“[ Repeat ] testing and counseling is one of the key [ services ] that the government should continue providing”: Participants’ Perceptions on Extended Repeat HIV Testing and Enhanced Counseling (ERHTEC) for Primary HIV Prevention in Pregnant and Lactating Ugandan Women

2019 ◽  
Author(s):  
Femke Bannink ◽  
Zikulah Namukwaya ◽  
Alex Amoone ◽  
Francis Ojok ◽  
Juliane Etima ◽  
...  
Keyword(s):  
Decision Making ◽  
Condom Use ◽  
Hiv Testing ◽  
Risk Reduction ◽  
Sexual Partners ◽  
Lactating Women ◽  
Multiple Sexual Partners ◽  
Couple Communication ◽  
Repeat Hiv Testing ◽  
Study Participants

Abstract Background The ‘Primary HIV Prevention among Pregnant and Lactating Ugandan Women’ (PRIMAL) randomized controlled trail aimed to assess an enhanced counseling strategy linked to extended repeat HIV testing among HIV-negative pregnant and lactating women aged 18-49 years and 410 of their male partners to address the first pillar of the WHO Global Strategy for the Prevention of Mother-to-Child HIV transmission. Methods: PRIMAL Study participants were enrolled from two antenatal care clinics and randomized 1:1 to an intervention or control arm. Both arms received repeat STI and HIV testing at enrollment, labor and delivery, and at 3, 6, 12, 18 and 24 months postpartum. The intervention consisted of enhanced quarterly counseling on HIV risk reduction, couple communication, family planning and nutrition delivered by study counselors. Control participants received repeat standard post-test counseling. Eighteen focus group discussions and 44 key informant interviews were held to evaluate study participants’ and service providers’ perceptions and acceptance of the intervention and understand the effects of the intervention on risk reduction, couple communication, and emotional support from partners. Results: At baseline participants mentioned multiple sexual partners and lack of condom use as the main risks for pregnant and lactating women to acquire HIV. The main reasons for having multiple sexual partners were 1) the cultural practice not to have sex in the late pre-natal and early post-natal period; 2) increased sexual desire during pregnancy; 3) alcohol abuse; 4) poverty; and 5) conflict in couples. Consistent condom use at baseline was limited due to lack of knowledge and low acceptance of condom use in couples. The majority of intervention participants enrolled felt enhanced counselling improved understanding, faithfulness, mutual support and appreciation within their couple. Another benefit mentioned by participants was improvement of couple communication and negotiation, as well as daily decision-making around sexual needs, family planning and condom use. Participants stressed the importance of providing counselling services to all couples. Conclusions: This study shows that repeat postpartum testing and enhanced individual and couple counselling increased condom use, supported risk reduction, and improved support, communication and decision-making about sexual and reproductive health for pregnant and lactating women.

scholarly journals “[Repeat] testing and counseling is one of the key [services] that the government should continue providing”: participants’ perceptions on extended repeat HIV testing and enhanced counseling (ERHTEC) for primary HIV prevention in pregnant and lactating women in the PRIMAL study, Uganda

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Femke Bannink Mbazzi ◽  
◽  
Zikulah Namukwaya ◽  
Alexander Amone ◽  
Francis Ojok ◽  
...  
Keyword(s):  
Family Planning ◽  
Hiv Prevention ◽  
Condom Use ◽  
Hiv Testing ◽  
Risk Reduction ◽  
Sexual Partners ◽  
Lactating Women ◽  
Multiple Sexual Partners ◽  
Couple Communication ◽  
Repeat Hiv Testing

Abstract Background The ‘Primary HIV Prevention among Pregnant and Lactating Ugandan Women’ (PRIMAL) randomized controlled trial aimed to assess an enhanced counseling strategy linked to extended postpartum repeat HIV testing and enhanced counseling among 820 HIV-negative pregnant and lactating women aged 18–49 years and 410 of their male partners to address the first pillar of the WHO Global Strategy for the Prevention of Mother-to-Child HIV transmission (PMTCT). This paper presents findings of qualitative studies aimed at evaluating participants’ and service providers’ perceptions on the acceptability and feasibility of the intervention and at understanding the effects of the intervention on risk reduction, couple communication, and emotional support from women’s partners. Methods PRIMAL Study participants were enrolled from two antenatal care clinics and randomized 1:1 to an intervention or control arm. Both arms received repeat sexually transmitted infections (STI) and HIV testing at enrolment, labor and delivery, and at 3, 6, 12, 18 and 24 months postpartum. The intervention consisted of enhanced quarterly counseling on HIV risk reduction, couple communication, family planning and nutrition delivered by study counselors through up to 24 months post-partum. Control participants received repeat standard post-test counseling. Qualitative data were collected from intervention women participants, counsellors and midwives at baseline, midline and end of the study through 18 focus group discussions and 44 key informant interviews. Data analysis followed a thematic approach using framework analysis and a matrix-based system for organizing, reducing, and synthesizing data. Results At baseline, FGD participants mentioned multiple sexual partners and lack of condom use as the main risks for pregnant and lactating women to acquire HIV. The main reasons for having multiple sexual partners were 1) the cultural practice not to have sex in the late pre-natal and early post-natal period; 2) increased sexual desire during pregnancy; 3) alcohol abuse; 4) poverty; and 5) conflict in couples. Consistent condom use at baseline was limited due to lack of knowledge and low acceptance of condom use in couples. The majority of intervention participants enrolled as couples felt enhanced counselling improved understanding, faithfulness, mutual support and appreciation within their couple. Another benefit mentioned by participants was improvement of couple communication and negotiation, as well as daily decision-making around sexual needs, family planning and condom use. Participants stressed the importance of providing counselling services to all couples. Conclusion This study shows that enhanced individual and couple counselling linked to extended repeat HIV and STI testing and focusing on HIV prevention, couple communication, family planning and nutrition is a feasible and acceptable intervention that could enhance risk reduction programs among pregnant and lactating women. Trial registration ClinicalTrials.gov registration number NCT01882998, date of registration 21st June 2013.

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

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.

scholarly journals Sexual Practices and HIV Seropositivity Disclosure among Adults in Nairobi, Kenya

2021 ◽  
Vol 3 (1) ◽  
pp. 1-11
Author(s):  
Phoebe D Ndayala ◽  
Lucy W Ngige ◽  
Alice Ondigi ◽  
Humphries Evelia
Keyword(s):  
Condom Use ◽  
Hiv Testing ◽  
Sexual Partner ◽  
Sexual Partners ◽  
Sexual Relationships ◽  
Sexual Practices ◽  
Sexual Encounter ◽  
Hiv Serostatus ◽  
Hiv Seropositive ◽  
Regular Sexual Partner

The purpose of the study was to assess the relationship between sexual practices and HIV seropositive status disclosure to sexual partners by People Living with Human Immune-Deficiency Virus (PLWHIV) in Nairobi, Kenya. A survey was conducted among 232 PLWHIV who were registered members of HIV support groups in an informal settlement. Results showed that half (50.5%) of the respondents had disclosed their HIV seropositive status to their sexual partners. Chi-square results revealed statistically significant relationships between HIV seropositive disclosure and the following sexual behaviours: condom use in the last sexual encounter (χ2 = 12.144; df = 1; p = 0.001); regular sexual partner (χ2 = 5.124; df = 1; p = 0.024); agreement on HIV testing with sexual partner (χ2 = 3.873; df = 1; p = 0.039) and knowledge of sexual partners’ HIV serostatus (χ2 = 6.536; df = 1; p = 0.011). The binary logistic regression results established four positive predictors of self-disclosure to sexual partners as regular sexual partner (AOR = 2.506; p = 0.012), knowledge of sexual partners’ HIV serostatus (AOR = 3.949; p = 0.015), condom use during the last sexual encounter (AOR = 3.507; p = 0.035) and agreement on HIV testing with sexual partner (AOR = 2.560; p = 0.020).  However, the desire to conceive (AOR = 3.050; p = 0.094) and the method of testing HIV serostatus (AOR = 0.853; p = 0.530) were not significant predictors of HIV seropositivity disclosure. It was concluded that respondents who knew their partners HIV serostatus and also used a condom during their last sexual encounter were four times more likely to disclose than those who were not aware of partners’ serostatus or those who did not use a condom in their last sexual encounter. Furthermore, those who were in regular sexual relationships and also agreed on HIV testing with sexual partners were twice more likely to disclose than those in casual sexual relationships. An analysis of sexual practices of PLWHIV can therefore enhance the formulation of targeted strategies aimed at enhancing HIV prevention and reduction of risky sexual behaviour among PLWHIV.

Determinants of high-risk sexual behaviour and condom use among adults in the Arusha region, Tanzania

1997 ◽  
Vol 8 (3) ◽  
pp. 176-183 ◽  
Author(s):  
Kagoma S. Mnyika ◽  
Knut-Inge Klepp ◽  
Gunnar Kvale ◽  
Naphtal Ole-King'Ori
Keyword(s):  
High Risk ◽  
Condom Use ◽  
Rural Areas ◽  
Sexual Debut ◽  
Population Based ◽  
Sexual Partners ◽  
Early Sexual Debut ◽  
Men And Women ◽  
Multiple Sexual Partners ◽  
Arusha Region

Summary: Determinants of multiple sexual partners and condom use among adults were assessed through a population-based survey in one urban, one semi-urban and one rural community in the Arusha region, northern Tanzania. The study samples were obtained by randomly selecting clusters of 10 households from the 3 communities. Informed verbal consent was sought from each respondent for participation in the study. High-risk sexual behaviours and condom use were assessed using a structured questionnaire. It was observed that significantly more men than women reported having multiple sexual partners (49% vs 25.2%; OR=1.69; 95% CI=1.51-1.90) and urban men were significantly more likely to report having multiple sexual partners than men in rural areas. In both men and women, early sexual debut was associated with having multiple sexual partners while travel, alcohol use, and sex under the influence of alcohol were significantly associated with multiple sexual partners in men only. AIDS-related discussion was significantly associated with having fewer sexual partners in both men and women. Of the 1551 respondents, 320 (20.6%) reported having ever used a condom and of the 320 respondents who had ever used a condom, 34 (10.6%) reported having used it at the last sexual intercourse. Significantly more men than women reported having ever used a condom (34.1% vs 14.1%; OR=1.77; 95% CI=1.56-2.01). In both men and women, early sexual debut and being young, unmarried, travelling out of the Arusha region and having multiple sexual partners were associated with increased condom use. For both men and women, frequent discussion of AIDS with family members or friends was associated with increased condom use. These data suggest that interventions targeting adolescents and young adults may be effective for control of HIV transmission in Tanzania. In particular, creation of opportunities for people to come together and discuss AIDS might be an important strategy.

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

2013 ◽  
Vol 7 (06) ◽  
pp. 436-447 ◽  
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.

scholarly journals Association between sociodemographic characteristics and sexual behaviors among a nationally representative sample of adolescent students in Brazil

2019 ◽  
Vol 35 (2) ◽  
Author(s):  
Natalia Oliveira Woolley ◽  
James Macinko
Keyword(s):  
Condom Use ◽  
Sexual Behaviors ◽  
Household Wealth ◽  
Sexual Partners ◽  
Sexual Initiation ◽  
Parental Supervision ◽  
Sociodemographic Characteristics ◽  
Multiple Sexual Partners ◽  
Race Ethnicity ◽  
Nationally Representative

Abstract: Although low socioeconomic status (SES) adolescents suffer from higher rates of adverse sexual and reproductive health outcomes, evidence on the association between SES and sexual behaviors has been less consistent. A cross-sectional analysis of the association between sociodemographic characteristics (household wealth, maternal education and race/ethnicity) and sexual behaviors (sexual initiation, multiple sexual partners, inconsistent condom use and inconsistent contraceptive use) of Brazilian adolescents was carried out using the 2015 Brazilian National Survey of School Health (PeNSE), a nationally representative school-based survey of 102,301 adolescents. Analyses included multivariable logistic models, which accounted for geographic and family characteristics. About 27.5% of adolescents were sexually initiated. Household wealth was associated with female sexual initiation, while race/ethnicity was associated with condom use and multiple sexual partners among males. For instance, black males had 35% higher odds of having multiple partners (aOR = 1.35, 95%CI: 1.13-1.62), but 22% lower odds of condom use (aOR = 0.78, 95%CI: 0.65-0.94), compared to white males. Frequent parental supervision was positively related to condom use (females, aOR = 1.28, 95%CI: 1.10-1.49; and males, aOR = 1.33, 95%CI: 1.18- 1.49). Results show the complex relationship between SES and sexual behaviors. Researchers should pay attention to gender, racial and social norms salient to adolescent sexual behaviors, as they can influence data collection and results. National policies should also support active parental supervision, since it can be a protective factor.

Safer sex and condom use: findings from the Second Australian Study of Health and Relationships

Sexual Health ◽  
2014 ◽  
Vol 11 (5) ◽  
pp. 495 ◽  
Author(s):  
Richard O. de Visser ◽  
Paul B. Badcock ◽  
Chris Rissel ◽  
Juliet Richters ◽  
Anthony M. A. Smith ◽  
...  
Keyword(s):  
Condom Use ◽  
Participation Rate ◽  
Sexual Partners ◽  
Computer Assisted ◽  
Lower Income ◽  
Barrier Methods ◽  
Multiple Sexual Partners ◽  
Sexually Transmissible Infections ◽  
Vaginal Sex ◽  
Bisexual Identity

Background It is important to have current and reliable estimates of the frequency and correlates of condom use among Australian adults. Methods: A representative sample of 20 094 men and women aged 16–69 years, from all states and territories, completed computer-assisted telephone interviews. The overall participation rate among eligible people was 66.2%. Results: Although most respondents had used a condom at some time in their lives, fewer than half of those who were sexually active in the year before being interviewed had used a condom in that year. Condom use in the last year was associated with youth, speaking a language other than English at home, bisexual identity, greater education, residence in major cities, lower income and having multiple sexual partners in the last year. One-quarter of respondents used a condom the last time they had vaginal intercourse and one-sixth of these were put on after genital contact. Condom use during most recent vaginal sex was associated with youth, lower income, having sex with a non-regular partner and not using another form of contraception. Condom use appears to have increased between 2001–02 and 2012–13. Conclusion: Consistent with other research, this study showed that condom use was strongly associated with partner type and use of other contraception. There may be a need to highlight among people with multiple sexual partners the fact that non-barrier methods of contraception do not offer protection against sexually transmissible infections. The finding that many condoms were applied after genital contact suggests a need to promote both use and correct use of condoms.

A MATHEMATICAL MODEL FOR COMBATING HIV/AIDS IN SOUTHERN AFRICA: WILL MULTIPLE STRATEGIES WORK?

2006 ◽  
Vol 14 (03) ◽  
pp. 357-372 ◽  
Author(s):  
FARAI NYABADZA
Keyword(s):  
Mathematical Model ◽  
Condom Use ◽  
Sexual Partners ◽  
Prevention Strategies ◽  
Multiple Sexual Partners ◽  
Voluntary Counseling And Testing ◽  
Multiple Strategies ◽  
Counseling And Testing ◽  
Potential Impact ◽  
Hiv Aids

A model for the transmission of HIV is proposed with the inclusion of prevention strategies, such as condom use, ARV drug treatment and voluntary counseling and testing. The model is used to predict the potential impact of the strategies that are currently being used to control HIV/AIDS. The model shows that reduction in the number of sexually contacts, by increasing condom use and avoidance of multiple sexual partners has a significant impact in reducing the transmission of the disease.

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