Predictors of Inconsistent Condom Use among a Hard to Reach Population of Young Women with Multiple Sexual Partners in Peri-Urban South Africa

Alcohol-related harms may be increased among adolescent girls and young women (AGYW) involved in sex work, yet data on alcohol misuse among AGYW in sub-Saharan Africa are still scarce. We conducted a cross-sectional study among 15–24-year-old AGYW from January 2013 to December 2018 in Kampala, Uganda and used the Alcohol Use Disorder Identification Test (AUDIT) to study alcohol use patterns and dependence symptoms (dependence score ≥4). Of 1440 participants (median age 21 years), 83.1% had less than secondary education, 79.8% reported ≥10 paying sexual partners in the past month, 46.0% had ever experienced intimate partner violence (IPV), and 20.6% were living with HIV. Overall, 59.9% scored ≥8 and 29.4% scored ≥16 on the AUDIT. Of 277 (15.8%) with dependence symptoms, 69.1% were screened alcohol dependent. An AUDIT score ≥8 was associated with older age, illicit drug use, experiencing IPV, inconsistent condom use with paying partners, and HIV sero-negativity. All factors remained associated with a higher score ≥16 except HIV status. Similarly, illicit drug use, experiencing IPV and inconsistent condom use were associated with dependence symptoms and, in addition, a higher number of paying sexual partners. Alcohol misuse is high in this population, they urgently need harmful substance use reduction interventions.

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The impact of highly active antiretroviral therapy on high-risk behaviour of HIV-infected patients in sub-Saharan Africa

The Journal of Infection in Developing Countries ◽

10.3855/jidc.2644 ◽

2013 ◽

Vol 7 (06) ◽

pp. 436-447 ◽

Cited By ~ 12

Author(s):

Dan Kabonge Kaye ◽

Othman Kakaire ◽

Michael Odongo Osinde ◽

John Chrysestom Lule ◽

Nelson Kakande

Keyword(s):

High Risk ◽

Condom Use ◽

Risk Behavior ◽

Sexual Partners ◽

Sub Saharan Africa ◽

Inconsistent Condom ◽

High Risk Behavior ◽

Multiple Sexual Partners ◽

Sub Saharan ◽

Inconsistent Condom Use

Introduction: High-risk sexual behaviors such as multiple sexual partners, inconsistent condom use, acquisition of sexually transmitted infection (STIs), and non-use of contraceptives persist in HIV patients undergoing care. We conducted a systematic review of studies conducted in the era of increased access to HAART (2000-2010) to assess whether wide-scale use of HAART was associated with high-risk behavior among HAART-using patients. Methodology: We conducted a comprehensive search of databases (AIDSLINE, National Library of Medicine, MEDLINE, PubMed, CINHAL and EMBASE) from January 2002 to January 2010, reviewed conference proceedings and journals, and contacted the researchers involved. We analyzed the association of high-risk behaviors (non-disclosure of sero-status to sexual partners, inconsistent condom use, unprotected sexual intercourse, multiple sexual partners, non-use of contraceptives and acquisition of STIs) with using HAART. Information from eligible studies was abstracted using a standardized checklist. Fourteen English-language studies met the selection criteria of having high-risk behavior as an outcome in patients using HAART in sub-Saharan Africa. Results: Of the 92 eligible articles screened, 14 met the criteria for inclusion as primary articles, 10 showed that HAART is not associated with increased high-risk behavior, two showed increase in acquisition of STIs among HAART-using patients, (which was inconsistent with other measures of high-risk behavior), and two studies showed short-term increase in high-risk behavior. Conclusions: Persistence of high-risk behavior in HAART-using patients suggests that more effort needs to be incorporated in HIV care to reduce such behavior to reduce HIV transmission to uninfected populations.

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Inconsistent Condom Use among Public Primary Care Patients with Tuberculosis in South Africa

The Scientific World JOURNAL ◽

10.1100/2012/501807 ◽

2012 ◽

Vol 2012 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Gladys Matseke ◽

Karl Peltzer ◽

Julia Louw ◽

Pamela Naidoo ◽

Gugu Mchunu ◽

...

Keyword(s):

South Africa ◽

Primary Care ◽

Condom Use ◽

Multivariable Analysis ◽

High Rate ◽

Consistent Condom ◽

Consistent Condom Use ◽

Inconsistent Condom ◽

The Past ◽

Inconsistent Condom Use

The high rate of HIV infections among tuberculosis (TB) patients in South Africa calls for urgent HIV reduction interventions in this subpopulation. While correct and consistent condom use is one of the effective means of HIV prevention among sexually active people, there is insufficient research on condom use among TB patients in South Africa. The aim of this paper was to determine the prevalence of inconsistent condom use among public primary care TB patients and its associated factors using a sample of 4900 TB patients from a cross-sectional survey in three health districts in South Africa. Results indicated that when asked about their consistency of condom use in the past 3 months, 63.5% of the participants reported that they did not always use condoms. In the multivariable analysis, being married (OR=1.66; 95% CI 1.25–2.20) or cohabitating or separated, divorced, or widowed (OR=3.67; 1.85–7.29), lower educational level (OR=0.66; 0.46–0.94), greater poverty (OR=1.60; 1.25–2.20), not having HIV status disclosed (OR=0.34; 0.25–0.48), sexual partner on antiretroviral treatment (OR=0.38; 0.23–0.60), and partner alcohol use before sex (OR=1.56; 1.30–1.90) were significantly associated with inconsistent condom use in the past 3 months. The low proportion of consistent condom use among TB patients needs to be improved.

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“I enjoy sex more without condoms": revisiting barriers and facilitators of consistent condom use among adolescents and young adults in South Africa

10.21203/rs.3.rs-271620/v2 ◽

2021 ◽

Author(s):

Anthony Ajayi ◽

Olumuyiwa Omonaiye ◽

Charlotte Nwogwugwu

Keyword(s):

South Africa ◽

Young People ◽

Condom Use ◽

Financial Support ◽

Consistent Condom ◽

Sexually Active ◽

Partner Communication ◽

Consistent Condom Use ◽

Inconsistent Condom ◽

Inconsistent Condom Use

Abstract Background Previous studies have examined consistent condom use correlates in South Africa, focusing on sociodemographic factors, HIV risk perceptions, relationship conflict, multiple sexual partners, and masculinity. However, the effect of family financial support, HIV testing, partner communication and self-efficacy for HIV prevention is less studied. We drew from a cross-sectional survey to address this gap and highlight the key barriers and facilitators of consistent condom use among young people. Methods We analysed data obtained from 631 unmarried sexually active male and females students selected using stratified sampling from a university in Eastern Cape Province of South Africa. Consistent condom use was defined as regular use of condoms in all sexual encounters in the past year. We used an open-ended question to probe the reasons for inconsistent condom use. Adjusted and unadjusted regression analysis were fitted to examine factors associated with consistent condom use. Results The prevalence of consistent condom use was 39.3% (CI: 35.5%-43.2%), with no significant gender and age differences. After adjusting for relevant covariates, living with foster parents (AOR; 1.80 95% CI; 1.09-2.97), adequate family financial support (AOR; 2.49 95% CI; 1.71-3.62), partner knew status (AOR; 1.91 95% CI; 1.09-3.37) and feeling confident in one's ability to prevent HIV (AOR; 1.77 95% CI; 1.09-2.86) were associated with increased odds of consistent condom use. However, self-report of low condom self-efficacy (AOR; 0.58 95% CI; 0.40-0.85) and alcohol use (AOR; 0.83 95% CI; 0.58-1.19) were associated with lower odds of consistent condom use. Young people who inconsistently used condoms reiterated that sex is often unplanned and condoms are not always available. The desire for maximum pleasure, partner's objection, trust, and use of hormonal contraceptives were further reasons others inconsistently use condoms. Conclusions Inconsistent condom use remains a challenge among unmarried sexually active young people in South Africa. Education of young people on the need for partner communication about HIV, HIV testing uptake, and condom use should happen more rigorously in school and through the media to improve their consistent use of condoms.

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HIV incidence and predictors of inconsistent condom use among adult men enrolled into an HIV vaccine preparedness study, Rustenburg, South Africa

PLoS ONE ◽

10.1371/journal.pone.0214786 ◽

2019 ◽

Vol 14 (4) ◽

pp. e0214786 ◽

Cited By ~ 1

Author(s):

Pholo Maenetje ◽

Christina Lindan ◽

Heeran Makkan ◽

Candice M. Chetty-Makkan ◽

Mary H. Latka ◽

...

Keyword(s):

South Africa ◽

Condom Use ◽

Hiv Vaccine ◽

Hiv Incidence ◽

Inconsistent Condom ◽

Adult Men ◽

Inconsistent Condom Use

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HIV testing and ethnicity among adolescent girls and young women aged 15–24 years in Ghana: what really matters?

Journal of Biosocial Science ◽

10.1017/s0021932021000456 ◽

2021 ◽

pp. 1-17

Author(s):

Ucheoma Nwaozuru ◽

Thembekile Shato ◽

Chisom Obiezu-Umeh ◽

Florida Uzoaru ◽

Stacey Mason ◽

...

Keyword(s):

Logistic Regression ◽

Condom Use ◽

Hiv Testing ◽

Adolescent Girls ◽

Young Women ◽

Sexual Partners ◽

Bivariate Analysis ◽

Multiple Sexual Partners ◽

Socioeconomic Determinants ◽

The Relationship

Abstract Despite the high prevalence of HIV among adolescent girls and young women (AGYW) aged 15–24 years in Ghana, HIV testing remains low among this population. The objective of this study was to examine the relationship between ethnicity and HIV testing among AGYW in Ghana. The 2014 Ghana Demographic and Health Survey data were used and analyses were restricted to 3325 female participants aged 15–24 years. Chi-squared tests and a logistic regression model were used to assess the association between ethnicity and HIV testing. Furthermore, the PEN-3 cultural model informed the conceptual framework that explained the relationship between ethnicity and HIV testing behaviour. Results from the bivariate analysis showed an association between ethnicity and HIV testing among AGYW (p<0.05). However, when controlling for other behavioural and socioeconomic determinants of HIV testing in the logistic regression, there was no association between ethnicity and HIV testing. The significant predictors of HIV testing were marital status, having multiple sexual partners, and condom use. The AGYW who were married (adjusted odds ratio [aOR] = 4.56, CI: 3.46–6.08) or previously married (aOR = 4.30, CI: 2.00–9.23) were more likely to test for HIV compared with those who were never married. Having multiple sexual partners (aOR = 0.41, CI: 0.20–0.85) and condom use (aOR = 0.56, CI: 0.38–0.84) were associated with lower odds of HIV testing. The results provide evidence that ethnicity is not associated with HIV testing among AGYW in Ghana, as the bivariate association was attenuated when other behavioural and socioeconomic determinants of HIV testing were accounted for. These findings highlight the importance of considering individual-level factors, community-level factors, and other socio-cultural factors as they really matter in the development of HIV prevention programmes for adolescent girls and young women in Ghana.

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Cultural practices, gender inequality and inconsistent condom use increase vulnerability to HIV infection: narratives from married and cohabiting women in rural communities in Mpumalanga province, South Africa

Global Health Action ◽

10.1080/16549716.2017.1341597 ◽

2017 ◽

Vol 10 (sup2) ◽

pp. 1341597 ◽

Cited By ~ 16

Author(s):

Sphiwe Madiba ◽

Nomsa Ngwenya

Keyword(s):

South Africa ◽

Rural Communities ◽

Hiv Infection ◽

Condom Use ◽

Gender Inequality ◽

Cultural Practices ◽

Inconsistent Condom ◽

Mpumalanga Province ◽

Inconsistent Condom Use

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HIV/STI RISK-TAKING SEXUAL BEHAVIOURS AND RISK PERCEPTION AMONG MALE UNIVERSITY STUDENTS IN TEHRAN: IMPLICATIONS FOR HIV PREVENTION AMONG YOUTH

Journal of Biosocial Science ◽

10.1017/s0021932017000049 ◽

2017 ◽

Vol 50 (1) ◽

pp. 86-101 ◽

Cited By ~ 6

Author(s):

Farideh Khalajabadi Farahani ◽

Mohammad Mahdi Akhondi ◽

Mehdi Shirzad ◽

Ali Azin

Keyword(s):

Risk Perception ◽

University Students ◽

Risk Taking ◽

Sexual Debut ◽

Sexual Partners ◽

Inconsistent Condom ◽

Multiple Sexual Partners ◽

Sexual Behaviours ◽

Male University Students ◽

Inconsistent Condom Use

SummaryRecent evidence indicates a rising trend in premarital sexual activity among young people in Iran. However, little is known about the extent to which young people’s sexual behaviours expose them to HIV and STI risks. This study aimed to assess HIV/STI-related sexual risk-taking behaviours (correlates and determinants) and HIV/STI risk perception among male university students in Tehran. A representative sample of male university students (N=1322) studying in government and private Tehran universities completed an anonymous questionnaire survey in 2013–14. Respondents were selected using two-stage stratified cluster sampling. About 35% of respondents had ever had premarital sex (n=462). The majority (about 85%) of the sexually experienced students reported having multiple sexual partners in their lifetime. More than half (54%) reported inconsistent condom use over the previous month. Despite this exposure to HIV/STI risk, the respondents had a very low level of HIV/STI risk perception. Only 6.5% were highly concerned about contracting HIV over the previous year, and an even lower percentage (3.4%) were concerned about contracting STIs in the near future. Early sexual debut (<18 years), studying in a private university, ever watching pornography and work experience were found to be significant predictors of having multiple sexual partners. Younger age at sexual debut, having one lifetime sexual partner and poor HIV knowledge were significant predictors of inconsistent condom use over the preceding month. HIV prevention programmes among Iranian youth need to focus on the postponement of first sex and enhancement of HIV/STI knowledge in the light of increasing access of young people to pornography.

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Low program access despite high burden of sexual, structural, and reproductive health vulnerabilities among young women who sell sex in Mombasa, Kenya

10.21203/rs.2.19715/v2 ◽

2020 ◽

Author(s):

Elizabeth Roberts ◽

Huiting Ma ◽

Parinita Bhattacharjee ◽

Helgar K Musyoki ◽

Peter Gichangi ◽

...

Keyword(s):

Reproductive Health ◽

Condom Use ◽

Young Women ◽

Sex Workers ◽

Sub Saharan Africa ◽

Cross Sectional Survey ◽

Inconsistent Condom ◽

Cross Sectional ◽

Sub Saharan ◽

Inconsistent Condom Use

Abstract Background: Across Sub-Saharan Africa, young women who sell sex (YSW) face institutional barriers in accessing sexual health and HIV prevention programs designed for female sex workers. In 2018, Kenya developed a national framework to guide service provision for YSW aged 14 – 24 years. To help inform the implementation of the framework, we estimated the burden of vulnerabilities related to the Sustainable Development Goals (SDGs) and program contact among YSW. Methods: We used data from Transitions, a 2015 bio-behavioural cross-sectional survey of 408 YSW aged 14 – 24 years in Mombasa, Kenya. We estimated the prevalence of sexual (inconsistent condom use), structural (financial, violence), and reproductive health vulnerabilities; and characterized engagement with local HIV programs tailored to sex workers. We then compared the prevalence of vulnerabilities by age group (14 – 18 years, N=117; 19 – 24 years, N=291) and by program contact (ever contacted by local program for sex workers). Results: 47.3% reported inconsistent condom use in the previous week with little variability by age. Structural vulnerabilities were common and did not vary by age: 83.6% did not have a regular source of income; 29.9% and 29.2% had experienced physical and sexual violence, respectively. 26.5% reported at least one pregnancy before age 18, and 18.5% used a non-reliable form of contraception with little variability by age. 25.7% were aware of at least one program, and only 13.7% of YSW had ever been contacted by a program (8.5% of those aged 14 – 18 years; and 15.8% of those aged 19 – 24 years, p=0.06). Sexual, structural, and reproductive health vulnerabilities did not vary by program contact. Conclusions: SDG-related vulnerabilities begin early in the lives of YSW and current programs are not reaching them.

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Low program access despite high burden of sexual, structural, and reproductive health vulnerabilities among young women who sell sex in Kenya

10.21203/rs.2.19715/v1 ◽

2019 ◽

Author(s):

Elizabeth Roberts ◽

Huiting Ma ◽

Parinita Bhattacharjee ◽

Helgar K Musyoki ◽

Peter Gichangi ◽

...

Keyword(s):

Reproductive Health ◽

Condom Use ◽

Young Women ◽

Sex Workers ◽

Service Provision ◽

Sub Saharan Africa ◽

Cross Sectional Survey ◽

Inconsistent Condom ◽

National Framework ◽

Inconsistent Condom Use

Abstract Background: Across Sub-Saharan Africa, young women who sell sex (YSW) face institutional barriers in accessing sexual health and HIV prevention programs designed for female sex workers. In 2018, Kenya developed a national framework to guide service provision for YSW aged 14 – 24 years. To help inform the implementation of the framework, we estimated the burden of vulnerabilities related to the Sustainable Development Goals (SDGs) and program contact among YSW. Methods: We used data from Transitions, a 2015 bio-behavioural cross-sectional survey of 408 YSW aged 14 – 24 years in Mombasa, Kenya. We estimated the prevalence of sexual (inconsistent condom use), structural (financial, violence), and reproductive health vulnerabilities; and characterized engagement with local HIV programs tailored to sex workers. We then compared the prevalence of vulnerabilities by age group (14 – 18 years, N=117; 19 – 24 years, N=291) and by program contact (ever contacted by local program for sex workers). Results: 47.3% reported inconsistent condom use in the previous week with little variability by age. Structural vulnerabilities were common and did not vary by age: 83.6% did not have a regular source of income; 29.9% and 29.2% had experienced physical and sexual violence, respectively. 26.5% reported at least one pregnancy before age 18, and 18.5% used a non-reliable form of contraception with little variability by age. 25.7% were aware of at least one program, and only 13.7% of YSW had ever been contacted by a program (8.5% of those aged 14 – 18 years; and 15.8% of those aged 19 – 24 years, p=0.06). Sexual, structural, and reproductive health vulnerabilities did not vary by program contact. Conclusions: SDG-related vulnerabilities begin early in the lives of YSW and current programs are not reaching them. Kenya’s 2018 national framework for YSW service provision offers an opportunity - via a pragmatic and rights-based paradigm shift in health services - to reduce vulnerabilities at the intersection of adolescence and sex work.

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