Understanding the linkages between male circumcision and multiple sexual partnership among married Ghanaian men: Analysis of data from the 2014 Ghana demographic and health survey

Multiple sexual partnership among adolescent boys and young men in Ghana: analysis of the 2003-2014 Ghana Demographic and Health Survey

BACKGROUND

Multiple sexual partnership (MSP) is a major cause of HIV/AIDS epidemic and unplanned pregnancies in sub-Saharan Africa. We investigate how individual, household, interpersonal, community and structural factors correlate with multiple sexual partnership of adolescent boys and young men in Ghana.

METHODS

We pooled secondary data from the 2003, 2008 and 2014 Ghana Demographic and Health Surveys (GDHS). Analytic sample of 1422 males aged 15-24 years who are sexually active and never married were used for the study. The outcome variable for the study was two or more sexual partners in the last 12 months preceding the survey. Five models were fitted using multilevel mixed effects logistic regression to identify predictors of multiple sexual partners. Results were presented using adjusted odds ratios (ORadj) with its corresponding 95% confidence interval.

RESULTS

The pooled data prevalence of multiple sexual partnership was 28.1%, with 18.7%, 30.0% and 33.3% of adolescent boys and young men involved in multiple sexual partnerships in 2003, 2008 and 2014, respectively. Results of the study showed that young men aged 20-24 years [ORadj = 1.39, 95% CI = 1.01-1.91], being from household with richest wealth index [ORadj = 1.76, 95% CI = 1.01-3.06] and those with secondary/higher education [ORadj = 2.94, 95% CI = 1.44-6.06] were more likely to have multiple sexual partners. On the other hand, those who delayed their first sex [ORadj = 0.45, 95% CI = 0.29-0.70] and those currently using modern contraceptive methods [ORadj = 0.37, 95% CI = 0.28-0.50] were less likely to have multiple sexual partners.

CONCLUSION

The findings provide support for the social ecological argument that sexual health behaviours are influenced by individual, interpersonal, community and contextual characteristics. Future policies and interventions seeking to address the increasing prevalence of multiple sexual partnerships among adolescent boys and young men should take into consideration family planning programmes and sexual education in affluent communities, secondary and higher institutions.

Factors Influencing the Uptake of Voluntary Medical Male Circumcision Among Boda-Boda Riders Aged 18–49 Years in Hoima, Western Uganda

Introduction

Methods

Results

Conclusion

Understanding the Evolving Role of Voluntary Medical Male Circumcision as a Public Health Strategy in Eastern and Southern Africa: Opportunities and Challenges

PURPOSE OF REVIEW

Voluntary male medical circumcision (VMMC) has been a cornerstone of HIV prevention in Eastern and Southern Africa (ESA) and is credited in part for declines in HIV incidence seen in recent years. However, these HIV incidence declines change VMMC cost-effectiveness and how it varies across populations.

RECENT FINDINGS

Mathematical models project continued cost-effectiveness of VMMC in much of ESA despite HIV incidence declines. A key data gap is how demand generation cost differs across age groups and over time as VMMC coverage increases. Additionally, VMMC models usually neglect non-HIV effects of VMMC, such as prevention of other sexually transmitted infections and medical adverse events. While small compared to HIV effects in the short term, these could become important as HIV incidence declines. Evidence to date supports prioritizing VMMC in ESA despite falling HIV incidence. Updated modeling methodologies will become necessary if HIV incidence reaches low levels.

Empirical linkages between female genital mutilation and multiple sexual partnership: evidence from the 2018 Mali and 2013 Sierra Leone Demographic and Health Surveys

Female genital mutilation (FGM) is very pervasive in Africa, with significant regional variations in the prevalence of this traditional practice. This study examined the linkages between FGM and multiple sexual partnership in Mali and Sierra Leone - two African countries with a high prevalence of FGM. Data were from the 2018 Mali and 2013 Sierra Leone Demographic and Health Surveys, and the study sample comprised 4750 women from Mali and 16,614 from Sierra Leone. Multilevel logistic regression was used for the data analysis, with reported adjusted odds ratios (aOR) and associated 95% confidence intervals. In Mali, women who had not undergone FGM were less likely to have multiple sexual partners (aOR=0.60, CI=0.38-0.96) compared with those who had undergone FGM. In Sierra Leone, women who had undergone FGM (aOR=1.15, CI=1.02-1.30) were more likely to have multiple sexual partners compared with those who had not undergone FGM. Age, level of education, wealth quintile, sex of household head, community socioeconomic status, mass media exposure, and community literacy level were found to be associated with the likelihood of multiple sexual partnership among women in Mali and Sierra Leone. Comprehensive, age-group-based risk-reduction strategies, such as abstinence education and decision-making skills (assertiveness) training, are needed to reduce girls' and young women's engagement in multiple sexual partnerships. Policy interventions, such as anti-FGM legislation and initiatives like the 'Schooling for the Female Child' initiative aimed at reducing social inequality among girls and women, might help decrease FGM and the likelihood of health-compromising behaviours like multiple sexual partnership.