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

This study explores the prevalence of symptoms of Sexually Transmitted Infections and treatment seeking behaviour for STIs among the MSM (kothis, panthis and double-deckers) in Tamil Nadu, India, and to examine the net effect of socio-demographic and sexual risk behaviour factors on the symptoms of STIs and treatment seeking behavior among MSM community. Data for this study has been drawn from the DLCC survey conducted in 2010 by AIDS Prevention and Control (APAC) project, with a sample of 532 MSM in Tamil Nadu. The technique of logistic regression model has been used to estimate the net effect of each socio-demographic and sexual risk behavior factors on the likelihood of reporting symptoms of STIs and on treatment seeking behavior. The study shows that 14.1 percent of MSM reported any symptom of STIs in the past twelve months. Out of the MSM who reported any symptom of STIs, majority of them sought treatment. Multivariate analysis reveals that the significant predictors for the prevalence of symptoms of STIs amongst the MSM were higher level of education, living-in with other sexual partners apart from the spouse, living alone away from the spouse and having more than 11 sexual partners in the last six months.

This paper tried to investigate the underlying factors influencing of prevalence of premarital sexual activities among BPO employees in Tamil Nadu, India. Samples were collected through a structured questionnaire from 526 unmarried respondents in Tamil Nadu, India, during Behavioural Surveillance Survey in 2009 by AIDS Prevention And Control (APAC) Project, Tamil Nadu, India. The logistic regression analysis is carried out for the net effect by various background characteristics. The results showed that about one-third of respondents reported ever involved premarital sexual activities among BPO employees in Tamil Nadu, India. However, a large difference observed between men (39.6 percent) and women (26.1 percent) on prevalence of premarital sexual activities. Multivariate logistic regression analysis indicates that Gender, younger, those living away from parents, watch blue films, consume alcohol, attend late night parties, and discussed with anyone about HIV/AIDS are significantly high likelihood of engaging pre-marital sex when other factors are controlled. The study concludes that there is a significant gender dimension in reporting of premarital sexual activity. This calls for further research and discussion.

Despite Uganda’s 30-year acclaimed history of controlling HIV, new infections are continuing to occur, with marked gender inequalities. This is attributed to reliance on a response informed by HIV/AIDS evidence generated through individualistic approaches to AIDS research. There is need to transcend these realms and recognize more the fundamental influence of social factors in women’s increased vulnerability to HIV infection. This research will investigate the relationship between socio-economic status (SES) and women’s higher seropositivity. Multilevel analysis will be carried out on data of Uganda Demographic and Health Survey, and Uganda HIV/AIDS Indicator Survey conducted in 2011. The research will analyse this cross sectional data of 32 710 individuals collected in 20 713 households. Multilevel analysis using Windows (MLwiN) software will be used for multilevel modelling. Primary analysis provides evidence that SES may be an important predictor of women’s higher seropositivity. HIV prevalence is higher among females, those in employment, the widowed, the wealthy, and the un-educated. The final analysis is expected to confirm the associations between SES and women’s higher seropositivity, and add to a growing body of evidence that SES plays an influential role in increasing women’s vulnerability to HIV infection.

The 1994 ICPD recommended that comprehensive reproductive health information is made accessible, affordable and acceptable to all users. In response, various educational programmes are being implemented in Ghana to encourage people adopt healthy reproductive lifestyles and attitudes. Currently, sexual and reproductive health education issues form an integral part of the curriculum in all levels of education in Ghana however; a sizeable proportion of the population are currently out-of-school. This study explored how information on sexual and reproductive health is delivered and discussed at dressmaking shops and hairdressing salons. Both quantitative and qualitative data were collected from 119 and 34 respondents respectively. Economic factors were identified as a major contributor regarding respondent’s access to and utlisation of sexual and reproductive health information. The study also revealed that some shops and salons did not have access to mass media although the respondents spend most of their time at these places. It was identified that some respondents paid little or no attention to reproductive health issues nor do they make deliberate effort to listen or view such programmes to avoid being tagged as spoilt girls. It was recommended that sex education programmes should be specifically designed for informal sector.

This paper studies sexual behavior related to the spread of STIs including HIV/AIDS using the 2006 Uganda Demographic and Health survey women dataset. These include multiple sexual partnerships in the last 12 months preceding the survey, transactional sex, premarital sex and condom use. Results of the study show that 4.8% of the 8513 women studied were involved in sex for gain, 39.7% reported having involved in premarital sex, 20% having multiple sexual relationships and 67.3% reported non condom use at their last sexual encounter. There was statistical significance between the risky sexual behaviour of the women studied and having sexually transmitted diseases. Logistic regression shows statistical significance between risky sexual behaviour and sexual infection except for transactional sex. Findings suggest the need for educating people about sexual transmission preventive messages that are aimed at transforming beliefs, norms and behaviour about sexual health among women in Uganda. STIs prevention programmes should seek to understand and alter the risky sexual behaviour that increase susceptibility to sexual infections among the population

The study explored the intersection between unfriendly government policy and exposure of youths to HIV/AIDS in Owerri, Nigeria. The government of Imo State (One of the 36 States in Nigeria, with Capital in Owerri) through the “Clean and Green” programme of the Environment and Transformation Commission (ENTRACO) demolished several makeshift apartments, styled ‘illegal structures’ where scores of private low-income earners practiced their craft vocation. Also affected were permanent buildings located close to main roads. More so, ban was placed on commercial motorcycle riding. These compounded the unemployment saga in the State as there is absence of industries and other significant job creating opportunities. The political economy theory is used as a conceptual framework. Questionnaire was administered on 30 persons living with HIV/AIDS (PLWHA), 2 Focus Group Discussions (FGDs) were held with commercial sex workers and in-depth interviews (IDIs) held with 5 health-care service providers in Owerri. Expected outcomes include a possible moonlighting, that exposes the female youth to HIV/AIDS. Lack of gainful employment; lack of financial assistance from kinsfolks and peer influence expose the women to HIV/AIDS. Access to cheap sex might be significant in the exposure of the males, who sometimes serve as bridge group, to HIV/AIDS.

Understanding of the burden of HIV in populations who are most at risk is poor, largely because these populations are poorly represented in national HIV surveillance systems and are hidden and stigmatized in many settings. Female sex workers have been reported to be at high risk for HIV infection in nearly every setting where they have been studied, yet in 2012 we still have limited understanding of the relative burden of HIV in these women.
Interventions targeting behavioral and structural-level risk factors for HIV among sex workers have proven successful for increasing protective behaviours and decreasing HIV and STI transmission. Despite these promising results, in Russia, the 2010-2011 UNGASS report indicates only 3% of sex workers are reached by HIV programmes across the country.
From 2001 to 2011, the best practices of HIV prevention among sex workers were collected in 75 cities of 50 Russian regions. The projects implemented in the Russian Federation used the comprehensive prevention model aimed at organizing accessible and adequate health services for sex workers.
After project financing stops, 13 organizations are planning to continue HIV/AIDS prevention activities among sex workers . However, it is obvious that without adequate support it would be difficult to maintain sustainability of the programmes.

This paper reports on a collaborative Indo-US project, entitled Research and Intervention in Sexual Health: Theory to Action (RISHTA) focused on prevention of HIV/STI among married men in three low income communities in Mumbai India. The Paper assesses the effectiveness of a brief intervention based on the narrative intervention model (NIM) an ecologically based, cognitive approach, with trained allopathic providers in a public primary care center and non-allopathic private providers based in the experimental communities. Quasi-experimental research design assessed to a systematic random sample of 2710 and a subset of 910 men was administered STI testing. A patient sample of 537 married men who utilized trained and untrained allopathic and non-allopathic. The results at the community level showed a significant drop from baseline (2004) to follow-up (2006) in gonorrhea (3.9 to 1.2%) and in extramarital sex (12.1 to 1.9%). At the patient level, male patients who went to trained providers showed significant improvement in knowledge about STDs, increased gender equitable attitudes, improved communication with spouse, and reduced extramarital sex, sex with sex worker and alcohol use, compared to those patients who went to untrained providers.

Women in India are at risk for HIV/STI primarily through the behavior of their spouse. This paper will describes, a multilevel intervention involving individual women, wives and husbands, the health system and the community that is aimed at prevention of HIV/STI transmission within marriage and reduction of sexual risk behavior. A Women’s Health Clinic was organized at the primary care center to treat women’s gynecological and STI related problems. Individual women presenting with the culturally based symptoms of vaginal discharge (safed pani) and related problems to the WHC are randomized into receiving treatment plus individual counseling (IC), group couples intervention (CI), both IC and CI and a control receiving standard care. The Women’s Structured Survey (WSS) was administered to assess women at baseline, six-month and one-year post intervention from 2009-2012. HLM model was used for data analysis and preliminary analysis comparing WSS baseline with WSS 6-month follow-up (N=886) and one year follow-up WSS (N=-866) comparing those involved in the intervention against the control. On the major outcome variables have shown that the intervention group shows better Sexual Health (p <.001), greater knowledge about STIs (p <.001), less sexual problems, (p <.001) better treatment seeking in health problems (p <.001).

When it comes to the topic of sex, analysts are often skeptical. And with good reason: respondents may lie or forget the juicy details of their intimate lives, and interviewers may exercise authority in how they capture it. In between the two lies a more fundamental problem endemic to social life: how people appear to others is never unmediated nor unfiltered. In this paper we use data from a cross-sectional HIV prevalence and sexual behavior survey conducted in 2010-2011 in a rural Southern African setting to explore the broader question of who says what to whom about their sexual lives. Preliminary results show a consistent age effect across outcomes-- that respondents report more “moral”, responsible sexual behavior to older fieldworkers; and a strong sex effect-- that men report more sexual partners to female fieldworkers. Understanding fieldworker effects on the production of sexual behavior survey data serves both methodological and theoretical goals.