Sexual behaviours and the spread of sexually transmitted infections, including HIV

Prior research has been concerned with the small correlation between high levels of HIV prevention awareness and actual contraceptive use among South African youths, suggesting that alternative explanations are needed to explain youths’ contraceptive use in a high HIV-prevalence society. One potential explanation is the ability of youths’ to effectively negotiate contraceptive use, especially among girls. This research uses the Cape Area Panel Study (n=1,380) to examine whether HIV prevention-related knowledge prior to first sexual intercourse and characteristics of youths’ first sex partner predict condom and other contraceptive use at first sex. We find that, similar with prior research, HIV prevention-related knowledge does not predict condom use for either males or females, however among females, having a partner who was two or more years older at first sex decreased the likelihood of using a condom by over 40%. This study extends prior research by using longitudinal data to predict behavior based on HIV knowledge and awareness prior to sexual debut and exploring other potential pathways, such as power dynamics within relationships that may influence the ability of youths to effectively negotiate contraceptive use. These findings have important implications for reproductive and sexual health programs in Sub-Saharan Africa.

Context-specific typologies of female sex workers (FSWs) are essential for the design of HIV intervention programming. This study develops a novel FSW typology for the analysis of transactional sex risk in rural and urban settings in Indonesia. Mixed methods include a survey of rural and urban FSWs (n=310), in-depth interviews (n=11), key informant interviews (n=5) and ethnographic assessments. Thematic analysis categorises FSWs into 5 distinct groups based on geographical location of their sex work settings, place of solicitation, and whether sex work is their primary occupation. Multiple regression analysis shows that the likelihood of consistent condom use was higher among urban venue-based FSWs for whom sex work is not the only source of income than for any of the other rural and urban FSW groups. This effect was explained by the significantly lower likelihood of consistent condom use by rural venue-based FSWs (adjusted OR: 0.35 95% CI 0.13-0.92, p=0.033). The FSW typology and differences in organisational features and social dynamics are more closely related to the risk of unprotected transactional sex, than levels of condom awareness and availability. Interventions need context-specific strategies to reach the different FSWs identified by this study’s typology.

We conducted a randomized controlled field trial to test whether short-term financial incentives have an impact on sexual behavior and the incidence of HIV and curable STIs among young people in Lesotho. The intervention linked eligibility to participate in a lottery to negative results for rapid tests for curable STIs: syphilis and Trichomonas vaginalis. The 3454 study participants were randomly allocated to two main arms: a treatment arm which is eligible to receive lottery tickets, and a control arm which is not. Both study arms received STI testing, counseling, and STI treatment at baseline and then every four months for two years. The treatment arm further allows sub-study of the effect of varying sizes of lottery prizes. Village level lotteries were organized every 4 months in which STI negative individuals from the treatment arm were eligible to participate. The study outcomes are HIV, syphilis and Trichomonas vaginalis incidence. Data analysis is currently finalized and preliminary results are encouraging, suggesting an impact of the intervention in significantly reducing HIV incidence, at least among females. The 2 year impact results will be available and fully analyzed by the time of the conference

Aims: Past studies on age at first sexual intercourse among South African youth have been largely cross-sectional and lack theoretical basis. This paper investigates factors influencing first sexual intercourse among South African youth using Waves 1-3 of Cape Area Panel Study data, based on Social Cognitive Theory. Methods: This quantitative data was analysed using Stata 12, and employs descriptive statistics, correlation and Cox Proportional Hazard Regression models. Results: The results showed that age, sex, racial origin, having attained secondary or tertiary educational level, and not attending school wielded a delaying effect on the rate of transition to first sexual intercourse at the three waves. On the other hand, not being happy about life, being from single-parent or both-parents family structures exerted a positive effect on the rate of transition into first sexual intercourse in Wave 1. Low level of happiness significantly encouraged the respondents to initiate their first sexual intercourse during the second wave. At the third wave, having low educational aspiration associated significantly with higher age at first sexual intercourse in 2005. Conclusions: This study concluded that personal and socio-economic/demographic factors were mostly important as far as the timing of first sexual intercourse is concerned.

This study focuses on the relationship between violent conflict and the timing of young women’s first sexual intercourse before marriage in Rwanda during 1990-2000. Rwanda was one of the African countries most affected by AIDS and also experienced civil war leading up to genocide in 1994. It is believed that violent conflict can affect the epidemiology of HIV/AIDS. The epidemiology of HIV may be exacerbated or inhibited, as conflict shatters individual lives and communities, depending on the characteristics of the conflict and the regional ecology of HIV. The study makes use of unique data on violent conflict at regional level in Rwanda that are linked to the sexual histories of individual women. I find that there is an increased risk of first sexual intercourse during years of conflict. This could possibly operate through contextual effects on sexual behavior, which could be voluntary sexual experience or forced sexual experience. Lack of parental and community control and rape being used as weapon of war are major theoretical pathways through which conflict could produce increased risk of experiencing first sex and increase the exposure opportunity and risk for STIs and HIV.

Various studies on sexuality shows men and women have different perception towards sexuality. For men sexual pleasure includes size of penis, penetrative sex, length of intercourse, sexual postures, and multiple partners. There are various products (Aphrodisiac) available like Viagra, penis spray, energy capsules etc. for men for extra sexual pleasure. The objectives of the study are to understand the felt need for these products among men, to understand the sexual behaviour under the influence of these products and to study its mental, physical, reproductive and sexual heath impact on female partners. The study shows that theses products are easily available in the market without prescription. Men belonged to different age group have different reasons to buy these products. Female partners complained severe physical fatigue, guilt and anger. Men avoid using condom under the influence of these products. There is strong need to improve communication between men and women about sexuality.

Increasing condom use is central to the national HIV/AIDS response in Ghana. Low condom use among sexually active Ghanaians, especially during high-risk sex, is a major challenge to HIV prevention. This paper examines the socio-cultural barriers to condom use in order to guide national efforts to reduce levels of unprotected sex. It also examines respondents’ condom use and individual HIV risk perceptions and identifies socio-cultural factors affecting condom use during high risk sexual activity. The study uses a randomly selected nationally representative sample of 2,074 males (12-59 years) and 3,953 females (12-49 years) and adopts descriptive and bivariate analyses and the condom barrier scale to assess barriers to condom use in Ghana within the context of HIV prevention. Among other things, the study finds differences in age, educational status and residence (rural/urban) to be significantly associated with perceptions of partner resistance to condom use in Ghana. The analysis further shows that more females than males face partner resistance to condom use during sexual activities across all the socio-demographic categories. Gender stereotypes that result in partner barriers must, therefore, receive adequate attention in the national HIV response relative to condom use against HIV and unwanted pregnancies.

The research was carried out to study sexual behavior, knowledge and attitude towards HIV/AIDs among six senior secondary school of age 12 – 20 years which was selected by a random sampling method. Ninety-seven percents of the students heard of HIV/AIDs, 84.7% reported it causes death and 18.7% reported there is a cure for HIV/AIDs. Twenty-three percent of the students have had their first sexual intercourse within mean age of 15.60 ± 2.30. Of those that have sexual intercourse, 66% have a regular partner while 34% do not have. Of the 47 students (23%) who became sexually active, 15 (31.9%) had sexual intercourse three months before the survey, 25 students (53.2%) cannot remember the number of times they had sex in the past three months. The use of condom was reported in 57.4% of the sexual active students while others did not see the need of using it. There was a high level of knowledge about ways of preventing HIV transmission. However, a considerable portion of the students harbored incorrect beliefs regarding mosquito bites. In conclusion, there is a pressing need for HIV/AIDs campaign especially school based AIDs education programs and activities in secondary schools to change their behavior.

Lack of safe sexual practices in varying context has been a major issue in both developed and developing nation. Many studies have supported the efficacy of condom in reducing the risk of HIV/AIDS transmission in heterosexual intercourse but there is a very limited study which could correlate the condom attitude and condom use behaviour. This study aims to understand the variation of condom attitude in high risk settings and how far condom use varies with varying sexual partner, as well as to explore the relationship between interface of alcohol consumption and condom use using a unique set of data (ASHRA) collected in 2007-08 among young men in low income communities in Mumbai. Health Belief Model and AIDS Risk Reduction Model would provide the theoretical orientation for this research. Risky sexual behaviour can be viewed in the context of the number and types of partnerships, and sexual acts. Logistic Regression revealed that young men in the high risk settings are significantly five times more likely to indulge in the risky sexual behaviour under the effect of alcohol. So relationship between the knowledge of the effectiveness of condom is a major contradiction and challenge in the fight against HIV/AIDS in the society.

Empirical estimates of the female-to-male sex ratio of infections in generalized HIV epidemics in sub-Saharan Africa range from 1.31 in Zambia to 2.21 in Ivory Coast. Gender inequalities in the sex ratio of infections can arise because of differences in exposure (to HIV positive partners), susceptibility (given exposure), and survival (once infected). Differences in susceptibility have to date received most attention, but neither the relatively high sex ratio of infections nor the heterogeneity in the empirical estimates in generalized epidemics is fully understood. In this contribution we focus on partnership network attributes and sexual mixing patterns that could lead to gender differences in the exposure to HIV positive partners. Using agent-based simulations, we show that gender asymmetric partnership concurrency, rapid partnership turnover, elevated partnership dissolution in female positive serodiscordant couples and lower partnership re-entry rates among HIV positive women can produce (substantial) differences in the sex ratio of infections. Coital dilution and serosorting have modest moderating effects.