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

In Nepal, little information has been collected about sexual practice where HIV/AIDS prevalence is increasing. The main objectives of this paper are to explore the sexual behavior especially focusing on prevalence of risky sexual behavior and investigate the influencing factors of risky sexual behavior among college students. A self-administered questionnaire was completed by 1276 (636 male and 640 female) students. A composite index of risky sexual behavior was constructed. Association between risky sexual behavior and the explanatory variables was assessed in bivariate analysis using Chi-square tests. The associations were further explored using multivariate logistic analysis.

Male students were about 3 times (OR=2.8) more likely to be involved in risky sexual behavior than female students. Unmarried students, who received RH education, were less likely to be engaged in risky sexual behavior than married. On the other hand, students who consumed alcohol frequently, who exposure pornography, and who have unmarried friend with experience of sexual intercourse were more likely to be engaged in risky sexual behavior than their comparison groups. College students are exposed to health hazards through their sexual behavior. This problem should be addressed early by targeting these groups of high risk students.

Little is known about risky sexual behaviors of HIV-positive Female Sex Workers (FSWs) in the developing world. This study aims to shed light on their condom use with regular clients and husbands, a first in India. Logistic regression analyses for consistent condom use with those partners are conducted for the sample of 606 HIV-positive FSWs in Karnataka. Older and non-migrant FSWs are less likely to consistently use condoms than younger and mobile FSWs (90 and 70% respectively). FSWs who changed occupations after HIV diagnosis are 70% less likely to use condoms. FSWs on ART, those currently cohabiting, and those that have felt stigma associated with being HIV-positive are more likely to have consistent condom use. FSWs with multiple repeat clients and who do not know the sexual behavior of these clients are more likely to use condoms consistently. These findings would help inform programs to target particularly vulnerable HIV-positive FSWs.

Using primary data, the study analysed the gender-wise impact of HIV/AIDS on socio-economic consequences of households in Puducherry region, union territory of Puducherry, South India. To better understand the impact of the disease, the study compared the changes in household economic conditions both at the time of interview and at the time of detecting HIV, i.e., ‘impact time’. Further, the most visible economic impact of HIV/AIDS related illness being on the household finances, the study also examines both direct and indirect costs of the disease. The results revealed that more male and female respondents are concentrated in high risk occupations at the time of contracting HIV, compared to females, more males are in advanced stage of the disease. Regardless of gender, their standard of living (SLI) and employment had significantly lower when compared to their SLI and employment before HIV detection. Among the currently employed respondents, females reported more number of workdays lost but the income lost by them is half lower than that of their male counterparts. The mean number of illness in the month preceding the survey was significantly higher for symptomatic than for the asymptomatic patients. But, there was no significant difference in direct and indirect costs of morbidity between the groups.

Using data from the 2007 IBBS in Indonesia, the study investigated the influence of individual- and contextual-level factors on condom use among 1,371 clients of female sex workers (FSW). A two-level random intercept model was specified for the multilevel analysis. The model included individuals at the first level and derived aggregates of an environmental-structural index, constructed using principal component analysis (Cronbach’s α = 0.71; Eigenvalue 2.94), at the second level. The analysis measured three outcome variables: condom use at last sex; in past 3 months; and in past year. Controlling for sociodemographic characteristics, environmental-structural support was a significant predictor of condom use at last sex (OR 1.77; 95% CI: 1.22-2.55; p<0.01), in the past 3 months (OR 2.23; 95% CI: 1.31-3.82; p<0.01); and in the past year (OR 2.09; 95% CI: 1.27-3.42; p<0.01). Almost one-fourth of the variation of condom use at last sex was accounted for by environmental-structural factors; this increased to almost one-third for condom use in the past 3 months and year. HIV prevention programs would benefit from efforts targeting the environmental-structural context to improve condom use behaviors and reduce HIV risk among male clients.

Research in sub-Saharan Africa indicates that men and women are at high risk of acquiring sexually transmitted infections (STIs), including HIV. There is considerable evidence that safer sexual practices (e.g., using condoms) is effective in reducing the risks of contracting HIV. Very few studies, however, have examined the predictors of such interventions in Tanzania, where HIV prevalence is high and heterosexual intercourse is the main mode of HIV transmission. Using data from the 2007-08 Tanzania HIV/AIDS and Malaria indicators Survey (THMIS), this study examines how risk perception, risky sexual behavior, and knowledge of HIV/AIDs affect condom use. Our findings underscore the importance of AIDs-related knowledge, HIV testing and engaging in risky sexual behavior in the decision to use condoms at last sexual intercourse. Addressing these issues through education campaigns, including encouraging testing for HIV and continued use of condom should be an important component of HIV prevention effects in Tanzania.

There is evidence that husbands pose the greatest risk of infecting their wives with STIs and HIV in Africa. The main purpose of this paper is to assess the attitude towards sexual control among married women. Factors influencing the sexual control of these women are also investigated. A survey was recently carried out in Mahikeng, South Africa. A total of 568 married or cohabiting women aged 18-49 years took part in the survey. The survey collected two dependent variables based on the questions can women demand for sex? and can women reject sexual intercourse? The logistic regression analysis was used. 81% of respondents reported that a married woman can demand sex from her husband. However, a significant proportion of married women (41%) do not approve that married women can reject sexual intercourse with their husband under any circumstances. This group of women needs serious consideration in terms of policy. Whilst variables that are significantly related with rejecting sex include age, nature of union, education, occupation, and number of living children, only age and nature of union were related to demand for sex. Women empowerment initiatives should be considered as a means to curb HIV/AIDS in this society.

Uganda registered a tremendous decline in HIV prevalence rates from 15% in 1991 to 5% in 2002 then up again to 6.4% in 2006 (2006 UDHS). Over years, the uptake and practice of preventive behaviour have declined, particularly among men. Currently, almost 40% of people with HIV are not diagnosed until they already have developed AIDS. The study aimed to assess the contribution of men in the fight of HIV/AIDS through HIV Counselling and Testing (HCT). The project monitored all individuals attending Sexually Transmitted Disease (STD), Safe Male Circumcision (SMC) and Anti Retroviral Treatment (ART) clinics. The project sought to check whether when requested, males brought their female counterparts for testing and vice versa during the September 2010 to Sept 2011 at a health facility. Clinical data was used. More males once tested brought more spouses for testing. The numbers were much less vice versa. For every 1 man tested at least 3 women were tested. This was also recorded in polygamous relationships.

Each year, thousands of young women are trafficked or lured into sex work to meet the demand of clients. There would not be a sex industry without the demand, however, the demand (client) side of the sex industry has had limited research. The focus has principally been on sex workers rather than on the clients. As a result, the characteristics of clients are almost unknown. This paper explores the perceptions and behaviours of Western male clients of female sex workers in Thailand based on interviews with the clients in entertainment venues.

The analysis of the study identified several factors common to men who employ the services of sex workers. These factors include: the fulfillment of masculine roles, social and sexual acceptance and supply of sex work. Findings suggest clients’ need to assert masculine identity through power and control over the sex worker and the need to feel desirable (accepted). In addition, anonymity and ease of attaining sex (inexpensive, submissive, exotic and amply supply of young women) fueled client demand for using the services of sex workers. Clients commonly reported (and was observed) mistreatment, abuse and violence against sex workers; however this was justified through payment of services.

We evaluate Respondent Driven Sampling (RDS)’s claim of population representation with empirical data by exploring the network coverage in a RDS study of female sex workers (FSW) in China. We take advantage of unique information on the social networks of FSW obtained from two overlapping studies of FSWs --RDS and a venue-based sampling approach (PLACE) -- and use an exponential random graph modeling (ERGM) framework from local networks to construct the likely network from which our observed RDS is drawn. We then run recruitment chains over this simulated population and produce a sample with characteristics consistent with the observed RDS. We estimate population coverage rates by comparing population proportions and RDS sample proportions. We discuss the results in light of (a) potential estimation improvements implicit in network information, (b) strategies for improving coverage rates, and (c) multiple sources of potential variability in coverage.

Here in this study an attempt has been made to suggest a new methodology, based on regression approach to estimate the life expectancy at birth and also the life expectancy at age one for districts of EAG states and Assam in India using the following four simple demographic indicators namely: the crude death rate, the crude birth rate, the infant mortality rate and the proportion (or percent) of population aged 65 and above from annual reports of Sample Registration System (SRS) data. The basis of this methodology is adopted from a methodology which is earlier suggested by Bourgeois-Pichat (1983) for some other purpose but this has not been tried before for Indian situation.
This methodology is applied to estimate the life expectancy at birth for 2011 to the districts of EAG states and Assam in India utilizing the Annual Health Survey (AHS-2011) published results data under the Office of Registrar General of India.
The consistency and acceptability of the results obtained through this new method have been tested by comparing them with that of LEB that can be obtained using other methods which have also used the similar input in their development and result is quite acceptable.