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

Sexuality is an important human phenomenon which is influenced by interaction of biological, psychological, social, cultural or religious factors. Many studies in sub-Saharan Africa have shown that multiple sexual partnerships contribute to the spread of HIV despite the high knowledge of HIV/AIDS transmission routes. Past studies on sexual behaviours in Nigeria have focused on women and adolescents while men’s sexuality has not been adequately explored. This study used data extracted from 2007 National HIV/AIDS and Reproductive Health Survey of sexually active Nigerian men aged 15-64years to investigate correlates and pattern of sexual partnership among men in Nigeria using multilevel logistic regression models. The findings indicate that individual characteristics such as ever use of condom, occupation, marital status influenced sexual behaviour of men compared to their contextual characteristics. Compared to men in the poorest group, moderately rich men were more likely to have multiple (OR=1.10, 95%CI=0.93-1.30) and non-regular sexual partners (OR=1.05, 95%CI=0.89-1.25). To promote safe and healthy sexuality among Nigerian men, behavioural intervention on sexual partnership targeting on individuals especially those in the middle class should be incorporated in the reproductive health policies.

Background: It is commonly suggested that teachers are more likely to engage in high-risk sexual behaviour compared to the rest of the adult population. This study set out to establish HIV risk behaviours among teachers in Uganda.
Methods: This was a cross sectional assessment among primary and secondary school teachers in Uganda between October and November 2011. A total of 183 teachers were interviewed using a structured questionnaire. HIV risk behaviour was defined as either having 2+ sexual partners, having sex with a partner of unknown status without using a condom, in the last three months preceding the survey. All data analysis was performed using SPSS version 17.0 and EPI Info Version 3.5.1.
Results: Forty five per cent of teachers reported having 2+ sexual partners in the last three months. Of these, 24% acknowledged having used a condom at their last sexual encounter while 9.8% knew their partners’ HIV status. Young teachers were more likely to have 2+ sexual partners and to engage in sex with partners of unknown HIV status compared to those above 30 years (OR=2.6, 95% CI 1.31-5.34), (OR=2.47, 95% CI 1.10-5.59).
Conclusion: Young teachers are more likely to engage in HIV risk behaviours than old teachers, suggesting a need to promote individual risk perception, condom use and reduction in sexual partners.

A large body of research has found that sexual partner concurrency increases the transmission of sexually transmitted infections, including HIV. Researchers are now calling for further investigation into the types of concurrency that promote or impede onward transmission of STIs. In this paper, we use life history data collected from youth in urban Kisumu, Kenya, to examine levels of protection within concurrencies, defined by combinations of sexual intercourse and condom use. We find that approximately one-third of concurrency episode months were completely protected by consistent condom use and/or no sexual intercourse, and thus the large majority of months were not protected and therefore at some risk of STI transmission. Regression results show that mutual concurrency is more likely to display full protection for females and longer concurrencies, which are thought to increase transmission potential, are more likely to be protected among both females and males.

Concurrent partnerships are often considered a primary driver of the HIV epidemic in Sub-Saharan Africa. Due to data constraints, however, few studies have been able to demonstrate its effect using empirical data. In this paper, we test whether HIV transmission rates are higher for individuals with concurrent partners - an effect that is ascribed to the higher viral load shortly after seroconversion. Data spanning a 14-year time period are pooled from two rural community sero-surveillance sites in south-Western Uganda. Sero-concordant negative married couples are followed over time, examining the risk of seroconversion for couples exposed to concurrency. A discrete-time hazard model is used to determine the risk of seroconversion among women whose husbands reported a concurrent partnership. We are unable to detect an effect of the husband’s concurrency on the HIV incidence of their wives. Our preliminary findings are in support of a growing body of literature that casts doubt on the role of concurrency for the spread of HIV.

Stigma and discrimination against PLHIVs could be social, physical, verbal or institutional and each or a combination of them could worsen the health condition of the affected person. Such people are often given names which are described as derogatory or insults. These observations have generally emerged from social researches on HIV/AIDS which have focused entirely on adult population. This study therefore assessed the knowledge, attitudes and perceptions of children (9-13yrs) towards PLHIVs in Cape Coast Metropolitan area of Ghana. This was a cross-sectional descriptive study conducted in three contrasting study sites (urban, peri-urban and rural). Data collected from the over four hundred and fifty children were both quantitative and qualitative in nature. Majority of the respondents were of the view that HIV/AIDS could be contracted through mosquito bite or witchcraft. Most of the respondents were unwilling to eat or sleep with a PLHIV. They were also neither ready to be taught by a female teacher who is HIV+ or buy fresh vegetables from an infected person. It was recommended that behavioural change communication programmes should also focus on children.

In India HIV prevention programs have focused on HIV transmission through unsafe injecting practices with less attention on sexual risk behaviors among injecting drug users (IDU).
Data were obtained from behavioral tracking survey conducted in 2009 among 1712 IDUs in two districts each of Manipur and Nagaland states in North east India. Sexual risk behaviors among IDUs were assessed in terms of multiple sex partners and sex with paid female partner in the last 12 months and inconsistent condom use with female partner. More than one-fourth (27%) in Manipur and almost one in two (47%) IDUs reported having had sex with two or more female partners in the past 12 months. In Manipur where heroin is commonly used, the odds of having multiple sex partners were higher among non-heroin users than heroin users (42% vs. 23%, Adjusted Odds Ratio (AOR): 1.7, 95% Confidence Interval (CI): 1.1-2.6) and who shared needles/syringes in the last one month than who did not share (46% vs. 26%, AOR: 2.2, CI: 1.2-4.0). In Nagaland, where Spasmoproxyvon is most common, regular injectors as compared to occasional injectors were more likely to report multiple sex partners (67% vs. 42%, AOR: 2.7, CI: 1.8-4.1) and sex with paid partners (13% vs. 3%, AOR: 6.0, CI: 3.0-12.1). Sharing of needles/syringes was positively associated with mul

Though India is traditionally perceived to be a 'dry' culture, but alcohol use in some form has always existed in the country and alcohol is an important dimension in sexual violence. Present article tries to study the role of alcohol in contribution sexual risk in different settings and populations across the HIV/AIDS high prevalence state. Data for this study was obtained from the National Family Health Survey, conducted in 2005-06 for 5 High Prevalence states. It was found that women those husband drink alcohol has reported more (2.37 percent) genital sore/ulcer in last 12 months compared to those women (1.39 percent) husband doesn’t drink alcohol in high HIV prevalence states. The analysis proved that alcohol consumption of partner has the high risk (0.99 percent) of getting HIV/AIDS compare to the respondent (0.44 percent) those husbands don’t drink alcohol.

Using the Information-Motivation-Behavioral Self Efficacy and Skills (IMB) model and applying discrete time hazard techniques, this study examines the correlates of age of first sexual intercourse for rural youth aged 11-17 enrolled in junior secondary schools in Edo State, Nigeria. Results indicate strong significant relationships between components of the IMB model and age at first sex for boys and girls, in particular for boys. Perceiving one’s self at risk of contracting HIV from sex delays the timing at first sex while experiencing pressure from others to engage in sex hastens the timing for boys and girls. Boys with knowledge about HIV have lower risks of experiencing first sexual intercourse earlier, but those who endorse more myths about the disease have higher risks. Boys who thought they could not abstain from sex had earlier first sex. Boys and girls with high condom use self-efficacy also had earlier timing to first sex. Policy makers are encouraged to improve knowledge about HIV/AIDS while emphasizing sexual abstinence as an important strategy to reducing the spread of HIV among rural youth in Edo state, Nigeria.

This study was to identify factors that affect survival of HIV/HBV co-infected patients. Data from TASO Uganda was used, and patients who registered with TASO between 2005 and 2010 were followed to determine their survival. The covariates of study were social-demographic and clinical factors. To estimate the survival function for every subgroup of each variable, the product- limit method developed by Kaplan and Meier was used and a log rank test to compare the survivorship functions across several groups. A proportional hazards model was used to examine the joint effect of the covariates on the duration of survival assuming a Gompertz distribution for the time variable. Results revealed the duration of survival for HIV/HBV co-infected patients increased with increasing weight. Patients who had Hepatocellular carcinoma or Cirrhosis at diagnosis were at an increased risk of death as compared to those who had chronic active hepatitis B. Patients on ARVs had an increased death rate as compared to their counter parts. Educated patients had a reduced death rate as compared to the uneducated ones. Therefore, emphasis should be on designing Information Education Communication (IEC) materials to sensitize the uneducated HIV/HBV co-infected patients on effects of non compliance and unbalanced diets.

This research investigates the association between HIV prevalence and use of injectable hormonal contraceptives (depot medroxyprogesterone acetate, DMPA), for sexually active women aged 15 to 49 in 18 African countries. First we use thematic maps to show the respective prevalences of HIV and injectables. We then run multi-level logit models to predict HIV status for users and nonusers of injectables. We run similar regressions for users of hormonal contraceptives versus non-users. Preliminary results show that a positive correlation exists between ever use of injectables and being HIV positive. This relationship seems to persist even when we control for high-risk behavior. The relationship between HIV and use of injectables might be positively mediated by use of other contraceptive methods - when the sample is restricted to women who have only ever used one method, there appears to be no difference in the odds of being HIV positive for users of DMPA and non-users. These relationship suggests a need to move forward with policy initiatives to protect women and their partners.