm
en
t,
an
d
s
er
v
ice
u
tili
za
tio
n
.
I
t
is
well
estab
lis
h
ed
th
at
m
is
p
er
ce
p
tio
n
s
ab
o
u
t
h
o
w
th
e
v
ir
u
s
s
p
r
ea
d
s
an
d
w
h
at
it
m
ea
n
s
to
liv
e
with
HI
V
ar
e
th
e
m
ain
ca
u
s
es
o
f
HI
V
-
r
elate
d
s
tig
m
a
[
1
1
]
,
[
1
2
]
.
T
h
e
p
u
r
p
o
s
e
o
f
th
is
s
tu
d
y
is
to
ex
am
in
e
th
e
r
is
k
r
elate
d
to
HI
V
v
o
lu
n
tar
y
co
u
n
s
elin
g
an
d
test
in
g
am
o
n
g
E
ast
J
av
a'
s
g
en
er
al
teen
ag
e
p
o
p
u
latio
n
.
I
n
th
e
p
r
ev
en
tiv
e
a
n
d
ea
r
ly
d
etec
tio
n
p
h
ase
in
th
e
teen
a
g
e
ag
e
g
r
o
u
p
,
th
is
s
tu
d
y
c
o
n
tr
ib
u
tes
to
th
e
ac
h
iev
em
en
t
o
f
th
e
th
ir
d
s
u
s
tain
ab
le
d
e
v
elo
p
m
en
t g
o
al
(
SDG)
2
0
3
0
: e
n
d
in
g
th
e
HI
V/AI
DS e
p
id
em
ic
b
y
2
0
3
0
.
2.
M
E
T
H
O
D
T
h
is
s
tu
d
y
em
p
lo
y
ed
a
cr
o
s
s
-
s
ec
tio
n
al
o
b
s
er
v
atio
n
al
d
esig
n
u
s
in
g
q
u
an
titativ
e
m
et
h
o
d
s
,
co
n
d
u
cte
d
in
J
u
ly
2
0
2
4
in
E
ast
J
av
a,
I
n
d
o
n
esia,
tar
g
etin
g
ad
o
lescen
ts
d
o
m
iciled
in
th
e
r
e
g
io
n
.
A
s
am
p
le
s
ize
o
f
3
2
9
was
d
eter
m
in
ed
u
s
in
g
a
s
am
p
le
s
ize
f
o
r
m
u
la
f
o
r
a
lar
g
e
p
o
p
u
la
tio
n
(
N
=
3
,
0
5
5
,
2
3
6
a
d
o
lesce
n
ts
b
ased
o
n
2
0
2
2
B
PS
E
ast
J
av
a
d
ata)
an
d
s
elec
ted
th
r
o
u
g
h
r
a
n
d
o
m
s
am
p
lin
g
with
th
e
in
clu
s
io
n
cr
iter
ia
o
f
E
ast
J
av
a
r
esid
en
cy
an
d
willin
g
n
ess
to
p
ar
ticip
ate.
r
esu
ltin
g
in
a
ca
lcu
late
d
s
am
p
le
s
ize
o
f
at
least
1
0
0
p
ar
t
icip
an
ts
with
a
1
0
%
m
ar
g
in
o
f
er
r
o
r
.
=
N
1
+
(
)
2
T
h
e
r
esear
ch
s
am
p
le
was
all
r
esp
o
n
d
en
ts
wh
o
m
et
th
e
in
clu
s
io
n
cr
iter
ia
a
n
d
f
illed
o
u
t
t
h
e
q
u
esti
o
n
n
air
e
co
m
p
letely
.
T
h
e
r
ec
r
u
itm
en
t
p
r
o
ce
s
s
b
y
d
is
tr
ib
u
tin
g
q
u
esti
o
n
n
air
es
u
s
in
g
Go
o
g
le
Fo
r
m
s
lin
k
s
o
n
s
o
cial
m
ed
ia
(
W
h
atsAp
p
a
n
d
I
n
s
tag
r
a
m
)
b
y
co
n
s
id
er
in
g
m
ed
i
a
th
at
ar
e
o
f
g
r
ea
t
in
ter
e
s
t
to
teen
ag
er
s
.
On
Go
o
g
le
Fo
r
m
wr
ite
a
n
ar
r
ativ
e
ex
p
lan
atio
n
o
f
th
e
p
u
r
p
o
s
e
an
d
b
e
n
ef
its
o
f
th
e
s
tu
d
y
,
as
well
as
co
n
s
en
t
to
b
ec
o
m
e
a
r
esp
o
n
d
en
t.
T
h
e
d
ata
co
llected
m
ea
s
u
r
e
d
in
d
e
p
en
d
en
t
v
ar
iab
les
in
clu
d
i
n
g
a
g
e,
g
en
d
er
,
p
ar
en
tal
i
n
co
m
e
(
e
q
u
al
,
a
n
d
a
b
o
v
e
th
e
city
m
in
im
u
m
wag
e)
,
VC
T
k
n
o
wled
g
e
(
m
o
d
er
ate
a
n
d
g
o
o
d
ca
teg
o
r
ies),
HI
V
s
y
m
p
to
m
s
(
n
o
n
e,
p
r
esen
t)
,
s
o
c
ial
m
ed
ia
(
b
ad
,
g
o
o
d
)
,
in
s
titu
tio
n
al
s
u
p
p
o
r
t
(
s
u
p
p
o
r
t
p
r
o
v
id
e
d
b
y
in
s
titu
tio
n
s
o
r
s
ch
o
o
ls
with
b
ad
an
d
s
u
p
p
o
r
ti
v
e
ca
teg
o
r
ies),
s
o
cial
ca
p
ital
(
m
ea
s
u
r
ed
b
y
tr
u
s
t,
n
o
r
m
s
,
an
d
n
etwo
r
k
s
with
b
ad
an
d
s
u
p
p
o
r
ti
v
e
ca
teg
o
r
ies),
s
tig
m
a
(
n
eg
ativ
e,
p
o
s
itiv
e)
.
T
h
e
d
ep
en
d
e
n
t
v
ar
iab
le
was
attitu
d
e
to
war
d
s
VC
T
f
o
r
HI
V
(
with
n
eg
ativ
e
an
d
p
o
s
itiv
e
ca
teg
o
r
ies)
[
1
3
]
.
T
h
e
q
u
esti
o
n
n
air
e
u
s
ed
was
test
ed
f
o
r
v
alid
ity
an
d
r
eliab
ilit
y
o
n
2
0
ad
o
lescen
ts
with
th
e
s
am
e
ch
ar
ac
ter
is
tics
,
with
a
ca
lcu
lated
r
-
v
alu
e
>
th
an
r
-
tab
le
(
0
.
4
2
3
)
,
an
d
a
r
eliab
ilit
y
v
alu
e
with
a
n
alp
h
a
C
r
o
n
b
ac
h
v
alu
e
>
0
.
6
.
C
r
o
s
s
-
tab
les
(
co
n
tin
g
en
cy
ta
b
les),
th
at
d
ep
ict
th
e
r
elatio
n
s
h
ip
b
etwe
en
t
h
e
in
d
e
p
en
d
en
t
a
n
d
d
ep
en
d
en
t
v
a
r
iab
les.
T
h
e
lev
el
o
f
r
is
k
was
ass
ess
ed
b
y
lo
o
k
i
n
g
at
th
e
p
r
e
v
alen
ce
r
atio
(
PR
)
with
a
9
5
%
co
n
f
i
d
en
ce
in
ter
v
al
[
1
4
]
.
Data
an
al
y
s
is
in
v
o
lv
e
d
cr
o
s
s
-
tab
u
latio
n
s
an
d
C
hi
-
s
q
u
ar
e
test
s
to
ex
am
in
e
a
s
s
o
ciatio
n
s
b
etwe
en
v
ar
iab
les,
with
p
r
ev
alen
ce
r
atio
s
(
PR
)
a
n
d
9
5
%
co
n
f
id
en
ce
in
ter
v
als ca
lcu
lated
to
ass
ess
r
is
k
lev
els;
a
p
-
v
alu
e
o
f
<0
.
0
5
was c
o
n
s
id
er
ed
s
tatis
tically
s
i
g
n
if
ican
t.
3.
RE
SU
L
T
S AN
D
D
I
SCU
SS
I
O
N
3
.
1
.
Resul
t
s
3
.
1
.
1
.
Cha
ra
ct
er
is
t
ics o
f
re
s
po
nd
ent
s
T
h
is
s
tu
d
y
u
s
ed
d
ata
co
llected
f
r
o
m
3
2
9
ad
o
lescen
ts
in
E
ast
J
av
a.
T
ab
le
1
s
h
o
ws
th
e
ch
ar
ac
ter
is
tics
o
f
teen
a
g
er
s
in
th
e
E
ast
J
av
a
r
eg
io
n
.
T
h
e
m
ajo
r
ity
o
f
r
es
p
o
n
d
e
n
ts
wer
e
2
0
-
2
4
y
ea
r
s
o
ld
(
6
5
.
3
%),
f
em
ale
(
8
4
.
8
%),
an
d
th
eir
p
ar
en
ts
'
in
co
m
e
was
at
o
r
ab
o
v
e
th
e
m
in
im
u
m
wag
e
(
7
0
.
2
%
)
.
Mo
s
t
r
esp
o
n
d
en
ts
also
h
ad
g
o
o
d
k
n
o
wled
g
e
o
f
VC
T
f
o
r
HI
V
(
5
6
.
2
%),
r
ec
eiv
e
d
s
u
p
p
o
r
t
f
r
o
m
s
ch
o
o
l/co
lleg
e
(
9
8
.
3
%),
h
ad
s
u
p
p
o
r
tiv
e
s
o
cial
ca
p
ital
(
9
0
.
0
%),
s
till
h
a
d
n
eg
ativ
e
s
tig
m
a
to
war
d
s
p
eo
p
le
with
HI
V
(
5
8
.
4
%)
,
an
d
l
ac
k
ed
s
o
cial
m
ed
ia
ac
ce
s
s
to
VC
T
f
o
r
HI
V
in
f
o
r
m
atio
n
(
5
3
.
5
%)
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J Pu
b
lic
Hea
lth
Sci
I
SS
N:
2252
-
8
8
0
6
S
o
cia
l m
ed
ia
a
n
d
s
o
cia
l c
a
p
it
a
l a
s
r
is
k
o
f v
o
lu
n
ta
r
y
co
u
n
s
elin
g
a
n
d
test
in
g
fo
r
…
(
E
n
y
Qu
r
n
iya
w
a
ti
)
1173
3
.
1
.
2
.
Ris
k
f
a
c
t
o
rs f
o
r
a
t
t
it
u
des
t
o
wa
rds
VCT f
o
r
H
I
V
R
is
k
f
ac
to
r
s
f
o
r
VC
T
f
o
r
HI
V
attitu
d
es
in
T
a
b
le
2
s
h
o
w
t
h
at
s
o
cial
m
ed
ia
ac
ce
s
s
h
as
a
s
ig
n
if
ican
t
ass
o
ciatio
n
with
a
p
r
ev
alen
c
e
r
atio
(
PR
)
o
f
1
0
.
1
3
3
(
9
5
%
C
I
;
1
.
2
9
3
–
7
9
.
4
2
2
)
,
an
d
s
o
c
ial
ca
p
ital
h
as
a
s
ig
n
if
ican
t
ass
o
ciatio
n
with
a
p
r
ev
alen
ce
r
atio
(
PR
)
o
f
1
0
.
7
4
1
(
9
5
%
C
I
;
3
.
2
4
0
–
3
5
.
6
0
1
)
.
T
h
is
s
h
o
ws
th
at
lack
o
f
s
o
cial
m
e
d
ia
ac
ce
s
s
an
d
less
s
u
p
p
o
r
tiv
e
s
o
cial
ca
p
ital
h
av
e
a
s
ig
n
if
ican
t
ef
f
ec
t
o
n
t
h
e
r
is
k
o
f
n
eg
ativ
e
attitu
d
es to
war
d
s
VC
T
f
o
r
HI
V
in
ad
o
lescen
ts
.
T
ab
le
1
.
C
h
ar
ac
ter
is
tics
o
f
ad
o
lescen
ts
in
E
ast J
av
a
C
h
a
r
a
c
t
e
r
i
s
t
i
c
n
%
A
g
e
18
-
1
9
y
e
a
r
s
1
1
4
3
4
.
7
20
-
2
4
y
e
a
r
s
2
1
5
6
5
.
3
G
e
n
d
e
r
M
a
l
e
50
`
1
5
.
2
F
e
mal
e
2
7
9
8
4
.
8
P
a
r
e
n
t
s'
i
n
c
o
m
e
B
e
l
o
w
t
h
e
c
i
t
y
mi
n
i
m
u
m
w
a
g
e
98
2
9
.
8
A
t
o
r
a
b
o
v
e
t
h
e
c
i
t
y
mi
n
i
mu
m w
a
g
e
2
3
1
7
0
.
2
V
C
T
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Evaluation Warning : The document was created with Spire.PDF for Python.
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3
,
Sep
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b
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20
25
:
1
1
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1174
HI
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is
an
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d
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willin
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to
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d
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t
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s
t
in
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p
r
e
v
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tio
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m
an
ag
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e
n
t,
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d
a
r
ed
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in
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r
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ted
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tig
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I
n
d
iv
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s
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HI
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im
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t
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f
d
is
cr
im
in
ati
o
n
o
r
n
eg
ativ
e
ju
d
g
m
en
t
[
1
6
]
.
On
e
s
tu
d
y
s
h
o
wed
th
at
th
o
s
e
wh
o
ar
e
s
tig
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-
f
r
ee
p
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s
t
-
co
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n
s
elin
g
ca
n
im
p
r
o
v
e
th
eir
s
o
cial
r
elatio
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s
h
ip
s
with
f
am
ily
an
d
co
m
m
u
n
ity
m
em
b
e
r
s
[
1
7
]
.
T
h
ey
also
h
ad
co
n
f
i
d
en
ce
th
at
test
r
esu
lts
an
d
p
er
s
o
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al
in
f
o
r
m
atio
n
wo
u
ld
b
e
k
ep
t
co
n
f
id
en
tial
[
1
8
]
.
A
n
e
g
ativ
e
attitu
d
e
to
war
d
s
VC
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f
o
r
HI
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is
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test
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r
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f
test
r
esu
lts
an
d
p
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ten
tial
s
o
cial
s
tig
m
a
[
1
9
]
.
I
n
d
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id
u
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with
th
is
attitu
d
e
f
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l
a
n
x
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d
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d
n
e
g
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if
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test
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esu
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s
h
o
w
th
at
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HI
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p
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s
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e
[
2
0
]
.
T
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e
y
m
ay
also
d
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b
t
th
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co
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f
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s
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to
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s
.
Fig
u
r
e
1
.
Sp
atial
an
aly
s
is
o
f
V
C
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f
o
r
HI
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n
d
s
o
ci
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ca
p
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m
o
n
g
a
d
o
lescen
ts
in
E
ast J
av
a,
I
n
d
o
n
esia
Fig
u
r
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2
.
Sp
atial
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s
is
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f
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C
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d
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c
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eq
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HI
V/AI
DS
p
r
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g
r
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io
n
[
1
0
]
.
Similar
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th
o
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ig
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A
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B
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b
e
less
s
u
p
p
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r
tiv
e
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f
VC
T
f
o
r
HI
V
[
2
1
]
.
I
t'
s
cr
u
cial
to
h
av
e
s
o
lid
u
n
d
er
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tan
d
i
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VC
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o
r
HI
V.
A
co
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r
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en
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iv
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n
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er
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d
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HI
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ca
n
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elp
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r
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t
th
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r
a
p
id
s
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d
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ed
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ce
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tig
m
a
an
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cr
im
in
atio
n
Evaluation Warning : The document was created with Spire.PDF for Python.
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ag
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[
2
2
]
.
I
n
s
titu
tio
n
al
s
u
p
p
o
r
t w
as a
ls
o
im
p
o
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tan
t,
with
9
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3
% o
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th
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o
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elt
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ted
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eir
in
s
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s
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win
g
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o
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itiv
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attitu
d
es.
T
h
is
s
u
p
p
o
r
t
is
in
th
e
f
o
r
m
o
f
i
n
f
o
r
m
atio
n
o
n
HI
V
r
is
k
f
ac
to
r
s
an
d
VC
T
f
o
r
HI
V
,
an
d
u
s
u
ally
h
as
th
e
p
o
ten
tial
to
in
f
lu
en
ce
p
o
s
itiv
e
attitu
d
es
as
it
co
m
es
in
th
e
f
o
r
m
o
f
d
o
ctr
in
al
k
n
o
wled
g
e,
f
am
iliar
ity
,
an
d
h
a
b
its
[
2
3
]
.
Neg
ativ
e
s
tig
m
a
to
war
d
s
HI
V
d
o
es
n
o
t
s
ee
m
to
h
av
e
m
u
c
h
ef
f
ec
t
o
n
attitu
d
es
to
war
d
s
VC
T
f
o
r
HI
V,
as
9
7
.
4
%
o
f
th
o
s
e
with
n
eg
ativ
e
s
t
ig
m
a
to
war
d
s
HI
V
s
u
f
f
er
er
s
s
till
s
h
o
wed
p
o
s
itiv
e
attitu
d
es to
war
d
s
V
C
T
f
o
r
HI
V.
Acc
o
r
d
in
g
to
s
tu
d
ies co
n
d
u
cted
in
Nig
er
ia,
th
e
m
ajo
r
ity
o
f
p
er
s
o
n
s
wh
o
wis
h
to
r
ec
ei
v
e
HI
V
s
er
v
ices
f
r
o
m
VC
T
g
en
er
ally
d
o
s
o
d
es
p
ite
th
e
s
tig
m
a
an
d
d
is
cr
im
in
atio
n
th
at
HI
V/AI
DS su
f
f
er
er
s
f
ac
e
[
2
4
]
.
Ad
o
lescen
t
g
ir
ls
wer
e
th
e
m
ajo
r
ity
o
f
th
o
s
e
with
a
n
eg
ativ
e
attitu
d
e
ab
o
u
t
VC
T
f
o
r
HI
V.
Acc
o
r
d
in
g
to
ea
r
lier
s
tu
d
ies
b
ased
o
n
a
s
t
u
d
y
f
r
o
m
th
e
E
th
io
p
ian
Fed
e
r
al
Dep
ar
tm
en
t
o
f
Hea
lth
,
wo
m
en
ar
e
p
ar
ticu
lar
ly
s
u
s
ce
p
tib
le
to
HI
V
in
f
ec
tio
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d
m
o
s
t
o
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th
em
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av
e
a
d
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ak
in
g
d
ec
is
io
n
s
ab
o
u
t
h
av
in
g
c
h
ild
r
en
[
2
5
]
.
T
h
o
s
e
wh
o
d
o
n
o
t
h
av
e
HI
V
s
y
m
p
to
m
s
also
ten
d
to
s
h
o
w
n
eg
ativ
e
attitu
d
es.
T
h
e
r
e
i
s
a
p
er
ce
p
tio
n
th
at
th
ey
ar
e
n
o
t
at
r
is
k
o
r
d
o
n
o
t
n
ee
d
test
in
g
b
ec
a
u
s
e
th
ey
f
ee
l
h
ea
lth
y
.
On
e
s
tu
d
y
s
h
o
wed
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h
at
an
im
p
o
r
tan
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f
ir
s
t
s
tep
in
HI
V
d
is
ea
s
e
m
an
a
g
em
en
t
is
ca
s
e
f
i
n
d
in
g
o
r
s
y
m
p
to
m
s
,
y
et
m
o
s
t
in
d
i
v
id
u
als
a
r
e
d
iag
n
o
s
ed
with
HI
V
in
f
ec
tio
n
asy
m
p
t
o
m
at
ically
[
2
6
]
.
T
h
e
r
ef
o
r
e
,
teen
ag
e
r
s
ar
e
p
r
o
n
e
to
h
av
e
a
n
eg
ativ
e
attitu
d
e
ab
o
u
t
VC
T
f
o
r
HI
V
s
in
ce
th
ey
d
o
n
o
t e
x
h
ib
it
p
ar
ticu
lar
HI
V
s
y
m
p
t
o
m
s
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d
ar
e
n
o
t c
o
n
s
cio
u
s
o
f
t
h
eir
h
ea
l
th
.
T
h
is
s
tu
d
y
d
em
o
n
s
tr
ates
th
at
th
e
r
is
k
o
f
VC
T
f
o
r
HI
V
attit
u
d
es
is
s
ig
n
if
ican
t
ly
im
p
ac
ted
b
y
s
o
cial
ca
p
ital
s
u
p
p
o
r
t
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d
s
o
cial
m
e
d
ia
av
ailab
ilit
y
.
Ad
o
lescen
ts
with
less
s
u
p
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o
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tiv
e
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o
cial
ca
p
ital
ch
ar
ac
ter
is
tic
s
h
av
e
a
r
is
k
o
f
1
0
,
7
4
1
n
eg
ativ
e
attitu
d
es
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d
s
VC
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f
o
r
HI
V.
I
n
co
n
tem
p
o
r
ar
y
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u
b
lic
h
ea
lth
,
s
o
cial
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p
ital
is
a
k
ey
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o
tio
n
.
T
h
e
ter
m
"
s
o
cial
ca
p
ital"
r
ef
e
r
s
to
th
e
co
n
n
ec
tio
n
s
th
at
m
i
g
h
t
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in
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al
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co
m
m
u
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ity
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ce
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s
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n
etwo
r
k
s
o
f
n
ea
r
b
y
r
eso
u
r
ce
s
an
d
ass
is
tan
ce
[
2
7
]
.
A
f
am
ily
'
s
,
n
eig
h
b
o
r
h
o
o
d
'
s
,
s
ch
o
o
l'
s
,
an
d
o
r
g
an
izatio
n
s
'
r
o
les
in
n
e
two
r
k
s
,
r
elatio
n
s
h
ip
s
,
n
o
r
m
s
,
co
h
er
en
ce
,
an
d
tr
u
s
t
ar
e
all
i
m
p
o
r
tan
t
asp
ec
ts
o
f
s
o
cial
ca
p
ital
[
2
8
]
.
So
cial
ca
p
i
tal
ass
es
s
es
th
e
b
elief
th
at
th
er
e
ar
e
r
u
les
in
r
elig
io
n
th
at
s
u
p
p
o
r
t
to
ac
t p
r
o
p
er
ly
an
d
ac
c
o
r
d
in
g
ly
i
n
m
ai
n
tain
in
g
h
ea
lth
,
b
eliev
e
th
at
d
o
in
g
VC
T
f
o
r
HI
V
is
a
s
o
cial
r
esp
o
n
s
ib
ilit
y
f
o
r
ea
c
h
in
d
iv
id
u
al,
b
eliev
e
in
th
e
s
u
p
p
o
r
t
th
at
ca
n
b
e
o
b
tain
e
d
f
r
o
m
f
am
ily
,
r
elig
io
u
s
lead
er
s
,
c
o
m
m
u
n
ity
lead
e
r
s
an
d
s
u
r
r
o
u
n
d
in
g
p
eo
p
le
h
a
v
e
a
p
o
s
itiv
e
im
p
ac
t
o
n
h
im
,
b
eliev
e
th
at
th
e
n
o
r
m
s
in
th
ei
r
en
v
i
r
o
n
m
en
t
s
u
p
p
o
r
t
to
u
n
d
er
g
o
p
o
s
itiv
e
ac
tiv
ities
in
clu
d
in
g
in
d
is
ea
s
e
p
r
ev
e
n
tio
n
[
2
3
]
,
[
2
8
]
.
So
cial
ca
p
ital
ca
n
b
e
a
f
o
u
n
d
atio
n
to
p
r
o
v
id
e
a
d
o
lescen
ts
with
b
o
u
n
d
ar
ies
,
esp
ec
ially
in
s
ex
u
al
b
eh
av
io
r
a
n
d
in
m
a
k
in
g
d
ec
is
io
n
s
to
tak
e
p
r
ec
au
tio
n
s
,
b
ec
au
s
e
ad
o
lesce
n
ts
wh
o
h
av
e
h
ig
h
lev
els
o
f
s
elf
-
esteem
an
d
co
n
f
id
en
ce
ca
n
m
o
s
tly
m
ak
e
th
eir
o
wn
d
ec
is
io
n
s
.
On
th
e
o
th
er
s
id
e,
in
ad
o
lescen
ts
wh
o
ar
e
ex
p
lo
r
ato
r
y
,
v
u
l
n
er
ab
le,
an
d
g
o
in
g
th
r
o
u
g
h
a
life
ch
an
g
e,
h
ig
h
er
s
elf
-
esteem
ca
n
o
cc
asio
n
ally
r
esu
lt
in
h
az
ar
d
s
[
2
8
]
.
T
h
er
e
f
o
r
e,
th
e
r
o
l
e
o
f
s
o
cial
is
v
er
y
im
p
o
r
t
an
t
in
th
e
f
o
r
m
atio
n
o
f
s
u
p
p
o
r
tiv
e
s
o
cial
ca
p
ital
s
o
th
at
ad
o
lescen
ts
h
av
e
a
h
ig
h
er
r
is
k
o
f
p
o
s
itiv
e
attitu
d
es to
war
d
s
d
is
ea
s
e
p
r
ev
en
tio
n
b
e
h
av
io
r
,
esp
ec
ially
in
co
n
d
u
ctin
g
VC
T
f
o
r
HI
V.
Po
o
r
s
o
cial
m
ed
ia
ac
ce
s
s
in
d
icate
s
a
h
ig
h
r
is
k
o
f
n
eg
ativ
e
a
ttit
u
d
es
i
n
ad
o
lescen
ts
to
war
d
s
VC
T
f
o
r
HI
V.
Ad
o
lescen
ts
wh
o
g
et
s
o
cial
m
ed
ia
n
etwo
r
k
i
n
ter
v
en
ti
o
n
s
ar
e
m
o
r
e
lik
ely
t
o
ac
q
u
ir
e
cr
itical
k
n
o
wled
g
e,
p
ar
ticu
lar
ly
ab
o
u
t
HI
V/AI
D
S
an
d
o
th
er
r
e
p
r
o
d
u
ctiv
e
h
ea
lth
co
n
ce
r
n
s
.
Ad
o
lescen
t
s
m
o
r
e
o
f
ten
g
et
HI
V/AI
DS
-
r
elate
d
in
f
o
r
m
a
tio
n
f
r
o
m
s
o
cial
m
ed
ia,
telev
is
i
o
n
,
an
d
p
r
i
n
t
m
ed
ia
th
a
n
o
t
h
e
r
s
o
u
r
ce
s
[
2
9
]
.
Ou
r
s
tu
d
y
s
h
o
ws
th
at
ad
o
lescen
ts
wh
o
ac
ce
s
s
s
o
cial
m
ed
ia
to
g
e
t
in
f
o
r
m
atio
n
ab
o
u
t
HI
V
d
is
ea
s
e
o
r
VC
T
f
o
r
HI
V
ar
e
s
till
lack
in
g
.
L
ess
u
s
e
o
f
s
o
cial
m
ed
ia
b
y
ad
o
lescen
ts
to
ac
ce
s
s
HI
V
in
f
o
r
m
atio
n
o
r
V
C
T
f
o
r
HI
V
h
as
a
1
0
.
1
3
3
tim
es g
r
ea
ter
r
is
k
o
f
h
a
v
in
g
a
n
e
g
ativ
e
attitu
d
e
to
war
d
s
VC
T
f
o
r
HI
V.
T
h
is
was a
s
s
ess
ed
b
y
h
o
w
o
f
ten
ad
o
lescen
ts
ac
ce
s
s
ed
s
o
cial
m
ed
ia
to
f
in
d
in
f
o
r
m
atio
n
a
b
o
u
t
VC
T
f
o
r
HI
V,
in
f
o
r
m
at
io
n
ab
o
u
t
HI
V
t
h
at
p
ass
ed
o
n
th
e
ir
s
o
cial
m
ed
ia
h
o
m
e
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ter
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th
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m
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m
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ar
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ter
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tio
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p
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r
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ca
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h
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Evaluation Warning : The document was created with Spire.PDF for Python.
I
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2
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6
I
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t J Pu
b
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Hea
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Sci
,
Vo
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14
,
No
.
3
,
Sep
tem
b
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20
25
:
1
1
7
1
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1
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1176
4.
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.
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