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Wagle A, Karki KB. Prevalence of risky sexual behaviour and its associated factors among youths of Pokhara metropolitan city, Nepal: a cross-sectional study. BMJ PUBLIC HEALTH 2024; 2:e000945. [PMID: 40018633 PMCID: PMC11816093 DOI: 10.1136/bmjph-2024-000945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 09/23/2024] [Indexed: 03/01/2025]
Abstract
Introduction Risky sexual behaviour, which puts young people at greater risk of acquiring HIV AIDS and sexually transmitted infection, is a significant public health concern all around the world. In 2020, 15% of ever reported HIV positive cases were youths in Nepal. This study aimed to estimate the prevalence of risky sexual behaviour and its associated factors among youths of Pokhara metropolitan city. Methodology A cross-sectional study was done. The study population was youths aged 15-24 who were currently studying in grades 11/12 or at the bachelor level. The sample size was 850, interviewed in two strata (male and female). A multistage cluster sampling technique was used. A self-administered, structured questionnaire was used to obtain information. Bivariate (χ2 test) and multivariate (logistic regression) analyses were performed to assess the statistically significant relationship between the dependent and independent variables. Results Overall, nearly a third (31%) respondents ever had sexual intercourse. Similarly, the overall prevalence of risky sexual behaviour was 18.6% (95% CI=16% to 21.2%), while the prevalence among sexually active respondents was 60% (95% CI=53.7% to 65.5%). The prevalence varied greatly among two sexes where 72% male and 31% female were involved in risky sexual behaviour. The logistic regression analysis showed that females were 72% (AOR=0.28, 95% CI=0.12 to 0.69) less likely than males and youths aged 20-24 were 72% (AOR=0.28, 95% CI=0.13 to 0.57) less likely than adolescents aged 15-19 to engage in risky sexual behaviour. Similarly, in regard to caste, Janajatis were almost six times (AOR=5.56, 95% CI=2.47 to 12.5) and Dalits/Madhesi/others were almost two times more likely to involve in risky sexual behaviour than Brahmin/Chhetri. Conclusion This study shows a significantly higher prevalence of risky sexual behaviour among adolescents, males and Janajatis than their counterparts. Hence, youths should be educated and empowered to practice safe sexual behaviour through appropriate educational and behaviour change interventions with a special focus on adolescents, males and Janajatis.
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Affiliation(s)
- Aakriti Wagle
- Government of Gandaki Province Ministry of Health, Pokhara, Nepal
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Okoye HU, Saewyc E. Influence of socio-contextual factors on the link between traditional and new media use, and young people's sexual risk behaviour in Sub-Saharan Africa: a secondary data analysis. Reprod Health 2024; 21:138. [PMID: 39350211 PMCID: PMC11443646 DOI: 10.1186/s12978-024-01868-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 08/20/2024] [Indexed: 10/04/2024] Open
Abstract
BACKGROUND Traditional and new media use links to young people's sexual risk behaviour. The social contexts of young people's daily lives that influence media use and sexual risk behaviour are often investigated as independent causal mechanisms. We examined the link between media use and young people's sexual risk behaviour, considering the intersecting socio-contextual factors in Sub-Saharan Africa. METHODS Age-adjusted bivariate logistic regression models tested the association between traditional media (TV, radio, and newspapers), and new media (mobile phone and online) use and sexual risk behaviour using the Demographic and Health Surveys from six Sub-Saharan African countries among unmarried sexually active youths, aged 15-24 years. Multivariate logistic regression models ascertained the media sources that had an additional influence on young people's sexual risk behaviour, after accounting for socio-contextual factors, and knowledge about HIV and other sexually transmitted infections. RESULTS Socio-contextual factors attenuated the association between media use and young people's sexual risk behaviour in many countries. However, those who did not have access to new and traditional media were more likely to use unreliable contraceptive methods or not use contraception. Adolescents in Nigeria who did not own phones were 89% more likely to use unreliable contraceptive methods or not use any methods [(AOR = 1.89 (1.40-2.56), p < .001)], those in Angola who did not read newspapers had higher odds of not using contraception or used unreliable methods [(aOR = 1.65 (1.26-2.15), p < .001)]. Young people in Angola (aOR = 0.68 (0.56-0.83), p < .001), Cameroon [(aOR = 0.66 (0.51-0.84), p < .001)], Nigeria [(aOR = 0.72 (0.56-0.93), p = .01)], and South Africa [(aOR = 0.69 (0.49-0.98), p = .03)] who did not own phones were less likely to have 2 or more sexual partners compared to those who owned phones. Lack of internet access in Mali was associated with lower odds of having 2 or more sexual partners (aOR = 0.45 (0.29-0.70), p < .001). Traditional media use was significantly associated with transactional sex in many countries. CONCLUSIONS Media use is linked to sexual risk behaviour among young people in Sub-Saharan Africa. Socioeconomic inequalities, levels of globalization, as well as rural-urban disparities in access to media, underscore the need to deliver tailored and targeted sexual risk reduction interventions to young people using both traditional and new media.
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Affiliation(s)
- Helen Uche Okoye
- School of Nursing, University of British Columbia, T201-2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada.
| | - Elizabeth Saewyc
- School of Nursing, University of British Columbia, T201-2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada
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Anley DT, Zemene MA, Gebeyehu AA, Gebeyehu NA, Adella GA, Kassie GA, Mengstie MA, Seid MA, Abebe EC, Gesese MM, Solomon Y, Moges N, Bantie B, Feleke SF, Dejenie TA, Chanie ES, Bayih WA, Tesfa NA, Taklual W, Tesfa D, Anteneh RM, Dessie AM. Hotspot areas of risky sexual behaviour and associated factors in Ethiopia: Further spatial and mixed effect analysis of Ethiopian demographic health survey. PLoS One 2024; 19:e0303574. [PMID: 38820433 PMCID: PMC11142568 DOI: 10.1371/journal.pone.0303574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 04/26/2024] [Indexed: 06/02/2024] Open
Abstract
INTRODUCTION Sexual behaviour needs to take a central position in the heart of public health policy makers and researchers. This is important in view of its association with Sexually Transmitted Infections (STIs), including HIV. Though the prevalence of HIV/AIDS is declining in Ethiopia, the country is still one of the hardest hit in the continent of Africa. Hence, this study was aimed at identifying hot spot areas and associated factors of risky sexual behavior (RSB). This would be vital for more targeted interventions which can produce a sexually healthy community in Ethiopia. METHODS In this study, a cross-sectional survey study design was employed. A further analysis of the 2016 Ethiopia Demographic and Health Survey data was done on a total weighted sample of 10,518 women and men age 15-49 years. ArcGIS version 10.7 and Kuldorff's SaTScan version 9.6 software were used for spatial analysis. Global Moran's I statistic was employed to test the spatial autocorrelation, and Getis-Ord Gi* as well as Bernoulli-based purely spatial scan statistics were used to detect significant spatial clusters of RSB. Mixed effect multivariable logistic regression model was fitted to identify predictors and variables with a p-value ≤0.05 were considered as statistically significant. RESULT The study subjects who had RSB were found to account about 10.2% (95% CI: 9.64%, 10.81%) of the population, and spatial clustering of RSB was observed (Moran's I = 0.82, p-value = 0.001). Significant hot spot areas of RSB were observed in Gambela, Addis Ababa and Dire Dawa. The primary and secondary SaTScan clusters were detected in Addis Ababa (RR = 3.26, LLR = 111.59, P<0.01), and almost the entire Gambela (RR = 2.95, LLR = 56.45, P<0.01) respectively. Age, literacy level, smoking status, ever heard of HIV/AIDS, residence and region were found to be significant predictors of RSB. CONCLUSION In this study, spatial clustering of risky sexual behaviour was observed in Ethiopia, and hot spot clusters were detected in Addis Ababa, Dire Dawa and Gambela regions. Therefore, interventions which can mitigate RSB should be designed and implemented in the identified hot spot areas of Ethiopia. Interventions targeting the identified factors could be helpful in controlling the problem.
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Affiliation(s)
- Denekew Tenaw Anley
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Melkamu Aderajew Zemene
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Asaye Alamneh Gebeyehu
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Natnael Atnafu Gebeyehu
- Department of Midwifery, College of Medicine and Health Science, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Getachew Asmare Adella
- Department of Reproductive Health and Nutrition, School of Public Health, Woliata Sodo University, Woliata Sodo, Ethiopia
| | - Gizachew Ambaw Kassie
- Department of Epidemiology and Biostatistics, School of Public Health, Woliata Sodo University, Woliata Sodo, Ethiopia
| | - Misganaw Asmamaw Mengstie
- Department of Biochemistry, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Mohammed Abdu Seid
- Department of Biomedical Science, Unit of Physiology, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Endeshaw Chekol Abebe
- Department of Biochemistry, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Molalegn Mesele Gesese
- Department of Midwifery, College of Medicine and Health Science, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Yenealem Solomon
- Department of Medical Laboratory Science, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Natnael Moges
- Department of Pediatrics and Child Health Nursing, College of Health sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Berihun Bantie
- Department of Comprehensive Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Sefineh Fenta Feleke
- Department of Public Health, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Tadesse Asmamaw Dejenie
- Department of Medical Biochemistry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Ermias Sisay Chanie
- Department of Pediatrics and Child Health Nursing, College of Health sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Wubet Alebachew Bayih
- Department of Maternal and Neonatal Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
- Faculty of Medicine, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
| | - Natnael Amare Tesfa
- School of Medicine, College of Health Science, Woldia University, Woldia, Ethiopia
| | - Wubet Taklual
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Dessalegn Tesfa
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Rahel Mulatie Anteneh
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Anteneh Mengist Dessie
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
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Fiorentino M, Coulibaly B, Couderc C, Keita BD, Anoma C, Dah E, Mensah E, Aka TN, Touré JR, Camara D, Kokouba AR, Maradan G, Mora M, Bourrelly M, Riegel L, Rojas-Castro D, Spire B, Laurent C, Sagaon-Teyssier L. Men Who Have Sex with Both Men and Women in West Africa: Factors Associated with a High Behavioral Risk of Acquiring HIV from Male Partners and Transmission to Women (CohMSM ANRS 12324-Expertise France). ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:757-769. [PMID: 37973698 PMCID: PMC10844348 DOI: 10.1007/s10508-023-02715-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 09/13/2023] [Accepted: 09/21/2023] [Indexed: 11/19/2023]
Abstract
HIV is highly prevalent in men who have sex with men (MSM) in West Africa. Many MSM in the region also have sex with women (MSMW). Accordingly, they are a potential bridge subpopulation for HIV transmission to women. We aimed to evaluate the proportions and characteristics of West African MSMW at high behavioral risk of acquiring HIV from male partners and transmitting it to female partners (HBRMF). The cohort ANRS-12324 CohMSM Study included 630 HIV-negative MSM in Burkina Faso, Cote d'Ivoire, Mali, and Togo. Among MSMW (i.e., with ≥ 1 female partner) in the cohort, HBRMF was identified using trajectory models based on seven at-risk sexual practices with male and female partners, including inconsistent condom use, multiple partnerships, and receptive same-sex anal intercourse. To assess the relevance of using trajectory models, we compared the proportions of participants who seroconverted during the cohort follow-up among those at HBRMF and those not at HBRMF. Factors associated with HBRMF were identified using a generalized estimation equation logistic regression model accounting for longitudinal data. Approximately half (47%) of the 304 MSMW (22% of all CohMSM study participants) were at HBRMF. This group accounted for 75% of the 28 HIV seroconversions observed during follow-up (p = 0.001). HBRMF was positively associated with being aged < 25 years (aOR 95% CI 1.67 [1.23-2.27]), being sexually attracted only to men (1.97 [1.38-2.78]), feelings of loneliness (1.92 [1.38-2.65]), and homonegative violence score (1.22 [1.05-1.41]). HBRMF was negatively associated with having had both stable and casual female partners in the previous 6 months (0.34 [0.20-0.60] vs. only a stable female partner). HBRMF tended to be negatively associated with having ≥ 4 sexual intercourses with female partners in the previous four weeks (0.54 [0.27-1.06] vs. no intercourse). Establishing official relationships with women might be a strategy for young and/or stigmatized MSMW to comply with social pressure to display a heterosexual lifestyle. However, this seems to increase the risk of HIV transmission to female partners. In the present study, almost half of MSMW were at HBRMF. This result stresses the need to adapt HIV research and prevention to MSMW and their female partners.
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Affiliation(s)
- Marion Fiorentino
- IRD, Inserm, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale, ISSPAM, Aix Marseille University, Marseille, 13385, France.
| | - Bakary Coulibaly
- ARCAD Santé PLUS, Centre Intégré de Recherche, de Soins et d'Action Communautaire, Bamako, Mali
| | | | - Bintou Dembélé Keita
- ARCAD Santé PLUS, Centre Intégré de Recherche, de Soins et d'Action Communautaire, Bamako, Mali
| | | | - Elias Dah
- Association African Solidarité, Ouagadougou, Burkina Faso
| | | | | | | | - Drissa Camara
- ARCAD Santé PLUS, Centre Intégré de Recherche, de Soins et d'Action Communautaire, Bamako, Mali
| | | | - Gwenaëlle Maradan
- IRD, Inserm, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale, ISSPAM, Aix Marseille University, Marseille, 13385, France
- Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Marion Mora
- IRD, Inserm, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale, ISSPAM, Aix Marseille University, Marseille, 13385, France
| | - Michel Bourrelly
- IRD, Inserm, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale, ISSPAM, Aix Marseille University, Marseille, 13385, France
| | - Lucas Riegel
- Coalition PLUS, Laboratoire de recherche communautaire, Pantin, France
| | - Daniela Rojas-Castro
- IRD, Inserm, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale, ISSPAM, Aix Marseille University, Marseille, 13385, France
- Coalition PLUS, Laboratoire de recherche communautaire, Pantin, France
| | - Bruno Spire
- IRD, Inserm, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale, ISSPAM, Aix Marseille University, Marseille, 13385, France
| | | | - Luis Sagaon-Teyssier
- IRD, Inserm, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale, ISSPAM, Aix Marseille University, Marseille, 13385, France
- ARCAD Santé PLUS, Centre Intégré de Recherche, de Soins et d'Action Communautaire, Bamako, Mali
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Chandra R, Paul P, Srivastava S. Prevalence and Predictors of Risky Sexual Behavior Among Young Men in India: Evidence From National Family Health Survey. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2023; 36:32-45. [PMID: 38600902 PMCID: PMC10903700 DOI: 10.1080/19317611.2023.2286984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 09/13/2023] [Accepted: 11/15/2023] [Indexed: 04/12/2024]
Abstract
Objective The study examines the prevalence and factors associated with high-risk sexual behavior among sexually active young Indian men. Methods This study used samples of 14,584 men aged 15 to 29 from the National Family Health Survey (NFHS-5), 2019-21. Results 14% of men engaged in early sexual debut (<18 years), 68% had unprotected sex, and 4% had multiple sexual partners in the past 12 months. Age, marital status, educational attainment, occupation, wealth quintile, alcohol consumption, internet use, media exposure, and region were significant predictors of risky sexual behavior. Conclusions We suggest a tailored approach for effective policy design considering risk factors of risky sexual behavior.
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Affiliation(s)
- Rakesh Chandra
- School of Health Systems Studies, Tata Institute of Social Science, Mumbai, India
| | - Pintu Paul
- Centre for the Study of Regional Development, Jawaharlal Nehru University, New Delhi, India
- Research and Data Officer, Aspire (A Society for Promotion of Inclusive and Relevant Education), New Delhi, India
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Musonda E, Phiri M, Shasha L, Bwalya C, Musemangezhi S, Ishimwe SMC, Kalinda C. Prevalence of HIV testing uptake among the never-married young men (15-24) in sub-Saharan Africa: An analysis of demographic and health survey data (2015-2020). PLoS One 2023; 18:e0292182. [PMID: 37796957 PMCID: PMC10553359 DOI: 10.1371/journal.pone.0292182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 09/13/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND In sub-Saharan Africa, HIV and AIDS remain a major public health concern among adolescents and young men. HIV testing is the first critical step for linking infected individuals to HIV treatment and prevention. However, HIV-testing uptake among sexually active young men remains low in the region. This study was conducted to assess the HIV testing rates among unmarried young men in sub-Saharan Africa. METHODS Using data from the most recent country Demographic and Health Surveys (DHS) conducted between January 1, 2015, and December 31, 2020, in 18 sub-Saharan African countries, an Inverse Heterogeneity model (IVhet) using MetaXL software was used to estimate country, regional and sub-regional pooled estimates of HIV testing uptake among sexually active unmarried young men in sub-Saharan Africa. Furthermore, multivariable binary logistic regression was conducted to examine the factors associated with HIV testing uptake among unmarried young men. RESULTS The overall pooled prevalence estimate of HIV testing uptake among sexually active unmarried young men in sub-Saharan Africa was 33.0% (95% CI: 21-45, I2 = 99%, p <0.001). There was variation in the prevalence across countries ranging from 7% (95% CI: 5-9) in Guinea to 77% (95% CI: 74-80) in Cameroon. Central Africa had the highest prevalence of HIV testing among unmarried young men, at 47% (95% CI:0-100) while West Africa had the lowest prevalence at 11% (95% CI:2-23). Results further show that young men aged 15-19 (aOR = 0.59, 95% CI 0.52-0.66) were less likely to test for HIV. Young men who spent 8 to 12 years in school (aOR = 3.26 95% CI 2.21-4.79) or 13 years and above (aOR = 3.56 95% CI 2.35-5.37) had increased odds of undertaking an HIV test. CONCLUSION The prevalence of HIV testing among sexually active unmarried young men remains low in sub-Saharan Africa. Therefore, the results suggest that health policymakers should consider re-evaluating the current HIV prevention policies and programmes with the view of redesigning the present HIV testing campaigns to enhance the uptake among young people.
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Affiliation(s)
- Emmanuel Musonda
- Department of Population Studies, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia
| | - Million Phiri
- Department of Population Studies, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia
- Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Liness Shasha
- Department of Population Studies, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia
| | - Chiti Bwalya
- Maryland Global Initiatives Corporation (MGIC), Lusaka, Zambia
| | - Shuko Musemangezhi
- Bill and Joyce Cummings Institute of Global Health, University of Global Health Equity, Kigali, Rwanda
| | | | - Chester Kalinda
- Bill and Joyce Cummings Institute of Global Health, University of Global Health Equity, Kigali, Rwanda
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Baraki SG, Thupayagale-Tshweneagae GB. Socio-cultural factors perceived to influence sexual behaviours of adolescents in Ethiopia. Afr J Prim Health Care Fam Med 2023; 15:e1-e10. [PMID: 37526559 PMCID: PMC10476444 DOI: 10.4102/phcfm.v15i1.3865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 02/05/2023] [Accepted: 02/09/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Adolescence is a period of transition from childhood to adulthood. It is the age of experimentation. They are vulnerable to the undesirable effect of sexual and reproductive health (SRH) problems such as human immunodeficiency virus, sexually transmitted infections and unsafe abortion and childbirth-related risks. AIM To explore and describe perceived organisational, community and societal level factors that influence sexual behaviours among adolescents in Ethiopia. SETTING The study was conducted by public health care organisations, youth centres and non-governmental organisations in Addis Ababa, Ethiopia. METHODS A qualitative descriptive study design was conducted with purposively selected health professionals and adolescents in Addis Ababa from June 2019 to February 2020. The data were collected using in-depth interviews, key informant interviews and focus group discussions. Transcribed interviews were imported to ATLAS. ti 7 for coding, categorising and creating themes using thematic analysis. Lincoln and Guba's model was used to ensure trustworthiness and ethical standards were applied. RESULTS Poor school involvement, social norms on sexual behaviour and lack of condom acceptability by the general population, financial problems and the gap in law enforcement were found perceived factors influencing sexual behaviour of adolescents. CONCLUSION Adolescents are engaging in various risky sexual behaviours because of various organisational, community level and societal level factors, which emphasises the need to introduce social and culturally acceptable age-appropriate comprehensive sexuality education for adolescents and other multilevel interventions.Contribution: Provide an in-depth understanding of the influence of sociocultural issues related to adolescent sexual behaviour for health system stakeholders.
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Affiliation(s)
- Semere G Baraki
- Department of Public Health, Menelik II Medical and Health Science College, Addis Ababa.
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Worede JB, Mekonnen AG, Aynalem S, Amare NS. Risky sexual behavior among people living with HIV/AIDS in Andabet district, Ethiopia: Using a model of unsafe sexual behavior. Front Public Health 2022; 10:1039755. [PMID: 36579063 PMCID: PMC9790964 DOI: 10.3389/fpubh.2022.1039755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 11/24/2022] [Indexed: 12/14/2022] Open
Abstract
Introduction Human immunodeficiency virus (HIV) infection continues to be a major public health problem in Ethiopia. Previous studies have described risky sexual behavior and associated factors among HIV-positive people. These studies, however, did not use a model of unsafe sexual behavior that could address both subjective and objective factors of sexual activity, and there is no study that examines the distal aspects of risky sexual behavior among people living with HIV/AIDS in Ethiopia. Therefore, this study aimed to examine the risky sexual behavior among people living with HIV/AIDS using a model of unsafe sexual behavior. Methods An institutional-based study was conducted from March to April 2022. The sample size was determined by using Sloven's formula. In this study, both quantitative and qualitative methods were employed. Study participants were selected using systematic sampling method. An interviewer-administered questionnaire was used to collect the data. Descriptive statistics and correlation tests were computed to analyze the data. The qualitative data was analyzed thematically. Results This study included a total of 181 PLWHA clients. The average score for participants' perception regarding the facts of HIV/AIDS was 48.7% (95% CI: 38.9, 58.4). Three months prior to the study, 46.3% of study participants had engaged in at least one risky sexual activity (95% CI: 33.8, 65.4). The correlation model revealed a positive correlation between living in a rural area and risky sexual behavior (p-value = 0.001). Furthermore, a poor perception of HIV risks was associated with risky sexual behavior (p-value = 0.003). Economic issues, stigma and discrimination, and usage of substances were also identified as contributing factors to unsafe sexual activity in the qualitative data. Conclusions A high proportion of PLWHA clients had engaged in at least one risky sexual activity in the 3 months prior to the study. It is not enough to be on ART; additional educational interventions that shape the sexual behavior of PLWHA clients must be considered.
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Affiliation(s)
- Jejaw Berihun Worede
- Department of Social Work, Bahir Dar University, Bahir Dar, Amara Regional State, Ethiopia
| | - Alemayehu Gonie Mekonnen
- School of Nursing and Midwifery, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Amara Regional State, Ethiopia,*Correspondence: Alemayehu Gonie Mekonnen
| | - Seblewongiel Aynalem
- Department of Social Work, Bahir Dar University, Bahir Dar, Amara Regional State, Ethiopia
| | - Nakachew Sewnet Amare
- School of Nursing and Midwifery, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Amara Regional State, Ethiopia
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Diress G, Adane S, Linger M, Merchaw A, Mengist B. Individual and community-level determinates of risky sexual behaviors among sexually active unmarried men: A multilevel analysis of 2016 Ethiopian Demographic and Health Survey. PLoS One 2022; 17:e0270083. [PMID: 35862425 PMCID: PMC9302804 DOI: 10.1371/journal.pone.0270083] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 06/04/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND In Ethiopia, HIV/AIDS continues to be a major public health problem mostly due to the high prevalence of risky sexual behaviors. However, research on risky sexual behavior and its determinants among unmarried men (never married, widowed, and divorced) who are highly vulnerable to risky sexual behavior was limited. Therefore, this study aimed to assess the magnitude of risky sexual behavior and its determinants among non-married men using a nationally representative sample. METHODS The analysis was done on 5680 sexually active unmarried men aged 15-59 years using data from the 2016 Ethiopia Demographic Health Survey (EDHS). The main outcome variable was risky sexual behavior which defined as having at least one of the following: multiple sexual partners; initiation of sex before the age of 18 years; inconsistent condom use in the last 12 months; alcohol consumption at last sex. Multivariable generalized linear mixed-effects regression was employed to identify variables associated with risky sexual behavior. RESULT The overall magnitude of risky sexual behavior was 26.9% (95% CI; 25.7, 28.0). Currently employed (AOR = 2.49, 95% CI = 1.64-3.77), history of HIV testing (AOR = 2.51, 95% C = 1.95-3.23), drinking alcohol almost every day (AOR = 5.49, 95 CI = 2.73-11.02), and using Internet daily (AOR = 1.99, 95% CI = 1.06-3.74) increase the odds of risky sexual behavior. Whereas, primary education (AOR = 0.44, 95% CI = 0.32-0.61), secondary education level (AOR = 0.46, 95% CI = 0.29-0.72) and a high proportion of community-level media exposure (AOR = 0.42, 95% CI = 0.12-0.75) decrease the odds of risky sexual behavior. CONCLUSION In general, a significant proportion of sexually active unmarried men in Ethiopia have practiced risky sexual behavior. An intervention should be designed which are against the factors found to increase the odds of risky sexual behavior to reduce the incidence of HIV and other sexually transmitted infections.
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Affiliation(s)
- Gedefaw Diress
- Department of Public Health, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Seteamlak Adane
- School of Public Health, College of Health Science, Woldia University, Woldia, Ethiopia
| | - Melese Linger
- Department of Human Nutrition, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Abebe Merchaw
- School of Nursing, College of Health Science, Woldia University, Woldia, Ethiopia
| | - Belayneh Mengist
- Department of Public Health, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
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Mokgatle M, Madiba S, Hlongwane N. Differences in Sexual Behavior and Partner Notification for Sexually Transmitted Infections Between the Out of School Youth and University Students in a Peri-Urban District in South Africa-A Cross-Sectional Survey. Front Public Health 2022; 10:793702. [PMID: 35812474 PMCID: PMC9257014 DOI: 10.3389/fpubh.2022.793702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 02/07/2022] [Indexed: 11/13/2022] Open
Abstract
The increase in sexually transmitted infections (STIs) in young people is a public health concern. Among those in university and out of school, different contextual factors contribute to their risky sexual behavior and increased susceptibility to STIs and HIV. There are limited comparative studies examining risky sexual behavior and partner notification (PN) between these two groups, particularly in South Africa. We investigated sexual behaviors, self-reported STI diagnosis, health seeking behavior, and preferred PN methods of university students and out of school youth. A descriptive cross-sectional survey was used using convenient sampling to select 917 students across five health sciences universities and through periodic sampling 699 out of school youth were selected from two main local shopping centers in South Africa. Descriptive statistics, bivariate and multivariable logistic analysis were performed using Stata IC version 14. More university students (71.7%) than out of school youth were in casual relationships (28.3%), with half of out of school youth being in steady relations (50.2%). Moreover, university students (65.7%) used a condom in the past 6 months compared to their counterparts (34.3%). Of the 124 youth who were diagnosed with STI in the past 12 months, majority (n = 106, 85%) were out of school youth. The probability of notifying a partner about a STI infection was 82% among university students compared to their counterparts (p = >0.05). The odds of notifying a partner was 1.79 times more for those having multiple sexual partners than those who had only one partner. Both groups preferred a face-to-face STI disclosure with partner; however, more university students (67%) preferred SMS notification than PN referral slips as compared to out of school youth (42%). Both the university students and the out of school youth engaged in risky sexual behaviors. Both groups preferred face-to-face and clinic SMS partner notifications, even though university students were in the majority. There is a need for developing health promotion scripts on disclosing STIs to sexual partners to empower the majority of the youth who prefer face-to-face PN over the prescribed methods.
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Affiliation(s)
- Mathildah Mokgatle
- Department of Biostatistics, School of Public Health, Sefako Makgatho Health Sciences University, Ga-Rankuwa, South Africa
- School of Transdisciplinary Research and Graduate Studies, College of Graduate Studies, University of South Africa (UNISA), Pretoria, South Africa
| | - Sphiwe Madiba
- Department of Environmental and Occupational Health, School of Public Health, Sefako Makgatho Health Sciences University, Ga-Rankuwa, South Africa
| | - Naomi Hlongwane
- School of Public Health, School of Health Care Sciences, Sefako Makgatho Health Sciences University, Ga-Rankuwa, South Africa
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11
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Kavuma D, Ndibazza J, Kirwana VB, Mukasa Kafeero H, Katongole SP, Baluku JB. Factors Associated with Condom Use Among Out-of-School Young People on Anti-Retroviral Therapy in Central Uganda. HIV AIDS (Auckl) 2022; 14:217-230. [PMID: 35502347 PMCID: PMC9056096 DOI: 10.2147/hiv.s357535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 04/02/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction Methods Results Conclusion
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Affiliation(s)
- David Kavuma
- Faculty of Health Sciences, Uganda Martyrs University-Nkozi, Kampala, Uganda
- Directorate of Medical Services, Mildmay Uganda, Kampala, Uganda
- Correspondence: David Kavuma, Tel +2560772839416, Email
| | - Juliet Ndibazza
- Faculty of Health Sciences, Uganda Martyrs University-Nkozi, Kampala, Uganda
| | - Venantius Bbaale Kirwana
- Monitoring, Evaluation and Learning, Sexual Reproductive Health and Rights Alliance, Kampala, Uganda
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Mcharo RD, Olomi W, Mayaud P, Msuya SE. Risky sexual behaviours among young adults attending Higher Learning Institutions in Mbeya, Tanzania: implications for STIs and HIV preventive programs. AAS Open Res 2021; 3:41. [PMID: 37168604 PMCID: PMC10080207 DOI: 10.12688/aasopenres.13123.2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2021] [Indexed: 09/17/2024] Open
Abstract
Background High-risk sexual behaviors(HRSBs) among young adults are key risk for Sexually Transmitted Infections(STIs), HIV and unplanned pregnancies. WHO has identified the 15-24years age-group as high-risk for STIs. Students at Higher Learning Institutions(HLIs) may be at higher risk because they are free of immediate parental-supervision, are a transient migratory population, probably at peak-years of sexual activity. In Tanzania, information is limited on sexual and preventive behaviours among young adults in HLIs. We describe risky sexual behaviours and preventive practices among young adults attending HLIs in Mbeya-Tanzania. Methods We conducted a cross-sectional study from March2019 to January2020 among randomly selected students aged 18-24years enrolled in HLIs within Mbeya. Probability proportional to size was used to determine total student number from each HLI. We used a self-administered questionnaire to collect information on sexual health education, activity, behaviour and STI knowledge. Results Total of 504students were enrolled with mean age of 21.5(SD 1.74)years. Total of 446(88.5%) students reported ever having had sex. Mean-age at first sex was 18.4years and 9.9% reported sexual debut <15years. A higher proportion of male students(57%) reported sexual debut with non-steady partners than females(37.9%). Lack of condom use at sexual debut was reported by 52% of the participants. Consistent condom use during past 4-weeks was reported at 33% and 16.5% among males and females, respectively. About 1 in 10 students reported forced sex by someone they were dating. Sex under the influence of alcohol was reported by 24% of the students. Nearly 8 in 10 (78.7%) students have heard of STIs, but only 16% were aware STIs can be asymptomatic. Conclusion STI prevention programs need to recognize young adults in HLIs as at-risk population; and advocate targeted messages to minimize risk to acquiring STIs, counseling and support for those experiencing sexual violence, promote condom use and safer-sex negotiation skills.
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Affiliation(s)
- Ruby Doryn Mcharo
- Department of HIV and Reproductive Health, National Institute for Medical Research-Mbeya Medical Research Centre (NIMR-MMRC), Mbeya, Tanzania
- Department of Epidemiology & Biostatistics, Institute of Public Health,, Kilimanjaro Christian Medical University College (KCMUCo), Moshi, Tanzania
| | - Willyhelmina Olomi
- Department of HIV and Reproductive Health, National Institute for Medical Research-Mbeya Medical Research Centre (NIMR-MMRC), Mbeya, Tanzania
| | - Philippe Mayaud
- Faculty of Infectious & Tropical Diseases, London School of Hygiene and Tropical Medicine (LSHTM), London, WC1E 7HT, UK
| | - Sia E. Msuya
- Department of Epidemiology & Biostatistics, Institute of Public Health,, Kilimanjaro Christian Medical University College (KCMUCo), Moshi, Tanzania
- Department of Community Health, Institute of Public Health, Kilimanjaro Christian Medical University College (KCMUCo), Moshi, Tanzania
- Community Health Department, KCMC Hospital, Moshi, Tanzania
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Ali R, Tadele A. Risky Sexual Behavior across Extremes of Wealth in sub-Saharan Africa: A Meta-Analysis of Demographic and Health Surveys. Ethiop J Health Sci 2021; 31:159-166. [PMID: 34158763 PMCID: PMC8188115 DOI: 10.4314/ejhs.v31i1.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background Risky sexual behavior increases the risk of contracting sexually transmitted disease including HIV and other reproductive health problems. There have been varying assumptions and different reported result explaining the relationship between risky sexual behavior and wealth. This review was intended to examine the disparity of risky sexual behavior among the two extremes of wealth in sub-Saharan African countries. Method This study reviewed demographic and health survey reports of sub-Saharan African countries. We excluded older reports and reports published in languages other than English. Finally, reports from 16 countries were considered for review. Data were entered in excel and transported to stata for analysis. Metaprop and Metan command were used to compute proportions and odds ratio. Standard chi-square and I square tests were used to assess heterogeneity. Result Pooled prevalence of having multiple sexual partner ranges from 2 to 12%. Over 80% of the countries reported that more than half of the individuals did not use condom at their last risky sexual intercourse. Poorest females were 0.62 [OR: 0.62, 95% CI (0.50, 0.78)] times less likely to have multiple sexual partners than males. Both males and females from the poorest wealth quantile had higher odds of not using condom at their last risky sexual intercourse, 1.41 [OR: 1.41, 95% CI (1.29, 1.53)], 1.41 [OR: 1.46, 95% CI (1.23, 1.73)], respectively. Conclusion Multiple sexual partners is relatively low in the region. Condom non-use is high in both genders. Additionally, poorest males and females were at higher risk of not using a condom at last risky sexual intercourse.
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Affiliation(s)
- Rahma Ali
- Department of Population and Family Health, Faculty of Public Health, Institute of Health, Jimma University
| | - Afework Tadele
- Department of Population and Family Health, Faculty of Public Health, Institute of Health, Jimma University
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Ibrahim K, Juliana AA, Setyorini D, Pramukti I. Internet Usage and Risky Sexual Behavior among High School Students in a Suburban Area of Indonesia. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.6379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Internet has been of great benefit to human life, however, it has some disadvantages which exist particularly among young people.
AIM: Therefore, this study aims to investigate the internet usage and risky sexual behavior among high school students in a suburban area in Indonesia.
METHODS: This was a cross-sectional study carried out using stratified random sampling in a high school located in a suburban area in West Java, Indonesia. Furthermore, self-administered Modified Internet Sex Screening Test (ISST) questionnaire was applied to measure the risky sexual behavior among the students.
RESULTS: The results showed that based on the overall risky sexual behavior from internet usage, 35 (12.9%), 211 (77.6%), and 26 (9.6%) subjects were at low, medium, and high risk, respectively. Furthermore, the male gender and browsing for sexual content video were discovered to be the significant risk factors associated with risky sexual behavior with an adjusted odds ratio (AOR) of 5.79 (95% CI: 1.15-29.14) and 3.11 (95% CI: 1.03-9.39), respectively.
CONCLUSIONS: From the results obtained, it was concluded that the prevalence of risky sexual behavior based on internet usage is high among students. Furthermore, it was discovered that male students need more attention by being involved in healthy sexual education. In addition, the role of policy-maker in filtering the accessible content for students is required.
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Ali MM, Merdad L, Bellizzi S. Socioeconomic variations in risky sexual behavior among adolescents in 14 sub-Saharan Africa countries who report ever having had sex. Int J Equity Health 2021; 20:11. [PMID: 33407497 PMCID: PMC7789383 DOI: 10.1186/s12939-020-01352-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 12/09/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Equity is a guiding principle of the Global Strategy for Women, Children and Adolescents' Health (2016-2030) aimed at improving adolescent health and responding more effectively to adolescents' needs. We investigated the socioeconomic differentials in having multiple sexual partners and condom use among unmarried adolescents who reported ever having had sex aged 15-19 years in 14 sub-Saharan countries. METHODS Using the most recent publicly available Demographic and Health Surveys conducted between 2011 and 2018, we calculated survey- and sex-specific proportions of two or more partners and condomless sex, both overall and by selected socioeconomic characteristics and we fitted logistic regression models to estimate the survey- and sex-specific adjusted odds ratios. The pooled adjusted odds ratios were estimated using multilevel logistic regression. RESULTS In most countries, higher percentages of male adolescents than female adolescents reported having more than one partner in the last 12 months. Conversely, a lower percentage of young male reported having condomless sex when compared to young female: from 19.8% in Gabon to 84.5% in Sierra Leone among male adolescents and from 32.6% in Gabon to 93.2% in Sierra Leone among female adolescents. In the multilevel analyses, condomless sex was associated with place of residence, wealth and schooling for both female and male adolescents, while among male adolescents multiple partnerships was significantly associated with place of residence. CONCLUSION Our findings on disparities in condomless sex associated with socioeconomic characteristics might reflect constraint choice and decision making. Results also suggest the need for educational programming and services and better access to barrier methods.
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Affiliation(s)
- Mohamed M Ali
- UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, 20 Avenue Appia, 1211, Geneva, Switzerland.
| | - Leena Merdad
- Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Saverio Bellizzi
- Partnership for Maternal, Newborn and Child Health, Geneva, Switzerland
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Darteh EKM, Dickson KS, Amu H. Understanding the Socio-demographic Factors Surrounding Young Peoples' Risky Sexual Behaviour in Ghana and Kenya. J Community Health 2020; 45:141-147. [PMID: 31444777 DOI: 10.1007/s10900-019-00726-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Globally, young people in sub-Saharan Africa continue to be the population at the greatest risk for sexually transmitted infections (STIs) such as HIV and AIDS, Syphilis, and Gonorrhoea. Research has shown significant relationship between young peoples risky sexual behaviours and their vulnerability to these STIs. The study examined risky sexual behaviours among the youth in Ghana and Kenya in relation to socio-demographic characteristics. The paper uses data from the 2014 Demographic and Health Surveys of Ghana and Kenya. Young people between the ages of 15 to 24 years who were not married or living with a man/woman were included in the study. They comprised 2545 females and 1437 males from Ghana and 3546 females and 4317 males from Kenya. Descriptive analyses and binary logistic regression estimation technique were used to analyse the data. While awareness of AIDS was universal among the youth of both countries, utilisation of condoms on last penetrative sex was low. Risky sexual behaviour among young people was significantly associated with age, level of education, wealth status and religion. Among males and females in Ghana, the odds of sexual risk taking behaviour were higher among those who were employed than those who were unemployed. The reverse of this, however, occurred in Kenya, where males and females who were employed were less likely to engage in risky sexual behaviours than their counterparts who were unemployed. Our findings underscore the need for the relevant stakeholders in the two countries; Ministries of Health, Ghana/KenyaHealth Service, and NGOs concerned with sexual and reproductive health of young people, to intensify education on consistent and proper use of condoms and, position condom use as an acceptable behaviour especially among young people who are sexually active; with multiple partners and who may have STIs. Health literacy, which is the degree to which individuals have the capacity to obtain, process, and understand basic health information and services to make appropriate health decisions, should be given priority. The governments of the two countries, especially Kenya, should promote youth entrepreneurship to reduce unemployment and strengthen job creation as a way of ensuring that young people engage on productive economic activities. With productive economic activities, females for instance may not have to engage in transactional multiple sexual relationships which is risky and, therefore, predisposes them to STIs such as gonorrhoea and HIV.
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Affiliation(s)
| | | | - Hubert Amu
- Department of Population and Behavioural Sciences, School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
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MIRZAEI-ALAVIJEH MEHDI, JALILIAN FARZAD, MOTLAGH MOHAMMADESMAIEL, SAADATFAR ABDOLLAH, FATTAHI MOHHAMAD. HIV/AIDS knowledge among Iranian Health Care Workers. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2020; 61:E386-E391. [PMID: 33150227 PMCID: PMC7595077 DOI: 10.15167/2421-4248/jpmh2020.61.3.1474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 03/31/2020] [Indexed: 11/25/2022]
Abstract
Background HIV/AIDS remains a major public health concern globally and Health Care Workers (HCWs) are in the frontline of preventing and providing care in the health care system. The aim of this study was to evaluate HIV/AIDS knowledge among Iranian HCWs. Methodology This cross-sectional study was conducted among 200 HCWs who were randomly selected from health care centers in Kermanshah city, west of Iran, 2018. HCWs filled out a self-administered questionnaire including the socio-demographic characteristics and HIV/AIDS knowledge items. Data were analyzed by SPSS version 16 using bivariate correlations, t-test, and ANOVA statistical tests. Results The mean score of HIV/AIDS knowledge was 29.73 [95% CI: 28.79, 30.67], ranged from 0 to 40 (74.3% of total percent). There was no significant association and correlation between HIV/AIDS knowledge and sex, education level, marital status, age and job history. Up to 50% had inadequate knowledge about HIV/AIDS status and transmission in Iran. Conclusions HCWs HIV/AIDS knowledge was average and it seems need to be educating regarding HIV/AIDS status and transmission in Iran.
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Affiliation(s)
- MEHDI MIRZAEI-ALAVIJEH
- Social Development & Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - FARZAD JALILIAN
- Lifestyle Modification Research Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Correspondence: Farzad Jalilian, Lifestyle Modification Research Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran, 67198-51351 - Tel (Fax). +988338263048 -
| | - MOHAMMAD ESMAIEL MOTLAGH
- Department of Pediatrics, Faculty Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - ABDOLLAH SAADATFAR
- Department of Urology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - MOHHAMAD FATTAHI
- Social Development & Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Moges NA, Adesina OA, Okunlola MA, Berhane Y, Akinyemi JO. <p>Risky Sexual Practice, Sexually Transmitted Infection and Associated Factors Among Newly Diagnosed HIV-positive People in Northwest Ethiopia</p>. HIV AIDS (Auckl) 2020; 12:431-439. [PMID: 32982470 PMCID: PMC7509308 DOI: 10.2147/hiv.s267215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 08/13/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose Risky sexual practice expose for the acquisition of sexually transmitted infection (STI) including human immunodeficiency virus (HIV). This study was conducted to fill the knowledge gap on the prevalence of risky sexual practice, STIs and associated factors among newly diagnosed HIV-positive people in northwest Ethiopia. Patients and Methods This study was a cross-sectional study design which was conducted on 745 newly diagnosed HIV patients. An interviewer-administered questionnaire was used to interview patients within seven days of HIV diagnosis using client exit interview approach. Data were entered to EpiData and exported to SPSS version 24 for analysis. Binary logistic regression analysis was employed to select factors for multivariate logistic regression at p-value of less than 0.25. Two separate logistic regression models were used for risky sexual practice and STI as dependent variables. The strength of statistical association was quantified using an adjusted odds ratio (AOR) with a 95% confidence level. Results The prevalence of risky sexual practices and STIs among newly diagnosed HIV-positive people were 15.8% (95%CI: 13.1–18.4) and 6.6% (95%CI: 4.8–8.5), respectively. Although there were no statistically significant factors associated with STI, having two or more lifetime sexual partners (AOR=3.19; 95%CI: 1.57–6.49) and frequent use of alcohol (AOR=3.10; 95%CI: 1.34–7.19) were the factors associated with risky sexual practice. Conclusion Risky sexual practice and STI were found to be low among newly identified HIV patients. Factors associated with risky sexual practice failed to explain STI diagnosis using the syndromic approach. Therefore, revisiting the definition of risky sexual practice is necessary for the universal test and treat approach since sustained viral suppression may leave the need for consistent use of condoms among HIV patients who are on ART especially with regular sexual partners. Further study is also recommended to measure changes in sexual practice after initiating antiretroviral therapy.
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Affiliation(s)
- Nurilign Abebe Moges
- Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
- Pan African University Life and Earth Sciences Institute, University of Ibadan, Ibadan, Nigeria
- Correspondence: Nurilign Abebe Moges Tel +251910106295 Email
| | - Olubukola Adeponle Adesina
- Department of Obstetrics and Gynecology, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Obstetrics and Gynecology, University College Hospital, Ibadan, Nigeria
| | - Michael A Okunlola
- Department of Obstetrics and Gynecology, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Obstetrics and Gynecology, University College Hospital, Ibadan, Nigeria
| | - Yemane Berhane
- Department of Epidemiology, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Joshua Odunayo Akinyemi
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
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Mcharo RD, Olomi W, Mayaud P, Msuya SE. Risky sexual behaviours among young adults attending Higher Learning Institutions in Mbeya, Tanzania: implications for STIs and HIV preventive programs. AAS Open Res 2020; 3:41. [PMID: 37168604 PMCID: PMC10080207 DOI: 10.12688/aasopenres.13123.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2020] [Indexed: 11/20/2022] Open
Abstract
Background: High-risk sexual behaviours (HRSBs) among young adults are a key risk for Sexually Transmitted Infections (STIs), HIV and unplanned pregnancies. The World Health Organization has identified the 15-24 year age-group as high-risk for STIs. Students at Higher Learning Institutions (HLIs) may be at higher risk because they are free of immediate parental supervision, a transient migratory population, and probably at peak years of sexual activity. Here, we describe risky sexual behaviours and preventive practices among young adults attending HLIs in Mbeya, Tanzania. Methods: Cross-sectional study was conducted from March 2019 to January 2020 among students aged 18-24 years enrolled in HLIs within Mbeya. A self-administered questionnaire was used to collect information on sexual health education, activity, behaviour and STI knowledge. Results: 504 students were enrolled; mean age of 21.5 (SD 1.74) years. 377 (74.8%) students were sexually active. Mean age of first sexual encounter was 18.4 years and 11.6% reported their sexual debut was <15 years. A higher proportion of male students (59.7%) reported their sexual debut with non-steady partners compared with female students (40.9%). Lack of condom use at sexual debut was reported by 43.3% of sexually active students. Consistent condom use during the past 4-weeks was reported at 23.3% and 16.9% among men and women, respectively. Almost 1 in 10 students reported being forced into having sex by someone they were dating. Sex under the influence of alcohol was reported by 25.5% of the students. Nearly 7 in 10 (77%) students had heard of STIs, but only 15% were aware STIs could be asymptomatic. Conclusion: STI prevention programs need to recognize young adults in HLIs as an at-risk population. HLIs must advocate targeted messages to minimize risks to acquiring STIs, offer counselling and support for those experiencing sexual violence, and promote condom use and safer-sex negotiation skills.
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Affiliation(s)
- Ruby Doryn Mcharo
- Department of HIV and Reproductive Health, National Institute for Medical Research-Mbeya Medical Research Centre (NIMR-MMRC), Mbeya, Tanzania
- Department of Epidemiology & Biostatistics, Institute of Public Health,, Kilimanjaro Christian Medical University College (KCMUCo), Moshi, Tanzania
| | - Willyhelmina Olomi
- Department of HIV and Reproductive Health, National Institute for Medical Research-Mbeya Medical Research Centre (NIMR-MMRC), Mbeya, Tanzania
| | - Philippe Mayaud
- Faculty of Infectious & Tropical Diseases, London School of Hygiene and Tropical Medicine (LSHTM), London, WC1E 7HT, UK
| | - Sia E. Msuya
- Department of Epidemiology & Biostatistics, Institute of Public Health,, Kilimanjaro Christian Medical University College (KCMUCo), Moshi, Tanzania
- Department of Community Health, Institute of Public Health, Kilimanjaro Christian Medical University College (KCMUCo), Moshi, Tanzania
- Community Health Department, KCMC Hospital, Moshi, Tanzania
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Strandberg A, Skoglund C, Gripenberg J, Kvillemo P. Alcohol and illicit drug consumption and the association with risky sexual behaviour among Swedish youths visiting youth health clinics. NORDIC STUDIES ON ALCOHOL AND DRUGS 2019; 36:442-459. [PMID: 32934578 PMCID: PMC7434140 DOI: 10.1177/1455072519845970] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 04/02/2019] [Indexed: 11/17/2022] Open
Abstract
AIMS High alcohol consumption and use of illicit drugs among young people is of great concern and there is a need to identify arenas where this group can be reached by preventive measures. The aim of the present study was to study prevalence of risky alcohol consumption, illicit drug use, and risky sexual behaviour (RSB) among young people visiting youth health clinics in Stockholm county. Another aim was to explore the association between risky alcohol consumption, illicit drug use and RSB. METHODS During autumn 2016, an anonymous questionnaire comprising questions about alcohol, illicit drugs and risky sexual behaviour was given to visitors at 11 youth health clinics in Stockholm county. RESULTS A total of 328 youths (M = 18.8 years, 89% girls) answered the questionnaire. Results show that 61.7% had risky alcohol consumption and 41.8% had tried illicit drugs. Risky sexual behaviour was more prevalent among respondents with risky alcohol consumption, and it was more common among non-students than students. CONCLUSIONS Findings indicate that a large proportion of visitors at youth health clinics in Stockholm county has a risky alcohol consumption and experiences of other drugs, and also that risky alcohol consumption is associated with three of five RSB outcomes. Non-students seemed to be a particularly exposed risk group with regard to both risky alcohol consumption and RSB. Overall, the results indicate that youth health clinics are an important arena for alcohol prevention.
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Affiliation(s)
| | | | | | - Pia Kvillemo
- STAD, Centre for Psychiatry Research, Stockholm, Sweden
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Abstract
Voluntary counselling and testing (VCT) for HIV has been promoted as a strategy to prevent HIV pandemics by changing sexual behaviour. Despite the provision of VCT in countries with generalized or high-burden epidemics, including Nigeria, the extent of its influence on behavioural change remains a conjecture. The main objective of this study was to examine the influence of HIV VCT on sexual behaviour changes among youths in Nigeria. The study utilized 2013 Nigeria Demographic and Health Survey (NDHS) data. Data were analysed from a nationally representative sample drawn from 8046 females and 6031 males aged 15-24 giving a total sample of 14,077 never-married youths. Descriptive and analytical analyses were carried out, including multivariate logistic regression. The study found a low uptake of HIV VCT and regional variation in behavioural changes between female and male youths. Voluntary HIV counselling and testing was found to be a protective factor for condom use at last sex for female youths, but significantly reduced the likelihood of primary sexual abstinence for both females and males, as well as having a single sexual partner for female youths. After controlling HIV VCT with other variables, certain socioeconomic factors were found to be significantly associated with behavioural changes. Thus, the attitudes of most Nigerian youths towards voluntary HIV counselling and testing needs to be improved through socioeconomic factors for healthy sexual activity. To achieve this, government and non-governmental organizations, as well as religious leaders and policymakers, should engage in appropriate and long-term activities directed at the sexual health needs of never-married youths, through voluntary HIV counselling and testing, to encourage them to change their sexual behaviour.
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Wendland EM, Horvath JDC, Kops NL, Bessel M, Caierão J, Hohenberger GF, Domingues CM, Maranhão AGK, de Souza FMA, Benzaken AS. Sexual behavior across the transition to adulthood and sexually transmitted infections: Findings from the national survey of human papillomavirus prevalence (POP-Brazil). Medicine (Baltimore) 2018; 97:e11758. [PMID: 30113461 PMCID: PMC6112916 DOI: 10.1097/md.0000000000011758] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 07/07/2018] [Indexed: 11/26/2022] Open
Abstract
The sexual behaviors of 15- to 24-year-olds increase the risk of this population to acquire sexually transmitted infections (STIs). The present study aimed to describe the sexual behavior in the transition to adulthood Brazilian population and its association with STI history.We analyzed cross-sectional data collected from 8562 sexually active women and men who participated in the National Survey of Human Papillomavirus Prevalence (POP-Brazil). This large-scale survey enrolled participants from 26 Brazilian capitals and the Federal District. Professionals from primary care facilities were trained to collect data utilizing a standardized questionnaire with questions on sociodemographic, sexual behavior, and drug use. We constructed a Poisson model with robust variance for both crude and adjusted analysis to investigate the associations between the variables. To adjust the distribution of the sample to the study population, we weighted the measures by the population size in each city and by gender.There were differences in several aspects from sexual behavior between genders. The majority of men reported an early sexual initiation, more sexual partners, and a different practice in sexual positions when compared with women. Women reported use of contraception more frequently than men (P < .001). The use of alcohol and drugs and the use of drugs before sexual intercourse impact in STIs equally between the genders. Exclusive for women, the presence of any STI was associated with the practice of vaginal sex and other types of intercourse (adjusted prevalence ratio [APR] 1.43, 95% CI 1.08-1.88). For men, the number of sexual partners in the last year (APR 1.02, 95% CI 1.01-1.04), not having vaginal sex (APR 3.25, 95% CI 1.78-5.92) and sexual experience with someone of the same sex (APR 4.05, 95% CI, 2.88-5.70) were associated with a higher presence of STIs.This is the first report regarding sexual behavior in a nationally representative population sample in Brazil. This study provides more valid estimates of sexual behavior and associated STIs, identifying important differences in sexual behavior and identifying predictors for referred STIs among females and males.
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Affiliation(s)
- Eliana Marcia Wendland
- Hospital Moinhos de Vento
- Federal University of Health Science of Porto Alegre, Porto Alegre, Brazil
| | | | | | | | | | | | | | | | - Flavia Moreno Alves de Souza
- Department of Surveillance, Prevention and Control of Sexually Transmitted Infections, HIV/AIDS and Viral Hepatitis, Brazilian Ministry of Health, Brazil
| | - Adele Schwartz Benzaken
- Department of Surveillance, Prevention and Control of Sexually Transmitted Infections, HIV/AIDS and Viral Hepatitis, Brazilian Ministry of Health, Brazil
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Abstract
The question of youth sexual behaviour has been widely debated, with researchers such as Berhan and Berhan (2015) arguing that young adults aged 15-24 are more likely to engage in risky behaviours. However, research has not adequately addressed the issue of positive sexual behaviours, in particular among young people in sub-Saharan Africa. Adapting the compensatory model of risk and resiliency theory, this study examined the determinants of positive sexual behaviours among youth in sub-Saharan Africa. Using recent data from Demographic and Health Surveys of sixteen countries representative of each African region (East, West, Southern and Central), it was hypothesized that positive sexual behaviours of youth (condom use at last sex and single sexual partnership) would be most strengthened by protective factors at the individual and family levels, and that these behaviours would differ by region due to regional variation in socio-cultural practices. Delayed age at sexual debut (first sex after the age of 15) was found to be the strongest protective factor for positive sexual behaviours among males and females in sub-Saharan Africa. Certain socioeconomic variables were found to be positively associated with positive sexual behaviours and the associations differed by gender.
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Ma Y, Zhao W, Shi C, Wang N, Fan T. Effects of HIV on metabolic and biological pathways of CD4 + T lymphocytes. Exp Ther Med 2018; 15:2946-2950. [PMID: 29456700 PMCID: PMC5795520 DOI: 10.3892/etm.2018.5749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Accepted: 12/12/2017] [Indexed: 11/23/2022] Open
Abstract
The effects of human immunodeficiency virus (HIV) on the metabolic and biological pathways of cluster of differentiation (CD)4+ T lymphocytes were investigated. A total of 150 patients with acquired immune deficiency syndrome (AIDS) and 50 healthy individuals who were admitted to hospital for physical examination during the period of June 2016 to January 2017, were selected as subjects in the present study. According to the virus load, 150 AIDS patients were divided into three groups: i) Viral load >106 copies/ml (group A, n=39), ii) 104 copies/ml < viral load <105 copies/ml (group B, n=76), and iii) viral load <104 copies/ml (group C, n=35). The relationship between viral loads in the three groups and CD4+ T lymphocyte counts was assessed. Active lymphocytes were isolated from T lymphocytes in the subjects, and the ratio of Th1 to Th2 was measured by flow cytometry. Effects of HIV on human T-lymphocyte differentiation were observed. Differences in T-lymphocyte metabolites were detected by proton nuclear magnetic resonance and their biological pathways analyzed. The results showed that CD4+ T-cell counts were decreased with the increase of the viral loads of patients. The viral loads of AIDS patients differentiated T lymphocytes. In other words, high viral loads accelerated the differentiation of T lymphocytes into Th1 cells. In the high HIV viral load group, the levels of glycerol phosphodiesterase, 7-dehydrocholesterol, p-hydroxyphenylacetic acid, cholesterol and deoxyuridine were increased, but the levels of 3-methoxytyramine, cytidine deaminase, deoxycorticosterone and 3-hydroxybutyric acid were decreased. The viral loads of AIDS patients are associated with CD4+ T-cell counts and the ratio of CD4+ T to CD8+ T cells. At the same time, HIV viral loads can affect the lipid biosynthesis of T-lymphocyte membranes, thus affecting the differentiation and proliferation of T lymphocytes and finally intervening its mediated immune responses.
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Affiliation(s)
- Yanli Ma
- Department of Infectious Diseases, Qingdao Sixth People's Hospital, Qingdao, Shandong 266033, P.R. China
| | - Wenge Zhao
- Department of Liver Diseases, Qingdao Sixth People's Hospital, Qingdao, Shandong 266033, P.R. China
| | - Changhe Shi
- Department of Liver Diseases, Qingdao Sixth People's Hospital, Qingdao, Shandong 266033, P.R. China
| | - Ning Wang
- Department of Internal Medicine, Postgraduate School of Qingdao University, Qingdao, Shandong 266033, P.R. China
| | - Tianli Fan
- Department of Infectious Diseases, Qingdao Sixth People's Hospital, Qingdao, Shandong 266033, P.R. China
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Ssewanyana D, Mwangala PN, Marsh V, Jao I, van Baar A, Newton CR, Abubakar A. Young people's and stakeholders' perspectives of adolescent sexual risk behavior in Kilifi County, Kenya: A qualitative study. J Health Psychol 2017; 23:188-205. [PMID: 29076401 PMCID: PMC5772428 DOI: 10.1177/1359105317736783] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
A lack of research exists around the most common forms of sexual risk behaviors among adolescents, including their underlying factors, in Sub-Saharan Africa. Using an Ecological Model of Adolescent Behavior, we explore the perceptions of 85 young people and 10 stakeholders on sexual risk behavior of adolescents in Kilifi County on the coast of Kenya. Our findings show that transactional sex, early sexual debut, coerced sex, and multiple sexual partnerships are prevalent. An urgent need exists to develop measures to counter sexual risk behaviors. The results contribute to understanding the range of risks and protective factors in differing contexts, tackling underlying issues at individual, family, local institutional, wider socio-economic, and political levels.
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Affiliation(s)
- Derrick Ssewanyana
- 1 Kenya Medical Research Institute (KEMRI), Kenya.,2 Utrecht University, The Netherlands
| | - Patrick N Mwangala
- 1 Kenya Medical Research Institute (KEMRI), Kenya.,3 Pwani University, Kenya
| | - Vicki Marsh
- 1 Kenya Medical Research Institute (KEMRI), Kenya.,4 University of Oxford, UK
| | - Irene Jao
- 1 Kenya Medical Research Institute (KEMRI), Kenya
| | | | - Charles R Newton
- 1 Kenya Medical Research Institute (KEMRI), Kenya.,3 Pwani University, Kenya.,4 University of Oxford, UK
| | - Amina Abubakar
- 1 Kenya Medical Research Institute (KEMRI), Kenya.,3 Pwani University, Kenya.,4 University of Oxford, UK
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Amoo EO, Oni GA, Ajayi MP, Idowu AE, Fadayomi TO, Omideyi AK. Are Men's Reproductive Health Problems and Sexual Behavior Predictors of Welfare? Am J Mens Health 2017; 11:487-497. [PMID: 26231731 PMCID: PMC5675243 DOI: 10.1177/1557988315598832] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The study examined men's reproductive health problems and sexual behavior and their implications for men's welfare in Nigeria. It used the Nigeria Demographic and Health Survey data set of 2013. The analysis used only male recode files, representing 17,359 males. The dependent variable is the computed wealth index, which was selected as proxy for welfare condition. Analysis involved univariate and multivariate levels. The findings indicated that 49.3% of the respondents currently have more than one sexual partner. The total lifetime sexual partner index identifies 70.2% of the men interviewed have had at least two sexual partners in their lifetime. It revealed that men who experience reproductive health challenges, such as sexually transmitted infections and genital ulcer, are 44% and 93%, respectively, less likely to enjoy good welfare condition. It also indicated that men in urban area are 7.256 times more likely to enjoy good welfare condition compared with their rural counterparts. There is a negative association between total lifetime sexual partnerships and exposure to good welfare. The study concludes that social workers, marriage counselors, other health personnel, and policy makers need to focus on the practice of multiple sexual partnership and reproductive health diseases as major determinants of men's welfare. The authors suggest that the index of welfare should include reproductive health issues and indicators of sexual behavior. Also, there is need for the establishment of specialized reproductive health care services and centers that are accessible to all men for effective servicing of reproductive health needs of men in the country.
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Abstract
Early sexual debut is of major concern because it is a correlate for health and economic shocks experienced in adulthood. In South Africa, this concern has provided impetus for research directed at the HIV and AIDS epidemic, teenage pregnancy and the effect of adolescent sexual behaviour on persistence in school. Of interest to the present study is high school completion, which is a well-established empirical barometer of adult socioeconomic opportunities. Using data from the five waves of the Cape Area Panel Study (CAPS), this paper examines the association between sexual behaviours initiated in pre- and early adolescence and high school completion rates. The CAPS study is a longitudinal survey that was designed to investigate young people's (aged 14-22 years) educational attainment and sexual behaviours in Cape Town, South Africa. The sample was constituted from 3213 individuals who had initiated sex during their teenage years and the analysis was undertaken when the youngest cohort was aged 21, an age at which they should have completed high school if they were on time. Logistic regression models were fitted separately for males and females. Overall, the results reveal that early sexual debut is correlated with long-term negative educational outcomes. Individuals who experience early sexual debut are less likely to complete high school than their counterparts who make their sexual debut later on in life. This effect is worse for Africans, who also disproportionately have an earlier sexual debut than other race groups. Apart from race however, the findings also reinforce the effect of other demographic factors on high school completion, namely, place of residence and family socioeconomic status as measured by parental education and household income. Hence, early sexual debut adds another layer of inequality and worsens the plight of Africans, females, those living in rural areas and those who come from low-income families.
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Odimegwu C, Somefun OD. Ethnicity, gender and risky sexual behaviour among Nigeria youth: an alternative explanation. Reprod Health 2017; 14:16. [PMID: 28143542 PMCID: PMC5282662 DOI: 10.1186/s12978-017-0284-7] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 01/07/2017] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND While studies in demography and public health have acknowledged the role of ethnic differences, the influence of ethnicity on youth sexual behaviour in Nigeria has received little or no attention. It is important to know how cultural norms and gender roles, which vary by ethnicity, may promote or prevent risky behaviour. Such information could provide insights into previously undetected sexual behaviour in multi-ethnic situations. METHODS The Nigeria Demographic and Health Surveys (NDHS) for 2003, 2008 and 2013 were pooled to examine the relationship between ethnicity and youth sexual reproductive health, proxied by age at sexual debut, multiple sexual partners (MSP) and condom use at last sexual activity, among the 6304 females and 1549 males who reported being sexually active in the four weeks preceding the survey. Multivariate analysis using a Cox proportional hazard regression model was used to determine the risk factors for early sexual activity among young people (15-24). Logistic regression was used to predict condom use at last sexual activity and MSP. RESULTS The median age at first sexual activity was 16 for females and 17 for males. 43% of male youths used condoms in their last sexual activity, compared to only 16% among females and a higher number of males (81%) had multiple sexual partners compared to females (35%). For females, elevated risks of first sex was higher among Hausa/Fulanis aged 15-19 and elevated risk of first sex was higher among Yoruba males. CONCLUSION This study provides further evidence that in order to promote protective sexual behaviours among youth in Nigeria, social, cultural and gender-specific tactics should be put in place for the prevention of HIV and other STIs.
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Affiliation(s)
- Clifford Odimegwu
- Demography and Population Studies, School of Public Health and Social Sciences, Faculty of Humanities, University of the Witwatersrand, Johannesburg, 2000 South Africa
| | - Oluwaseyi Dolapo Somefun
- Demography and Population Studies, School of Public Health and Social Sciences, Faculty of Humanities, University of the Witwatersrand, Johannesburg, 2000 South Africa
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Odimegwu CO, De Wet N, Banda PC. Risky sexual behaviour among women: Does economic empowerment matter? Case of Gabon, Mozambique, Sierra-Leone and Zambia. AJAR-AFRICAN JOURNAL OF AIDS RESEARCH 2016; 15:333-340. [DOI: 10.2989/16085906.2016.1238401] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Clifford O. Odimegwu
- Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Nicole De Wet
- Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Pamela C. Banda
- Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Lakew Y, Benedict S, Haile D. Social determinants of HIV infection, hotspot areas and subpopulation groups in Ethiopia: evidence from the National Demographic and Health Survey in 2011. BMJ Open 2015; 5:e008669. [PMID: 26589427 PMCID: PMC4663400 DOI: 10.1136/bmjopen-2015-008669] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVE This study identifies social determinants of HIV infection, hotspot areas and subpopulation groups in Ethiopia. DESIGN The study used data from the 2011 Ethiopian Demographic and Health Survey (EDHS). Sample blood tests from the finger pricks collected on filter paper cards were labelled with a barcode unique to each respondent. Spatial scan statistics and geographic information system tools were used to map hotspot areas of HIV prevalence. Bivariate and multivariable logistic regression models were used to identify social determinants of HIV infection. POPULATION A total of 30,625 adults (16,515 women and 14,110 men) were included from 11 administrative states of Ethiopia. MAIN OUTCOME MEASURES Laboratory-confirmed HIV serostatus is the main outcome variable. RESULTS HIV prevalence reached 10-21% in the central, eastern and western geographic clusters of Ethiopia. Multivariable analysis showed that individuals who were in the middle, richer and richest wealth quintiles had increased odds of having HIV over those in the poorest quintile. Adults who had primary, secondary and higher educational levels had higher odds of being HIV positive than non-educated individuals. The odds of having HIV were higher among adults who had multiple lifetime sexual partners than those with a single partner. An increasing odds of HIV infection were observed among adults in the age groups of 25-29, 30-34, 35-39 and 40-45 years compared with adults in the age group of 45-49 years. Merchants had higher odds of being HIV positive than those who were not employed. The odds of having HIV were higher among urban residents and females than among rural residents and males, respectively. CONCLUSIONS This study found statistically significant HIV concentrations in administrative zones of central, eastern and western Ethiopia. Geospatial monitoring and targeting of prevention strategies for specific population groups is recommended.
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Affiliation(s)
- Yihunie Lakew
- Ethiopian Public Health Association, Addis Ababa, Ethiopia
| | - Susan Benedict
- The University of Texas Health Science Center at Houston, School of Nursing, Houston, Texas, USA
| | - Demewoz Haile
- Department of Reproductive Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Amhara Region, Ethiopia
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Kenyon CR, Tsoumanis A, Schwartz IS. HIV Prevalence Correlates with High-Risk Sexual Behavior in Ethiopia's Regions. PLoS One 2015; 10:e0140835. [PMID: 26496073 PMCID: PMC4619767 DOI: 10.1371/journal.pone.0140835] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 09/29/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND HIV prevalence varies between 0.9 and 6.5% in Ethiopia's eleven regions. Little has been published examining the reasons for this variation. METHODS We evaluated the relationship between HIV prevalence by region and a range of risk factors in the 2005 and 2011 Ethiopian Demographic Health Surveys. Pearson's correlation was used to assess the relationship between HIV prevalence and each variable. RESULTS There was a strong association between HIV prevalence and three markers of sexual risk: mean lifetime number of partners (men: r = 0.87; P < 0.001; women: r = 0.60; P = 0.05); reporting sex with a non-married, non-cohabiting partner (men: r = 0.92; P < 0.001, women r = 0.93; P < 0.001); and premarital sex. Condom usage and HIV testing were positively associated with HIV prevalence, while the prevalence of circumcision, polygamy, age at sexual debut and male migration were not associated with HIV prevalence. CONCLUSION Variation in sexual behavior may contribute to the large variations in HIV prevalence by region in Ethiopia. Population-level interventions to reduce risky sexual behavior in high HIV incidence regions should be considered.
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Affiliation(s)
- Chris R. Kenyon
- HIV/STI Unit, Institute of Tropical Medicine, Antwerp, Belgium
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | | | - Ilan Steven Schwartz
- Department of Medical Microbiology, Faculty of Health Sciences, College of Medicine, University of Manitoba, Winnipeg, Canada
- Department of Epidemiology and Social Medicine, Faculty of Health Sciences, University of Antwerp, Belgium
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Atuyambe LM, Kibira SPS, Bukenya J, Muhumuza C, Apolot RR, Mulogo E. Understanding sexual and reproductive health needs of adolescents: evidence from a formative evaluation in Wakiso district, Uganda. Reprod Health 2015; 12:35. [PMID: 25896066 PMCID: PMC4416389 DOI: 10.1186/s12978-015-0026-7] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Accepted: 04/13/2015] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Adolescents are frequently reluctant to seek sexual and reproductive health services (SRH). In Uganda, adolescent health and development is constrained by translation of the relevant policies to practice. Recent studies done in central Uganda have shown that there is need for a critical assessment of adolescent friendly services (AFS) to gain insights on current practice and inform future interventions. This study aimed to assess the sexual reproductive health needs of the adolescents and explored their attitudes towards current services available. METHODS A qualitative study was conducted in Wakiso district, central Uganda in September 2013.Twenty focus group discussions (FGDs) stratified by gender (10 out-of-school, and 10 in-school), were purposefully sampled. We used trained research assistants (moderator and note taker) who used a pretested FGD guide translated into the local language to collect data. All discussions were audio taped, and were transcribed verbatim before analysis. Thematic areas on; adolescent health problems, adolescent SRH needs, health seeking behaviour and attitudes towards services, and preferred services were explored. Data was analysed using atlas ti version 7 software. RESULTS Our results clearly show that adolescents have real SRH issues that need to be addressed. In and out-of-school adolescents had sexuality problems such as unwanted pregnancies, sexually transmitted infections (STIs), defilement, rape, substance abuse. Unique to the females was the issue of sexual advances by older men and adolescents. We further highlight RH needs which would be solved by establishing adolescent friendly clinics with standard recommended characteristics (sexuality information, friendly health providers, a range of good clinical services such as post abortion care etc.). With regard to health seeking behaviour, most adolescents do not take any action at first until disease severity increase. CONCLUSIONS Adolescents in Uganda have multiple sexual and reproductive health needs that require special focus through adolescent friendly services. This calls for resource support in terms of health provider training, information education and communication materials as well as involvement of key stakeholders that include parents, teachers and legislators.
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Affiliation(s)
- Lynn M Atuyambe
- Department of Community Health and Behavioural Sciences, Makerere University School of Public Health, P.O.Box 7072, Kampala, Uganda.
| | - Simon P S Kibira
- Department of Community Health and Behavioural Sciences, Makerere University School of Public Health, P.O.Box 7072, Kampala, Uganda.
| | - Justine Bukenya
- Department of Community Health and Behavioural Sciences, Makerere University School of Public Health, P.O.Box 7072, Kampala, Uganda.
| | - Christine Muhumuza
- Department of Epidemiology and Biostatistics, Makerere University School of Public Health, Kampala, Uganda.
| | - Rebecca R Apolot
- Department of Community Health and Behavioural Sciences, Makerere University School of Public Health, P.O.Box 7072, Kampala, Uganda.
| | - Edgar Mulogo
- Department of Community Health, Mbarara University of Science and Technology, Kampala, Uganda.
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