scholarly journals Risky sexual behaviours among women of reproductive age in a high HIV burdened township in KwaZulu-Natal, South Africa

2020 ◽  
Author(s):  
Mbuzeleni Hlongwa ◽  
Karl Peltzer ◽  
Khumbulani Hlongwana

Abstract Background: Despite several intervention programmes in South Africa, risky sexual behaviours among women of reproductive age remain a public health concern, thereby making them prone to unintended pregnancies and/or sexually transmitted infections (STIs), such as human immunodeficiency virus (HIV) infection. This study investigated the predictors of risky sexual behaviours among women of reproductive age in a high HIV-burdened township in KwaZulu-Natal (KZN), South Africa. Methods: This was a cross-sectional study conducted among 471 women of reproductive age (18-49 years, mean: 25.83) in 10 public health clinics in Umlazi Township, using a structured questionnaire. Data were coded, entered into Epi Data Manager and exported to Stata for analysis. A Pearson Chi-square test and logistic regression models (bivariate and multivariate) were employed to assess the level of the association between the predictor and outcome variables and the p-value 0.05 or lower was considered statistically significant.Results: More than half (51.80%) of women were aged 18-24 years and only a handful (18.26%) had tertiary qualification. The majority were single (88.96%) and the unemployed accounted for 53.50%. This study found that women who talked about condoms with partner during the preceding 12 months were more likely (p=<0.0001) to have used condoms during their last sexual experience. Older women (p=0.035) were more likely to have used a condom at last sex, compared to younger women. However, women who were exposed to physical partner violence (hitting and/or slapping), those who had been diagnosed with HIV and those whose sexual partners were diagnosed with HIV, did not show a significant association with condom use at last sexual encounter.Conclusion: Exposure to physical partner violence and poor partner discussions about condoms are key deterrents to condom usage. Holistic interventions are required in order to address the risky behaviours, and consequently reduce sexually transmitted infections and/or unintended pregnancies.

2020 ◽  
Author(s):  
Mbuzeleni Hlongwa ◽  
Karl Peltzer ◽  
Khumbulani Hlongwana

Abstract Background: Despite several intervention programmes in South Africa, risky sexual behaviours among women of reproductive age remain a public health concern, thereby making them prone to unintended pregnancies, human immunodeficiency virus (HIV) infection and/or sexually transmitted infections (STIs). This study investigated the predictors of risky sexual behaviours among women of reproductive age in a high HIV burdened township in KwaZulu-Natal (KZN), South Africa.Methods: This was a cross-sectional study conducted among 471 women of reproductive age (18-49 years, mean: 25.83) in 10 public health clinics in Umlazi township, using a structured questionnaire. Data were coded, entered into Epi Data Manager and exported to Stata for analysis. A Pearson Chi-square test and logistic regression models (bivariate and multivariate) were employed to assess the level of the association between the predictor and outcome variables and the p-value 0.05 or lower was considered statistically significant.Results: More than half (51.80%) of women were aged 18-24 years and only a handful (18.26%) had tertiary qualification. The majority were single (88.96%) and the unemployed accounted for 53.50%. This study found that women who talked about condoms with their partners in the past 12 months were more likely (p=<0.0001) to have used condoms during their last sexual experience. Older women (p=0.035) were more likely to use a condom at last sex, compared to younger women. However, women who were exposed to physical partner violence (hitting and/or slapping), those who had ever been diagnosed with HIV and those whose sexual partners were diagnosed with HIV, did not show a significant association with condom use during last sexual experience.Conclusion: Exposure to physical partner violence and poor partner discussions about condoms are key deterrents to condom usage. Holistic interventions are required in order to address the risky behaviours, and consequently reduce sexually transmitted infections and/or unintended pregnancies.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dessie Abebaw Angaw ◽  
Alemakef Wagnew Melesse ◽  
Bisrat Misganaw Geremew ◽  
Getayeneh Antehunegn Tesema

Abstract Background Intimate partner violence is a serious global public health problem particularly in low-and middle-income countries such as Ethiopia where women's empowerment is limited. Despite the high prevalence of intimate partner violence in Ethiopia, there is limited evidence on the spatial distribution and determinants of intimate partner violence among reproductive-age women. Exploring the spatial distribution of intimate partner violence is crucial to identify hotspot areas of intimate partner violence to design targeted health care interventions. Therefore, this study aimed to investigate the spatial distribution and determinants of intimate partner violence among reproductive-age women in Ethiopia. Methods A secondary data analysis was done based on the 2016 Ethiopian Demographic and Health Survey (EDHS) data. A total weighted sample of 6090 reproductive-age women were included in the study. The spatial scan statistical analysis was done to identify the significant hotspot areas of intimate partner violence. A multilevel binary logistic regression analysis was fitted to identify significant determinants of intimate partner violence. Deviance, Intra-cluster Correlation Coefficient (ICC), Median Odds Ratio, and Proportional Change in Variance (PCV) were used for model comparison as well as for checking model fitness. Variables with a p-value less than 0.2 were considered in the multivariable analysis. In the multivariable multilevel analysis, the Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) were reported to declare statistical significance and strength of association between intimate partner violence and independent variables. Results The spatial analysis revealed that the spatial distribution of intimate partner violence was significantly varied across the country (Moran’s I = 0.1007, p-value < 0.0001). The SaTScan analysis identified a total of 192 significant clusters, of these 181 were primary clusters located in the Benishangul-Gumuz, Gambella, northwest Amhara, and west Oromia regions. In the multivariable multilevel analysis; women aged 45–49 years (AOR = 2.79, 95% CI 1.52–5.10), women attained secondary education (AOR = 0.61, 95% CI 0.38–0.98), women in the richest household (AOR = 0.58, 95% CI 0.35–0.97), > 10 family size (AOR = 3.85, 95% CI 1.41–10.54), and high community women empowerment (AOR = 0.66, 95% CI 0.49–0.8)) were significantly associated with intimate partner violence. Conclusions Intimate partner violence among reproductive-age women had significant spatial variation across the country. Women's age, education status, family size, community women empowerment, and wealth status were found significant determinants of intimate partner violence. Therefore, public health programs should design targeted interventions in identified hot spot areas to reduce the incidence of intimate partner violence. Besides, health programmers should scale up public health programs designed to enhance women's autonomy to reduce the incidence of intimate partner violence and its consequences.


2021 ◽  
pp. 088626052098038
Author(s):  
Mohammad Vaqas Ali ◽  
Jawad Tariq

The study was an attempt to identify demographic, household, and women empowerment factors that predicted emotional, physical, and sexual violence in ever-married women of reproductive age (15–49 years, n = 3,965) in Pakistan by performing secondary analysis on Pakistan Demographic and Health Survey, 2017–2018. The analysis was done using SPSS (v.22) and binary and multivariate logistic regression techniques were performed for analyses. The analysis found that 30.2% of women experienced emotional, 24.1% reported less severe physical, 6.5% experienced severe physical, and 4.3% experienced sexual violence, respectively. The multivariate analysis found that husband’s age, education, wealth, and alcohol consumption were significant predictors of intimate partner violence (IPV). Additionally, womens’ age, education, and number of children also significantly predicted IPV. With respect to empowerment variables, ownership of house was a significant predictor of less severe physical violence, ownership of property significantly predicted emotional violence, and autonomy in household purchase decisions was significantly related to severe physical violence. The control on husband’s income as a measure of empowerment significantly predicted all four types of IPV. Belief in patriarchy also turned out to be an important factor in determining emotional and less severe physical violence. The study concludes that women empowerment in household context can prevent less serious forms of violence but to hinder serious forms of violence, interventions at family and community level will be required.


2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Chinyere Ojiugo Mbachu ◽  
Ifunanya Clara Agu ◽  
Chinonso Obayi ◽  
Irene Eze ◽  
Nkoli Ezumah ◽  
...  

Abstract Background Misconceptions about the usefulness of condoms and other contraceptives still expose many unmarried adolescents to the risk of unwanted teenage pregnancies and sexually-transmitted infections (STIs). This study explored beliefs and misconceptions about condoms and other contraceptives among adolescents in Ebonyi state, south-east Nigeria. Method A qualitative study was undertaken in six local government areas in Ebonyi state, southeast Nigeria. Data were collected within a period of one month from in and out-of-school adolescents aged 13–18 years using twelve focus group discussions (FGD). The data were analyzed using the thematic framework approach. Result Majority of the adolescents were knowledgeable about methods of contraception, how they are used and their modes of action. They were also knowledgeable about the dual effects of condoms in prevention of pregnancy and STIs. However, some misconceptions that were expressed by some adolescents were that pregnancy could be prevented by the use of (i) hard drugs, (ii) laxatives, (iii) white chlorine, and (iv) boiled alcoholic beverages. Condoms were described by some adolescent boys as reusable. Condoms were also perceived by some adolescents to reduce sexual pleasure, and this opinion was mostly held by boys. Coitus interruptus (withdrawal method) was therefore considered more preferable than condoms for prevention of pregnancy. Conclusion Although majority adolescents have knowledge about contraception and condom use, some misconceptions still persist. These misconceptions put many adolescents at increased risk for pregnancy and STIs which are detrimental to their health and wellbeing. Concerted efforts should be made through educational and behaviour change interventions in schools and within communities to debunk persisting misconceptions about contraception including the use of condom, and properly educate adolescents on safe sex practices. Plain English summary Adolescents engage in unprotected sexual intercourse and other risky sexual behaviours because of some mistaken beliefs and wrong impressions about how to prevent unwanted pregnancy. These risky sexual behaviours predispose adolescents to sexually transmitted infections, unsafe abortion and other reproductive health problems. In this qualitative study, we explored some of these mistaken beliefs about condoms and other methods of preventing pregnancy. During focus group discussions, adolescents identified modern contraceptive methods, and described their modes of action and how they are used. They also discussed their contraceptive preferences and perceived effects of condoms on sexual pleasure. Although some of these adolescents were able to correctly mention various types of contraceptives and their modes of action, there were numerous wrong impressions. Hard drugs, laxatives, white chlorine and boiled alcoholic beverage were listed as emergency contraceptive methods. Emergency pills were perceived to work by flushing away spermatozoa from a girl’s system after sexual intercourse. Male condoms were perceived to be potentially dangerous because they could break and enter into the body of the female sexual partner. Some adolescent boys had the notion that particular brands of male condoms could be washed and reused. Notions about condom use and sexual pleasure varied for girls and boys. Some adolescent girls perceived that condom use during sex increases sexual pleasure because of the assurance of being protected from STIs and pregnancy. Adolescent boys were of the opinion that condoms interfere with the pleasure of direct ‘flesh to flesh’ contact during sex. There was a general belief that contraceptive use in early age reduces fertility prospects for boys and girls. Mistaken beliefs about methods of preventing pregnancy persist among adolescents, and this raises concerns about the quality of information they receive. Concerted efforts should be made to debunk these wrong beliefs and properly educate adolescents on safe sex practices.


2019 ◽  
Author(s):  
Dieudonne Hakizimana ◽  
Marie Paul Nisingizwe ◽  
Jenae Logan ◽  
Rex Wong

Abstract Background Anemia among Women of Reproductive Age (WRA) continues to be among the major public health problems in many developing countries, including Rwanda, where it increased in prevalence between the 2015 and 2010 Rwanda Demographic and Health Survey (RDHS) reports. A thorough understanding of its risk factors is necessary to design better interventions. However, to the best of our knowledge, no study has been conducted in Rwanda on a nationally representative sample to assess factors associated with anemia among WRA. Accordingly, this study was conducted to address such gap. Methods A quantitative, cross-sectional study was conducted using data from the RDHS 2014-2015 report. The study population consisted of 6680 WRA who were tested for anemia during the survey. Anemia was defined as having a hemoglobin level equal to or below 10.9 g/dl for a pregnant woman, and hemoglobin level equal to or below 11.9 g/dl for a non-pregnant woman. Pearson’s chi-squared test and multiple logistic regression were conducted for bivariate and multivariable analysis, respectively. Results The prevalence of anemia among WRA was 19.2% (95% CI: 18.0 - 20.5). Four factors were found to be associated with lower odds of anemia, including being obese (OR: 0.61, 95% CI: 0.40 - 0.91), being in the rich category (OR: 0.74, 95% CI: 0.63 - 0.87), sleeping under a mosquito net (OR: 0.85, 95% CI: 0.74 - 0.98), and using hormonal contraceptives (OR: 0.61, 95% CI: 0.50 - 0.73). Five factors were associated with higher odds of anemia, including being underweight (OR: 1.39, 95% CI: 1.09 - 1.78), using an intrauterine device (OR: 1.98, 95% CI: 1.05 - 3.75), being separated or widowed (OR: 1.35, 95% CI: 1.09 - 1.67), and living in the Southern province (OR: 1.45, 95% CI: 1.11 - 1.89) or in the Eastern province (OR: 1.41, 95% CI: 1.06 - 1.88). Conclusion Anemia continues to pose public health challenges; novel public health interventions should consider geographic variations in anemia risk, seek to improve women’s economic statuses, and strengthen iron supplementation especially for Intrauterine device users. Additionally, given the association between anemia and malaria, interventions to prevent malaria should be enhanced.


Author(s):  
Durga K. ◽  
Karthika K.

Background: Sexually transmitted infections (STIs) present a huge burden of disease and adversely affect the reproductive health of people. The disease prevalence is about 6% in India. This study is done to determine the prevalence of STIs in women of reproductive age (15-49yrs) attending gynaec outpatient block at Institute of Obstetrics and Gynaecology, Chennai and to identify the risk factors.Methods: It is a prospective analytical study conducted at IOG from Febraury 2010 to January 2011 where 1000 women of reproductive age attending gynec op were included of which 500 women were asymptomatic and 500 women were symptomatic for STIs. A well-structured proforma was prepared for selection of women, history, examination, investigations and treatment. Asymptomatic women were also screened and treated. Partners were also screened and treated. Depending upon the statistical data, the risk factors were identified and analysed.Results: Overall prevalence of STI was 27.2% of which 22.5% was in symptomatic group and 4.7% in asymptomatic group. Bacterial vaginosis was the commonest STI. The important risk factors identified were age group between 26-30 years, high risk sexual behaviours, poor socioeconomic factors, poor menstrual hygiene and lack of contraception.Conclusions: STIs cause major health problem and it is important to diagnose and treat them at the earliest. The importance of STIs has been more widely recognised since the advent of the HIV/AIDS epidemic, and there is good evidence that their control can reduce HIV transmission. Women diagnosed with one STI should be screened for other STI due to coexistant infections. Screening and treatment of partners and follow-up tests of cure should be performed wherever possible.


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