scholarly journals From ‘sugar daddies’ to ‘sugar babies’: exploring a pathway among age-disparate sexual relationships, condom use and adolescent pregnancy in South Africa

Sexual Health ◽  
2015 ◽  
Vol 12 (1) ◽  
pp. 59 ◽  
Author(s):  
Elona Toska ◽  
Lucie D. Cluver ◽  
Mark Boyes ◽  
Marija Pantelic ◽  
Caroline Kuo
Keyword(s):  
South Africa ◽  
Condom Use ◽  
Adolescent Pregnancy ◽  
Pregnancy Rates ◽  
Sexual Relationships ◽  
Adverse Outcomes ◽  
Consistent Condom ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Unwanted Pregnancies

Background Adolescent pregnancy has been linked to adverse outcomes. Most studies proposing risk pathways for adolescent pregnancy in South Africa are qualitative, hypothesising links among age-disparate relationships, reduced condom use and higher pregnancy rates. No known South African studies have quantitatively explored pathways to adolescent pregnancy. Objectives: This study aimed to: (i) identify the factors associated with adolescent pregnancy and (ii) explore a pathway of risk by assessing whether condom use mediated the relationship between age-disparate sexual relationships and adolescent pregnancy. Methods: A cross-sectional survey of 447 sexually active girls aged 10–19 years was undertaken in six health districts of South Africa. Multivariate logistic regressions controlled for confounders. Mediation tests used bootstrapping. Results: Consistent condom use (β = –2.148, odds ratio (OR) = 8.566, P ≤ 0.001) and school enrolment (β = –1.600, OR = 0.202, P ≤ 0.001) were associated with lower pregnancy rates. Age-disparate sex (β = 1.093, OR = 2.982, P ≤ 0.001) and long-term school absences (β = 1.402, OR = 4.061, P ≤ 0.001) were associated with higher pregnancy rates. The indirect effect of age-disparate sex on adolescent pregnancy through condom use was significant, irrespective of age, age at sexual initiation, poverty and residential environment (B = 0.4466, s.d. = 0.1303, confidence interval: 0.2323–0.7428). Conclusion: This survey supports hypotheses that inability to negotiate condom use in age-disparate sexual relationships may drive adolescent pregnancy. Interventions addressing these relationships, facilitating condom use and increasing access to sexual health services among adolescents might avert unwanted pregnancies.

scholarly journals Concurrent partnering and condom use among rural heterosexual African-American men

Sexual Health ◽  
2014 ◽  
Vol 11 (1) ◽  
pp. 81 ◽  
Author(s):  
JaNelle M. Ricks ◽  
Angelica Geter ◽  
Richard A. Crosby ◽  
Emma Brown
Keyword(s):  
African American ◽  
Condom Use ◽  
African American Men ◽  
Consistent Condom ◽  
Sexual Risk Behaviour ◽  
Eastern United States ◽  
Cross Sectional Survey ◽  
Consistent Condom Use ◽  
Cross Sectional ◽  
Concurrent Partnerships

Background Limited research has targeted HIV risk among heterosexual African-American men in the rural south-eastern United States. Methods: A cross-sectional survey was administered to 538 men to assess HIV knowledge, attitudes towards HIV testing and sexual risk behaviour. Results: Fifty-one percent reported consistent condom use in the past 3 months. Monogamous men reported more consistent condom use (t = 3.47, d.f. = 536, P < 0.001). In concurrent partnerships, condom use was inversely related to age (adjusted odds ratio (AOR) = 0.98, 95% confidence interval (CI) = 0.95–0.998, P = 0.03) and increased with the number of female partners (AOR = 1.49, 95% CI = 1.26–1.76, P < 0.001). Conclusions: African-American HIV prevention outreach should include focus on concurrent partnering in rural settings.

scholarly journals Sexual practices and condom use among a sample of Northern and Indigenous adolescents in Northern Canada: cross-sectional survey results

2018 ◽  
Vol 45 (2) ◽  
pp. 147-154 ◽  
Author(s):  
Carmen H Logie ◽  
Candice L Lys ◽  
Jamie Fujioka ◽  
Nancy MacNeill ◽  
Kayley Mackay ◽  
...  
Keyword(s):  
Drug Use ◽  
Condom Use ◽  
Sexual Activity ◽  
Consistent Condom ◽  
Cross Sectional Survey ◽  
Consistent Condom Use ◽  
Cross Sectional ◽  
Study Objective ◽  
Sti Prevention ◽  
Indigenous Adolescents

BackgroundSexually transmitted infections (STI) prevention in the Northwest Territories (NWT), Canada is an urgent concern as STI prevalence is seven-fold the national average. The study objective was to explore factors associated with sexual activity and condom use among adolescents in the NWT.MethodsWe conducted a cross-sectional survey with youth aged 13–18-years-old in 17 NWT communities. We use Poisson regression models with a robust sandwich error variance to estimate adjusted relative risks estimates of the likelihood of experiencing the primary outcomes of sexual activity (vaginal/anal/oral sex) and consistent condom use (oral/anal sex) in the past 3 months by gender.ResultsParticipants (n=607; mean age: 14.2 years; SD: 1.5) included adolescent cisgender girls (n=302; 49.5%), cisgender boys (n=298; 48.9%) and transgender persons (n=7; 1.2%). Most identified as Indigenous (n=444; 73.1%) and 14.0% (n=85) as lesbian, gay, bisexual or queer sexuality (LGBQ+). Among sexually active individuals (n=115), less than half (n=54; 47.0%) reported past 3 month consistent condom use. In adjusted analyses among girls, sexual activity was associated with age, STI knowledge, and alcohol/drug use; LGBQ+ identity and alcohol/drug use were associated with reduced likelihood of condom use. Among boys, sexual activity was associated with age and alcohol/drug use; LGBQ+ identity was associated with increased likelihood of condom use.ConclusionsFindings demonstrate sexual activity among adolescents in the NWT varies by gender, age, and alcohol/drug use. Consistent condom utilisation was low, particularly for those using alcohol/drugs. Gender-tailored STI prevention strategies with Northern adolescents should address alcohol/drug use and build protective factors.

scholarly journals Promoting Consistent Condom Use among Young Adults in the Vhembe District, Limpopo, South Africa

2018 ◽  
Vol 20 (1) ◽  
Author(s):  
Namadzavho Joyce Muswede ◽  
Azwihangwisi Helen Mavhandu-Mudzusi
Keyword(s):  
South Africa ◽  
Young Adults ◽  
Condom Use ◽  
Sex Education ◽  
Rural Areas ◽  
Healthcare Providers ◽  
Consistent Condom ◽  
Cross Sectional ◽  
Negative Attitudes ◽  
Vhembe District

Condoms are considered useful in the prevention of unplanned pregnancies and sexually transmitted infections including the human immunodeficiency virus. However, condom use is a challenge among young adults in rural areas. This paper reports the views of young adults regarding the strategies which can be utilised for promoting condom use in one of the rural clinics in the Vhembe district, Limpopo, South Africa. This quantitative, cross-sectional, descriptive study was conducted in one of the clinics in the Vhembe district. Data were collected using structured questionnaires administered to 372 young adults who came to visit the clinic. Data analysis was done using Statistical Package for Social Sciences (SPSS) version 28. Results indicate that condom use among the youth can be promoted though (i) improving the negative attitudes of healthcare providers to condom issuing and use, (ii) involving other stakeholders who have an impact on the use of condoms, and (iii) promoting condom use. Retraining of healthcare providers to improve negative attitudes is a matter of priority. In-service training should focus on disseminating information about patients’ rights. The following recommendations were put forth: enhancement of communication strategies for marketing condom use, broadening sex education in the school curriculum, and improving the negative attitudes of healthcare providers to the promotion of condom use.

scholarly journals HIV risk behaviour among public primary healthcare patients with tuberculosis in South Africa

2013 ◽  
Vol 14 (3) ◽  
pp. 125-130 ◽  
Author(s):  
Karl Peltzer
Keyword(s):  
South Africa ◽  
Condom Use ◽  
Sexual Intercourse ◽  
Hiv Risk ◽  
Primary Healthcare ◽  
Informal Settlement ◽  
Risk Behaviour ◽  
Hiv Positive ◽  
Cross Sectional Survey ◽  
Cross Sectional

Objective. To identify factors associated with HIV in tuberculosis (TB) patients in a public primary healthcare (PHC) setting in South Africa (SA).Method. Among 4 900 consecutively selected TB patients (54.5% men; women 45.5%) from 42 public PHC clinics in 3 districts in SA, a cross-sectional survey was performed to assess new TB and new TB retreatment patients within one month of anti-TB treatment.Results. The sample comprised 76.6% new TB patients and 23.4% TB retreatment patients. Of those who had tested for HIV, 59.9% were HIV-positive; 9.6% had never tested for HIV. In multivariate analysis, older age (odds ratio (OR) 5.86; confidence interval (CI) 4.07 - 8.44), female gender (OR 0.47; CI 0.37 - 0.59), residing in an informal settlement (OR 1.55; CI 1.13 - 2.12), being a TB retreatment patient (OR 0.55; CI 0.42 - 0.72), occasions of sexual intercourse with condom use (OR 1.07; CI 1.02 - 1.13) and having a sexual partner receiving antiretroviral treatment (ART) (OR 7.09, CI 4.35 - 11.57) were associated with an HIV-positive status in TB patients.Conclusion. This study revealed high HIV risk behaviour (e.g. unprotected last sexual intercourse and alcohol and drug use in the context of sexual intercourse) among TB patients in SA. Various factors were associated with HIV risk behaviour. Condom use and substance use risk reduction need to be considered as HIV-prevention measures when planning such strategies for TB patients.

scholarly journals Hepatitis B, hepatitis C and HIV prevalence and related sexual and substance use risk practices among key populations who access HIV prevention, treatment and related services in South Africa: findings from a seven-city cross-sectional survey (2017)

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Andrew Scheibe ◽  
Katherine Young ◽  
Anna Versfeld ◽  
C. Wendy Spearman ◽  
Mark W. Sonderup ◽  
...  
Keyword(s):  
South Africa ◽  
Substance Use ◽  
Hepatitis C ◽  
Hepatitis B ◽  
Hiv Prevalence ◽  
Consistent Condom ◽  
Key Populations ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Risk Practices

Abstract Background People who use drugs including people who inject drugs (PWUD/ID), sex workers (SWs) and men who have sex with men (MSM) are at increased risk of HIV and viral hepatitis infection. Limited epidemiological data on the infections exists in key populations (KPs) in South Africa. We investigated the prevalence of hepatitis B (HBV), hepatitis C (HCV) and HIV and selected risk factors among these KPs to inform effective responses. Methods We used convenience sampling to recruit a targeted 3500 KPs accessing HIV-related health services across Cape Town (SWs, MSM, PWUD/ID), Durban (SWs, PWUD/ID), Pietermaritzburg (SWs), Mthatha (SWs), Port Elizabeth (SWs), Johannesburg (MSM) and Pretoria (MSM and PWUD/ID) into a cross-sectional survey. An interviewer questionnaire to assess socio-demographic characteristics, drug use and sexual risk practices, was administered. HBV surface antigen (HBsAg); HCV antibody, viral load and genotype, and HIV antibody, was tested. Results Among the 3439 people included in the study (1528 SWs, 746 MSM, 1165 PWUD/ID) the median age was 29 years, most participants were black African (60%), and 24% reported homelessness. 82% reported substance use in the last month, including alcohol (46%) and heroin (33%). 75% were sexually active in the previous month, with condom use at last sex at 74%. HIV prevalence was 37% (highest among SWs at 47%), HBsAg prevalence 4% (similar across KPs) and HCV prevalence was 16% (highest among PWUD/ID at 46%). Conclusions HBV, HCV and HIV pose a health burden for KPs in South Africa. While HIV is key for all included KPs, HCV is of particular importance to PWUD/ID. For KPs, HBV vaccination and behavioural change interventions that support consistent condom and lubricant access and use are needed. Coverage of opioid substitution therapy and needle and syringe services, and access to HCV treatment for PWUD/ID need to be expanded.

scholarly journals Hepatitis B, Hepatitis C and HIV Prevalence and Related Sexual and Substance Use Risk Practices Among Key Populations Who Access HIV Prevention, Treatment and Related Services in South Africa: Findings from A Seven-City Cross-Sectional Survey (2017)

2020 ◽  
Author(s):  
Andrew Scheibe ◽  
Katherine Young ◽  
Anna Versfeld ◽  
C Wendy Spearman ◽  
Mark Sonderup ◽  
...  
Keyword(s):  
South Africa ◽  
Substance Use ◽  
Hepatitis C ◽  
Hepatitis B ◽  
Hiv Prevalence ◽  
Consistent Condom ◽  
Key Populations ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Risk Practices

Abstract Background: People who use drugs including people who inject drugs (PWUD/ID), sex workers (SWs) and men who have sex with men (MSM) are at increased risk for HIV and viral hepatitis infection. Limited data exists on the epidemiology of these infections among these key populations (KPs) in South Africa. We aimed to describe the prevalence of hepatitis B (HBV), hepatitis C (HCV) and HIV and selected risk factors among these KPs to inform effective responses. Methods: We used convenience sampling to recruit a targeted 3 500 KPs accessing HIV-related health services across Cape Town (SWs, MSM, PWUD/ID), Durban (SWs, PWUD/ID), Pietermaritzburg (SWs), Mthatha (SWs), Port Elizabeth (SWs), Johannesburg (MSM) and Pretoria (MSM and PWUD/ID) into a cross-sectional survey. We used an interviewer administered questionnaire to assess socio-demographic characteristics, drug use and sexual risk practices. We tested for HBV surface antigen (HBsAg), HCV (antibody, viral load and genotype) and HIV antibody. We used descriptive statistics to explore data, which were stratified by KP. Results: Among the 3 439 people included in the study (1 528 SWs, 746 MSM, 1 165 PWUD/ID) the median age was 29 years, most participants were black African (60%), and 24% reported homelessness. 82% reported substance use in the last month, including alcohol (46%) and heroin (33%). 75% were sexually active in the previous month, with condom use at last sex at 74%. HIV prevalence was 37% (highest among SWs at 47%), HBsAg prevalence 4% (similar across KPs) and HCV prevalence was 16% (highest among PWUD/ID at 46%). Conclusions: HBV, HCV and HIV are major health threats for KPs in South Africa. While HIV is an important condition for all included KPs, HCV is of particular importance to PWUD/ID. For KPs, HBV vaccination and behaviour change interventions that support consistent condom and lubricant access and use are needed. Coverage of opioid substitution therapy and needle and syringe services, and access to HCV treatment for PWUD/ID need to be expanded.

scholarly journals Gender, peer and partner influences on adolescent HIV risk in rural South Africa

Sexual Health ◽  
2012 ◽  
Vol 9 (2) ◽  
pp. 178 ◽  
Author(s):  
Abigail Harrison ◽  
Jenni Smit ◽  
Susie Hoffman ◽  
Thobile Nzama ◽  
Cheng-Shiun Leu ◽  
...  
Keyword(s):  
South Africa ◽  
Condom Use ◽  
Sexual Activity ◽  
Hiv Risk ◽  
Sexual Communication ◽  
Peer Norms ◽  
Cross Sectional Survey ◽  
Pregnancy Risk ◽  
Cross Sectional ◽  
Prevention Interventions

Background and methods In preparation for a school-based intervention in KwaZulu-Natal, South Africa, a cross-sectional survey of potential HIV risk factors in youth aged 14–17 (n = 983) was conducted. Results: Boys were significantly more likely than girls to report lifetime sexual activity (37.7% v. 13.8%, P < 0.01). Among boys and girls, 46.1% reported condom use at last sex. Discussion of condom use with a partner was the strongest predictor of condom use (boys, odds ratio (OR) = 7.39; girls, OR = 5.58, P < 0.0001). Age was independently associated with sexual activity for boys (OR = 1.49, P < 0.0001) and girls (OR = 1.74, P = 0.02). For boys, perceptions of male peer behaviour were associated with both ever having participated in sexual activity (OR = 1.48, P < 0.01) and condom use at last sex (OR = 1.79, P < 0.01). Girls who equated condom use with having numerous partners were more likely to use them. Among boys, results challenged some expected gender beliefs: support for girls’ initiative in relationship formation and refusal of sex were significant predictors of sexual activity. Among girls, higher pregnancy risk perception (OR = 1.32, P = 0.02) and knowledge (OR = 4.85, P = 0.055) were associated with sexual activity. Conclusions: Creating more gender equitable norms can reduce HIV risk behaviours. HIV prevention interventions should build on existing gender equitable beliefs, and work to promote others, including sexual communication and negotiation skills, and modelling of positive peer norms.

scholarly journals Risk Factors Associated With HIV Among Men Who Have Sex With Men (MSM) in Ecuador

2016 ◽  
Vol 11 (5) ◽  
pp. 1331-1341 ◽  
Author(s):  
Isabel Hernandez ◽  
Miguel Reina-Ortiz ◽  
Ayesha Johnson ◽  
Carlos Rosas ◽  
Vinita Sharma ◽  
...  
Keyword(s):  
Condom Use ◽  
Prevalence Rate ◽  
Behavioral Interventions ◽  
Hiv Prevalence ◽  
Consistent Condom ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Attitudes And Practices ◽  
Sex With Men ◽  
Hiv Aids

The Joint United Nations Program on HIV/AIDS estimates that between 0.3% and 0.7% of adults aged 15 to 49 years were living with HIV in Ecuador in 2013. However, very little is known about the HIV prevalence rate among men who have sex with men (MSM) in that country. A cross-sectional survey was conducted to investigate the knowledge, attitudes, and practices regarding HIV/AIDS as well as to estimate the prevalence of HIV among MSM in one of the cities with high HIV prevalence rates in Ecuador. In this study, questionnaires were administered to 307 adult MSM. An HIV prevalence of 10% was observed. Knowledge about HIV was high; 91% of participants could identify how HIV is transmitted. Although consistent condom use for anal sex was relatively high (89%) among participants who reported having pay-for-service clients, only 64% reported using a condom during oral sex with a client. Participants who had multiple male sexual partners (i.e., their stable male partners plus other partner[s]) had 3.7 times higher odds of testing positive for HIV compared with those who did not. They also had reduced odds of condom use. Participants who were forced to have anal receptive sex had 3 times higher odds of testing positive for HIV. Despite the finding that participants exhibited high knowledge about HIV/AIDS, a high prevalence rate of HIV was observed, which warrants targeted behavioral interventions. These data are consistent with MSM being one of the highest at-risk population groups for HIV in this region of Ecuador.

Hepatitis B, hepatitis C and HIV prevalence and related risk practices among key populations in South Africa: findings from a seven-city cross-sectional survey

2019 ◽  
Author(s):  
Andrew Scheibe ◽  
Katherine Young ◽  
Anna Versfeld ◽  
C Wendy Spearman ◽  
Mark Sonderup ◽  
...  
Keyword(s):  
South Africa ◽  
Hepatitis C ◽  
Hepatitis B ◽  
Hiv Prevalence ◽  
Consistent Condom ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Related Risk ◽  
Increased Risk ◽  
Risk Practices

Abstract Background: People who use drugs including people who inject drugs (PWUD/ID), sex workers (SWs) and men who have sex with men (MSM) are at increased risk for HIV and viral hepatitis infection. Limited data exists on the epidemiology of these infections among these key population groups (KPs) in South Africa. We aimed to describe the prevalence of hepatitis B (HBV), hepatitis C (HCV) and HIV and related risk factors among these KPs to inform effective responses. Methods: We aimed to recruit 3 500 KPs across Cape Town (SWs, MSM, PWUD/ID), Durban (SWs, PWUD/ID), Pietermaritzburg (SWs), Mthatha (SWs), Port Elizabeth (SWs), Johannesburg (MSM) and Pretoria (MSM and PWUD/ID) for participation in a cross-sectional survey. We used an interviewer administered questionnaire to assess socio-demographic characteristics, drug use and sexual risk practices. We tested for HCV (antibody, viral load and genotype), HBV surface antigen (HBsAg) and HIV antibody. We used descriptive statistics to explore data, which was stratified by KP. Results: Among the 3 439 included in the study (1 528 SWs, 746 MSM, 1 165 PWUD/ID) the median age was 29 years, most participants were black African (60%), and 24% reported homelessness. 82% reported substance use in the last month, including alcohol (46%) and heroin (33%). 75% were sexually active in the previous month, with condom use at last sex at 74%. HIV prevalence was 37% (highest among SWs at 47%), HBsAg prevalence 4% (similar across KPs) and HCV prevalence of 16% (highest among PWUD/ID at 46%). Conclusions: HCV, HBV and HIV are major health threats for KPs in South Africa. While HIV is an important condition for all included KPs, HCV is of particular importance to PWUD/ID. For KPs, HBV vaccination and behaviour change interventions that support consistent condom and lubricant access and use are needed. Coverage of opioid substitution therapy and needle and syringe services and access to HCV treatment for PWUD/ID need to be expanded.

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