1
|
Okoro UJ, Carey KB, Johnson BT, Carey MP, Scott-Sheldon LAJ. Alcohol Consumption, Risky Sexual Behaviors, and HIV in Nigeria: A Meta-Analytic Review. Curr Drug Res Rev 2020; 11:92-110. [PMID: 31875782 DOI: 10.2174/1874473712666190114141157] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 11/29/2018] [Accepted: 01/03/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND Alcohol consumption is associated with risky sex, which increases the risk of acquiring and transmitting HIV. OBJECTIVE To examine the prevalence of, and associations among alcohol, risky sex, and HIV, in Nigeria. METHODS We searched electronic databases and reviewed reference sections of relevant papers to locate studies that sampled people living in Nigeria and assessed both alcohol and sexual risk behavior. We calculated effect sizes to determine (a) prevalence of alcohol and sex behaviors and (b) associations between alcohol consumption and risky sex, and examined moderators to determine if sample characteristics predicted behavioral or biological outcomes. RESULTS Of the 696 unique records identified, 35 manuscripts reporting on 42 separate studies met the inclusion criteria. Participants in these studies (N = 83,350; M age = 26 years; 48% women; 10% HIV-infected) reported high rates of heavy drinking (63%) and low rates of consistent condom use (24%). One-third of participants (30%) also reported using alcohol before sexual activity. Participants who consumed alcohol were more likely to report sexual activity (OR = 3.66, 95% CI = 3.09, 4.33), multiple partners (OR = 3.22, 95% CI = 2.38, 4.36), and condomless sex or inconsistent use of condoms (OR = 2.30, 95% CI = 1.54, 3.43). CONCLUSION High rates of heavy drinking and low rates of condom use have been well-documented in Nigeria. Results from this meta-analysis can be used to inform critically needed alcohol-related HIV interventions.
Collapse
Affiliation(s)
- Uzoamaka J Okoro
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, United States.,Alpert School of Medicine, Brown University, Providence, RI, United States.,Brown University School of Public Health, Providence, RI, United States
| | - Kate B Carey
- Brown University School of Public Health, Providence, RI, United States
| | - Blair T Johnson
- Department of Psychology, University of Connecticut, Storrs, CT, United States
| | - Michael P Carey
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, United States.,Alpert School of Medicine, Brown University, Providence, RI, United States.,Brown University School of Public Health, Providence, RI, United States
| | - Lori A J Scott-Sheldon
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, United States.,Alpert School of Medicine, Brown University, Providence, RI, United States.,Brown University School of Public Health, Providence, RI, United States
| |
Collapse
|
2
|
Belus JM, Baucom DH, Wechsberg WM. Individual and Relationship Predictors of Couple-Level Sexual Concurrency in Heterosexual South African Couples. ARCHIVES OF SEXUAL BEHAVIOR 2020; 49:999-1015. [PMID: 31552573 PMCID: PMC7060824 DOI: 10.1007/s10508-019-1444-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 02/27/2019] [Accepted: 03/21/2019] [Indexed: 05/11/2023]
Abstract
One of the major goals of couple-based HIV prevention programs in sub-Saharan Africa is to reduce outside sex partners, known as sexual concurrency. This cross-sectional study examined sexual concurrency at the couple-level and differentiated couples based on whether neither, one, or both partners engaged in sexual concurrency over the past 6 months. Individual predictors (alcohol use and lifetime history of physical or sexual trauma) and relationship predictors (mistrust, relationship inequity, relationship satisfaction, and sexual satisfaction) were used as predictors of couple-level sexual concurrency. A quantitative investigation using path analysis was carried out with data collected from 286 South African heterosexual couples. Results showed that alcohol use for both sexes, relationship dissatisfaction for women, and mistrust among women were predictive of different types of sexual concurrency. Findings suggest that consideration of the experiences and behavior of both partners may be useful in understanding different reasons for engagement in sexual concurrency.
Collapse
Affiliation(s)
- Jennifer M Belus
- Department of Psychology, University of Maryland, College Park, MD, 20740, USA.
| | - Donald H Baucom
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Wendee M Wechsberg
- Substance Use, Gender and Applied Research, RTI International, Research Triangle Park, NC, USA
- Health Policy and Management, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Psychology in the Public Interest, North Carolina State University, Raleigh, NC, USA
- Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
| |
Collapse
|
3
|
Akinyemi JO, Ogunbosi BO, Fayemiwo AS, Adesina OA, Obaro M, Kuti MA, Awolude OA, Olaleye DO, Adewole IF. Demographic and epidemiological characteristics of HIV opportunistic infections among older adults in Nigeria. Afr Health Sci 2017; 17:315-321. [PMID: 29062325 DOI: 10.4314/ahs.v17i2.4] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND In view of the maturing HIV epidemic in sub-Saharan Africa, better understanding of its epidemiology among older adults is necessary in order to design appropriate care and treatment programmes for them. OBJECTIVES To describe the demographic and epidemiological characteristics of HIV opportunistic infections among newly enrolled patients aged 50 years and above in Ibadan, South-West Nigeria. METHODS Analysis of data extracted from electronic records of 17, 312 subjects enrolled for HIV/AIDS care and treatment between January 2006 and December 2014 at the ART clinic, University College Hospital, Ibadan. RESULTS Age of the patients ranged from 18 to 90 years with a mean of 36.4 years (SD= 10.3) with older adults constituting 12.0% (2075). Among older adults, about half (52.9%) were females. Majority (59.1%) were currently married while 25.9% were widowed. Prevalence of opportunistic infections was 46.6%. The commonest opportunistic infections (OIs) were: oral candidiasis (27.6%), chronic diarrhoea (23.5% and peripheral neuropathy (14.8%). Significant factors associated with opportunistic infections in older adults were: CD4 count less than 350 (OR=3.12, CI: 2.29-4.25) and hepatitis C virus co-infection (OR=2.17, CI: 1.14-4.13). CONCLUSION There is need for prompt response to the peculiar challenges associated with the emerging shift in the epidemiology of HIV and associated infections in sub-Saharan Africa.
Collapse
Affiliation(s)
- Joshua O Akinyemi
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Babatunde O Ogunbosi
- Department of Paediatrics, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Adetona S Fayemiwo
- Department of Medical Microbiology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Olubukola A Adesina
- Department of Obstetrics and Gynaecology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Michael Obaro
- Department of Pharmacology and Therapeutics, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Modupe A Kuti
- Department of Chemical Pathology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Olutosin A Awolude
- Department of Obstetrics and Gynaecology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - David O Olaleye
- Department of Virology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Isaac F Adewole
- Department of Obstetrics and Gynaecology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| |
Collapse
|
4
|
Abstract
Epidemiological, economic, and social forces have produced high levels of volatility in family and household structure for young people growing up in sub-Saharan Africa in recent decades. However, scholarship on the family to date has not examined the influence of this family instability on young people's well-being. The current study employs unique life history calendar data from Western Kenya to investigate the relationship between instability in caregiving and early initiation of sexual activity. It draws on a body of work on parental union instability in the United States, and examines new dimensions of family change. Analyses reveal a positive association between transitions in primary caregiver and the likelihood of early sexual debut that is rapidly manifested following caregiver change and persists for a short period. The association is strongest at early ages, and there is a cumulative effect of multiple caregiver changes. The results highlight the importance of studying family stability in sub-Saharan Africa, as distinct from family structure, and for attention to dimensions such as age and recency.
Collapse
|
5
|
Abstract
Women's social networks and social power are increasingly seen as important factors modulating their health in sub-Saharan Africa. Polygyny, a common marital structure in many societies, mediates important intra-household relationships by requiring both competition and co-operation among co-wives. Using mixed methods, semi-structured questionnaires were administered to 298 women aged 15-84 living in the Kolondiéba region of rural Mali in 1999, and supplemented by detailed interviews with 40 women. Three categories of outcome were explored: illness experience, therapeutic itinerary and social support received. Quantitative data were analysed using regression analysis and qualitative data using a grounded theory approach. In quantitative analyses, controlling for age and household wealth index, senior wives were less likely to be escorted to a healer by their husbands during illness than were junior wives or monogamous women. Polygynous women were also less likely to obtain a treatment for which there was a monetary fee. Fewer than one-third of polygynous women reported the assistance of a co-wife during illness in any given task. In qualitative analyses, women further related varied mechanisms through which polygyny impacted their health trajectories. These ranged from strongly supportive relationships, to jealousy because of unequal health or fertility, bias in emotional and material support provided by husbands, and accusations of wrong-doing and witchcraft. This study highlights the need for more prospective mixed methods analyses to further clarify the impact of polygyny on women's health-related experiences and behaviours in sub-Saharan Africa.
Collapse
|
6
|
Bove RM, Vala-Haynes E, Valeggia C. Women's health in urban Mali: social predictors and health itineraries. Soc Sci Med 2012; 75:1392-9. [PMID: 22818488 PMCID: PMC3560408 DOI: 10.1016/j.socscimed.2012.06.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2012] [Revised: 05/30/2012] [Accepted: 06/04/2012] [Indexed: 01/08/2023]
Abstract
Social and marital factors may influence women's health outcomes. This is of particular relevance in sub-Saharan Africa, where women's health indicators lag behind the rest of the world. Our study examines the impact of social mediators of women's health during key events (pregnancy and illness) in urban Mali. In this cross-sectional study, we interviewed 324 women aged 15-80, living in Bamako, the capital city, in 1999. We used mixed quantitative and qualitative methods to obtain detailed histories of pregnancy and illness during specific time periods preceding the survey. We examined the role of marital factors (polygyny, widowhood), social factors (sources of support and scales derived for social network and social power), and household wealth on women's therapeutic itineraries. We compared the sociodemographic characteristics of our sample with those of the 2001 Mali Demographic and Health Survey and used their data on contraception to enrich analyses. We found that most pregnant women delivered in a health center and most women sought medical care during an illness event. Household wealth influenced illness reporting, and financial concerns were obstacles to medical care. Polygyny was associated with lower prevalence of contraceptive use, lower social power, as well as with less support received during pregnancy from women's husbands and in-laws. Widowhood appeared to increase susceptibility to illness, while decreasing resort to biomedical care. Our social composite scores highlighted differences in healthcare utilization in an urban setting with near-uniform access to biomedical care. We validate the utility of locally-derived composite scores, which may provide a deeper understanding into the social mediation of health outcomes for women.
Collapse
Affiliation(s)
- Riley M Bove
- Harvard Medical School, 77 Avenue Louis Pasteur, NRB168, Boston MA 02115, USA
| | - Emily Vala-Haynes
- Population Studies Center, 239 McNeil Building, University of Pennsylvania, 3718 Locust Walk, Philadelphia, PA 19104-6298, USA
| | - Claudia Valeggia
- Department of Anthropology, University of Pennsylvania, 432 University Museum, 3260 South St, Philadelphia, PA 19104-6398, USA
| |
Collapse
|
7
|
Luke N, Clark S, Zulu EM. The relationship history calendar: improving the scope and quality of data on youth sexual behavior. Demography 2012; 48:1151-76. [PMID: 21732169 DOI: 10.1007/s13524-011-0051-2] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Most survey data on sexual activities are obtained via face-to-face interviews, which are prone to misreporting of socially unacceptable behaviors. Demographers have developed various private response methods to minimize social desirability bias and improve the quality of reporting; however, these methods often limit the complexity of information collected. We designed a life history calendar-the Relationship History Calendar (RHC)-to increase the scope of data collected on sexual relationships and behavior while enhancing their quality. The RHC records detailed, 10-year retrospective information on sexual relationship histories. The structure and interview procedure draw on qualitative techniques, which could reduce social desirability bias. We compare the quality of data collected with the RHC with a standard face-to-face survey instrument through a field experiment conducted among 1,275 youth in Kisumu, Kenya. The results suggest that the RHC reduces social desirability bias and improves reporting on multiple measures, including higher rates of abstinence among males and multiple recent sexual partnerships among females. The RHC fosters higher levels of rapport and respondent enjoyment, which appear to be the mechanisms through which social desirability bias is minimized. The RHC is an excellent alternative to private response methods and could potentially be adapted for large-scale surveys.
Collapse
Affiliation(s)
- Nancy Luke
- Department of Sociology and Population Studies and Training Center, Brown University, Providence, RI 02912, USA.
| | | | | |
Collapse
|
8
|
Essien EJ, Monjok E, Chen H, Abughosh S, Ekong E, Peters RJ, Holmes L, Holstad MM, Mgbere O. Correlates of HIV knowledge and sexual risk behaviors among female military personnel. AIDS Behav 2010; 14:1401-14. [PMID: 20387111 DOI: 10.1007/s10461-010-9701-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Uniformed services personnel are at an increased risk of HIV infection. We examined the HIV/AIDS knowledge and sexual risk behaviors among female military personnel to determine the correlates of HIV risk behaviors in this population. The study used a cross-sectional design to examine HIV/AIDS knowledge and sexual risk behaviors in a sample of 346 females drawn from two military cantonments in Southwestern Nigeria. Data was collected between 2006 and 2008. Using bivariate analysis and multivariate logistic regression, HIV/AIDS knowledge and sexual behaviors were described in relation to socio-demographic characteristics of the participants. Multivariate logistic regression analysis revealed that level of education and knowing someone infected with HIV/AIDS were significant (P < 0.05) predictors of HIV knowledge in this sample. HIV prevention self-efficacy was significantly (P < 0.05) predicted by annual income and race/ethnicity. Condom use attitudes were also significantly (P < 0.05) associated with number of children, annual income, and number of sexual partners. Data indicates the importance of incorporating these predictor variables into intervention designs.
Collapse
Affiliation(s)
- E James Essien
- University of Houston, Texas Medical Center, Houston, TX 77030, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|
9
|
Hough CA. Loss in childbearing among Gambia's kanyalengs: using a stratified reproduction framework to expand the scope of sexual and reproductive health. Soc Sci Med 2010; 71:1757-63. [PMID: 20965107 DOI: 10.1016/j.socscimed.2010.05.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2009] [Revised: 05/01/2010] [Accepted: 05/06/2010] [Indexed: 11/26/2022]
Abstract
This paper draws on ethnographic fieldwork with Gambian women who have experienced infertility and/or child mortality and who have consequently become kanyalengs. Kanyaleng kafoos are groups of women united by their reproductive difficulties whose bold public performances are designed to "beg God" for fertility and for children who will survive. I situate 'kanyalengs' disrupted childbearing within a framework of stratified reproduction, which reveals the tensions between ongoing demands to meet norms of high fertility, women's heavy burden of reproductive disease and the limits of a reproductive public health agenda narrowly focused on family planning and HIV prevention. To ameliorate these tensions, I call for an expansion of the sexual and reproductive health (SRH) agenda in Gambia to include RTI/STI prevention, diagnosis and management. This expansion reflects the goals set out by the Cairo International Conference on Population and Development for a broader approach to reproductive health, the productive potential of linkages between SRH and HIV prevention efforts, as well as the reproductive objectives of Gambian women and men.
Collapse
Affiliation(s)
- Carolyn A Hough
- Department of Sociology, Augustana College, 639 38th St, 61201, Rock Island, IL, United States.
| |
Collapse
|
10
|
Saddiq A, Tolhurst R, Lalloo D, Theobald S. Promoting vulnerability or resilience to HIV? A qualitative study on polygamy in Maiduguri, Nigeria. AIDS Care 2010; 22:146-51. [PMID: 20390493 DOI: 10.1080/09540120903039844] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Literature on the links between polygamy and HIV and AIDS is limited and the findings inconclusive. Literature to date in Sub-Saharan Africa has relied mainly on case-control studies and surveys. This qualitative study aimed to explore different community members' perceptions of the links between the practice of polygamy and vulnerability or resilience to HIV and AIDS in Maiduguri, north-eastern Nigeria. The study used focus group discussions and in-depth interviews with religious and community leaders and different groups of women and men in the community. Participant views on the links between polygamy and HIV were varied. However, one clear emerging theme was that it is not the practice of polygamy per se that shapes vulnerability to HIV and AIDS but the dynamics of sexual relations and practices both within and beyond the marital union--whether monogamous or polygamous. The ways in which these social relationships are negotiated and experienced are in turn shaped by religious traditions, gender roles and relations, education and socio-economic status. Within the religious environment of north-eastern Nigeria, where asymmetrical gender roles and relations and connotations of morality shape experiences of sexual interactions, windows of opportunity to promote behaviour-change strategies to support women and men's resilience to HIV need to be carefully created. Health practitioners and planners should develop partnerships with religious and community leaders and women's groups to construct and deliver behaviour-changes strategies.
Collapse
|
11
|
Smith DJ. Promiscuous Girls, Good Wives, and Cheating Husbands: Gender Inequality, Transitions to Marriage, and Infidelity in Southeastern Nigeria. ANTHROPOLOGICAL QUARTERLY 2010; 83. [PMID: 24259752 DOI: 10.1353/anq.0.0118] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The transition from premarital sexual relationships and courtship to marriage and parenthood in southeastern Nigeria involves particularly dramatic adjustments for young women who have absorbed changing ideas about sexuality, marriage, and gender equality, and who have had active premarital sexual lives. In the eyes of society, these women must transform from being promiscuous girls to good wives. This paper examines these adjustments and, specifically, how young married women's lives are affected by the reality of male infidelity and a persistent gendered double standard regarding the acceptability of extramarital sex.
Collapse
|
12
|
Clark S, Poulin M, Kohler HP. Marital Aspirations, Sexual Behaviors, and HIV/AIDS in Rural Malawi. JOURNAL OF MARRIAGE AND THE FAMILY 2009; 71:396-416. [PMID: 20161389 PMCID: PMC2782839 DOI: 10.1111/j.1741-3737.2009.00607.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
We explore how marital aspirations are related to the sexual behaviors of adolescents and young adults in Malawi, where HIV/AIDS prevalence among adults exceeds 10%. We also consider whether the specter of AIDS is shaping ideals about marriage. By combining survey data (N = 1,087) and in-depth interviews (N = 133) with young Malawians from the Malawi Diffusion and Ideational Change Project, we show that looking for and finding a suitable spouse are linked to sexual behaviors and, thus, HIV risks. Moreover, concerns about contracting HIV are closely tied to the ideal characteristics of a future spouse. Our findings draw long-overdue attention to the importance of marital aspirations in understanding adolescent sexual behaviors and risks in the era of AIDS.
Collapse
Affiliation(s)
- Shelley Clark
- McGill University, Stephen Leacock Building, Room 713, 855 Sherbrooke Street West, Montreal, Quebec, H3A 2T7 ( )
| | | | | |
Collapse
|
13
|
Abstract
In this paper we review the literature on the association between polygyny and women's health in sub-Saharan Africa. We argue that polygyny is an example of "co-operative conflict" within households, with likely implications for the vulnerability of polygynous women to illness, and for their access to treatment. We begin with a review of polygyny and then examine vulnerability to sexually transmitted infections (STIs, including HIV) and differential reproductive outcomes. Polygyny is associated with an accelerated transmission of STIs, both because it permits a multiplication of sexual partners and because it correlates with low rates of condom use, poor communication between spouses, and age and power imbalances among other factors. Female fertility is affected by the interplay between marital rank, household status, and cultural norms in polygynous marriages. Finally, we present areas which have received only cursory attention: mental health and a premature, "social" menopause. Although data are scarce, polygyny seems to be associated with higher levels of anxiety and depression, particularly around stressful life events. It is our hope that the examples reviewed here will help build a framework for mixed method quality research, which in turn can inform decision makers on more appropriate, context-dependent health policies.
Collapse
Affiliation(s)
- Riley Bove
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School, 55 Fruit street, Boston, MA 02114, USA.
| | | |
Collapse
|
14
|
Smith DJ. Modern marriage, men's extramarital sex, and HIV risk in southeastern Nigeria. Am J Public Health 2007; 97:997-1005. [PMID: 17463366 PMCID: PMC1874209 DOI: 10.2105/ajph.2006.088583] [Citation(s) in RCA: 122] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2006] [Indexed: 11/04/2022]
Abstract
For women in Nigeria, as in many settings, simply being married can contribute to the risk of contracting HIV. I studied men's extramarital sexual behavior in the context of modern marriage in southeastern Nigeria. The results indicate that the social organization of infidelity is shaped by economic inequality, aspirations for modern lifestyles, gender disparities, and contradictory moralities. It is men's anxieties and ambivalence about masculinity, sexual morality, and social reputation in the context of seeking modern lifestyles--rather than immoral sexual behavior and traditional culture--that exacerbate the risks of HIV/AIDS.
Collapse
|
15
|
Adejuyigbe EA, Odebiyi AI. Parental HIV serodiscordance: implications for the care of the HIV seropositive child in a resource-poor setting. AIDS Care 2007; 18:537-43. [PMID: 16831779 DOI: 10.1080/13548500500228698] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
This prospective study compared the care and support provided for symptomatic HIV seropositive children of HIV serodiscordant parents (only the mother of the child is HIV infected) with children of seroconcordant parents (both parents are HIV infected) during admission and after discharge from a tertiary health institution in southwestern Nigeria. Information was collected from parents of eligible children by semi-structured questionnaires and observation of the children and their parents while on admission and at home. Of the 51 couples who met the study criteria, there were 27 seroconcordant couples and 24 serodiscordant couples. The children from serodiscordant couples were more frequently discharged against medical advice, abandoned, lost to follow-up, cared for by their mothers alone and were not up-to-date with their immunization schedule when compared with children from seroconcordant parents. These were statistically significant (p < 0.05). There was a higher mortality among these children and their mothers (p < 0.05). Paternal reasons for not providing adequate care for the children from serodiscordant parents included fear of being infected, doubt of child's paternity and waste of family resources on a 'child who is dying'. None of the children from both groups received support from governmental and non-governmental agencies. It is concluded that the care of sick HIV seropositive children of serodiscordant parents poses special challenges for clinicians working in Nigeria where there is no social support system.
Collapse
|
16
|
Adebayo DO, Udegbe IB, Sunmola AM. Gender, Internet Use, and Sexual Behavior Orientation among Young Nigerians. ACTA ACUST UNITED AC 2006; 9:742-52. [PMID: 17201600 DOI: 10.1089/cpb.2006.9.742] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This study examined the influence of gender and Internet use on the sexual behavior orientation of young adults in Nigeria. Using an ex-post-facto design, data were collected from a total of 231 participants. Results of the hierarchical regression model provided support for the influence of gender and Internet use on sexual behavior orientation among young Nigerians. Further, results also revealed an interaction effect; as the use of the Internet increased, male participants reported a greater extent of risky sexual behavior orientation than their female counterparts. The findings were explained in the context of the theoretical foundations of the study, while practical implications for combating youths' risky sexual behavior orientation were highlighted.
Collapse
Affiliation(s)
- D O Adebayo
- Department of Psychology, Faculty of the Social Sciences, University of Ibadan, Ibadan, Nigeria.
| | | | | |
Collapse
|
17
|
Khan SI, Hudson-Rodd N, Saggers S, Bhuiyan MI, Bhuiya A. Safer sex or pleasurable sex? Rethinking condom use in the AIDS era. Sex Health 2006; 1:217-25. [PMID: 16335753 DOI: 10.1071/sh04009] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Condom use in Bangladesh is low despite nationwide family planning initiatives and HIV interventions. METHODS Fifty men aged between 18 and 55 years from diverse socio-demographic backgrounds and five key informants were interviewed in a qualitative male sexuality study. RESULTS Refusal to use condoms is not only a personal choice, but pertains to relationships. The meanings of reduced bodily pleasure associated with condom use are socially constructed. Men's emotions and trust expressed through understanding of direct penile-vaginal contact and ejaculation inside the vagina as 'pure' and 'natural' sex oppose condom use. Sexual prowess in the form of prolonged intercourse without condoms, as depicted in Western pornography, was perceived as a 'real man's' sexual skill. Men sought to preserve a 'good man's' image by avoiding condoms, which symbolised promiscuous men in AIDS educational messages. CONCLUSION Social dimensions of masculine sexuality, pleasure, eroticism and the emotional aspect of men's lives have to be addressed for effective condom promotion.
Collapse
Affiliation(s)
- Sharful Islam Khan
- Social and Behavioral Sciences Unit, ICDDR, B: Centre for Health and Population Research, Bangladesh, GPO Box 128, Dhaka-1000, Bangladesh.
| | | | | | | | | |
Collapse
|
18
|
Roth EA, Ngugi E, Fujita M. Self-deception does not explain high-risk sexual behavior in the face of HIV/AIDS: A test from northern Kenya. EVOL HUM BEHAV 2006. [DOI: 10.1016/j.evolhumbehav.2005.04.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
19
|
Helleringer S, Kohler HP. Social networks, perceptions of risk, and changing attitudes towards HIV/AIDS: new evidence from a longitudinal study using fixed-effects analysis. Population Studies 2005; 59:265-82. [PMID: 16249149 DOI: 10.1080/00324720500212230] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The study presented here is an investigation of the importance of social interactions to perceptions of the risk of AIDS, and explores spousal communication about the AIDS epidemic in rural Malawi. A fixed-effects analysis based on longitudinal data collected in 1998 and 2001 shows that social interactions on the subject of HIV/AIDS have significant and substantial effects on respondents' perceptions of the risk of HIV/AIDS, even after controlling for unobserved factors that affect the selection of social networks. These effects are more complex than previously thought. The dominant mechanisms--social learning and social influence--are found to vary by sex and by region, because of regional variations in the marriage pattern and the resulting implications for the formation of local social networks. The conclusion of the study is that rather than fostering denial and inaction, social interactions are an important vector of change in the face of the HIV/AIDS epidemic.
Collapse
|
20
|
Mitsunaga TM, Powell AM, Heard NJ, Larsen UM. Extramarital sex among Nigerian men: polygyny and other risk factors. J Acquir Immune Defic Syndr 2005; 39:478-88. [PMID: 16010173 DOI: 10.1097/01.qai.0000152396.60014.69] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The AIDS epidemic in Nigeria is generalized, with infection primarily occurring through heterosexual transmission. It is important to understand patterns of sexual behavior to assess their impact on the epidemic and to design appropriate intervention strategies. This study examined risk factors for extramarital sex among Nigerian men, with a particular focus on polygyny and peri- and postpartum abstinence. Data from the 2003 Nigeria Demographic and Health Survey were analyzed for 1153 men and their wives. Eleven percent of men reported extramarital sex in the previous year. Logistic regression models showed that men with 3 or more wives were at the greatest risk for extramarital sex, followed by monogamous men, when compared with men with 2 wives. Other significant predictors included region, religion, wealth, age at sexual debut, and self-perceived risk of HIV infection. Peri- and postpartum abstinence was not significant. Based on these findings, HIV prevention programs should include men with 3 or more wives and those living in the southwest region, in addition to activities targeting men of all ages. Given the heterogeneity within Nigeria, further in-depth studies should be undertaken to explore the relation between number of wives, peri- and postpartum abstinence, and extramarital sex within specific communities.
Collapse
Affiliation(s)
- Tisha M Mitsunaga
- AIDS Prevention Initiative Nigeria, Harvard School of Public Health, Boston, MA 02115, USA
| | | | | | | |
Collapse
|
21
|
Slap GB, Lot L, Huang B, Daniyam CA, Zink TM, Succop PA. Sexual behaviour of adolescents in Nigeria: cross sectional survey of secondary school students. BMJ 2003; 326:15. [PMID: 12511453 PMCID: PMC139494 DOI: 10.1136/bmj.326.7379.15] [Citation(s) in RCA: 78] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To determine whether family structure (polygamous or monogamous) is associated with sexual activity among school students in Nigeria. DESIGN Cross sectional school survey with a two stage, clustered sampling design. PARTICIPANTS 4218 students aged 12-21 years attending 39 schools in Plateau state, Nigeria. Responses from 2705 students were included in the analysis. MAIN OUTCOME MEASURE Report of ever having had sexual intercourse. Variables of interest included sexual history, age, sex, religion, family polygamy, educational level of parents, having a dead parent, and sense of connectedness to parents and school. RESULTS Overall 909 students (34%) reported ever having had sexual intercourse, and 1119 (41%) reported a polygamous family structure. Sexual activity was more common among students from polygamous families (42% of students) than monogamous families (28%) (chi2=64.23; P<0.0001). Variables independently associated with sexual activity were male sex (adjusted odds ratio 2.52 (95% confidence interval 2.05 to 3.12)), older age (1.62 (1.24 to 2.14)), lower sense of connectedness with parents (1.87 (1.48 to 2.38)), having a dead parent (1.59 (1.27 to 2.00)), family polygamy (1.58 (1.29 to 1.92)), lower sense of connectedness with school (1.25 (1.09 to 1.44)), and lower educational level of parents (1.14 (1.05 to 1.24)). Multistep logistic regression analysis showed that the effect of polygamy on sexual activity was reduced by 27% by whether students were married and 22% by a history of forced sex. CONCLUSIONS Secondary school students in Nigeria from a polygamous family structure are more likely to have engaged in sexual activity than students from a monogamous family structure. This effect is partly explained by a higher likelihood of marriage during adolescence and forced sex. Students' sense of connectedness to their parents and school, regardless of family structure, decreases the likelihood of sexual activity, and fostering this sense may help reduce risky sexual behaviour among Nigerian youth.
Collapse
Affiliation(s)
- Gail B Slap
- Division of Adolescent Medicine, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center (ML-4000), 3333 Burnet Avenue, Cincinnati, Ohio 45229-3039, United States.
| | | | | | | | | | | |
Collapse
|
22
|
|
23
|
Mantell JE, Hoffman S, Weiss E, Adeokun L, Delano G, Jagha T, Exner TM, Stein ZA, Karim QA, Scheepers E, Atkins K, Weiss E. The acceptability of the female condom: perspectives of family planning providers in New York City, South Africa, and Nigeria. J Urban Health 2001; 78:658-68. [PMID: 11796812 PMCID: PMC3455873 DOI: 10.1093/jurban/78.4.658] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
This article seeks to fill the gap in female condom acceptability research by examining family planning (FP) providers' attitudes and experiences regarding the female condom in three countries (South Africa, the US, and Nigeria) to highlight providers' potential integral role in the introduction of the female condom. The case studies used data drawn from three independent projects, each of which was designed to study or to change FP providers' attitudes and practices in relation to the female condom. The case study for New York City used data from semistructured interviews with providers in one FP consortium in which no special female condom training had been undertaken. The data from South Africa were drawn from transcripts and observations of a female condom training program and from interviews conducted in preparation for the training. The Nigerian study used observations of client visits before and after providers were trained concerning the female condom. In New York City, providers were skeptical about the contraceptive efficacy of the female condom, with only 8 of 22 providers (36%) reporting they would recommend it as a primary contraceptive. In South Africa, providers who had practiced insertion of the female condom as part of their training expressed concern about its physical appearance and effects on sexual pleasure. However, they also saw the female condom as a tool to empower clients to increase their capacity for self-protection. Structured observations of providers' counseling interactions with clients following training indicated that Nigerian providers discussed the female condom with clients in 80% of the visits observed. Despite the lack of a uniform methodology, the three case studies illuminate various dimensions of FP providers' perceptions of the acceptability of the female condom. FP providers must be viewed as a critical factor in female condom acceptability, uptake, and continued use. Designing training programs and other interventions that address sources of provider resistance and enhance providers' skills in teaching female condom negotiation strategies may help to increase clients' use of the female condom.
Collapse
Affiliation(s)
- J E Mantell
- The HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, New York 10032, USA.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Van Rossem R, Meekers D, Akinyemi Z. Consistent condom use with different types of partners: evidence from two Nigerian surveys. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2001; 13:252-267. [PMID: 11459361 DOI: 10.1521/aeap.13.3.252.19745] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
HIV prevalence in Nigeria is increasing rapidly. Increased condom use is the most viable solution to slow down or reverse this trend. This article uses data from two waves of a nation-wide survey, each with over 5,000 respondents, to examine factors that influence consistency of condom use with various types of partners. The results show that while the overall level of consistent condom use has remained low, reported consistent condom use with occasional partners and commercial sex workers exceeds 60%. There is also some evidence of an increasing trend in consistent condom use, even after controlling for differences in sample composition and other factors. The most important factors affecting consistency of condom use are awareness that condoms are effective at preventing HIV and that they are effective at preventing unwanted pregnancy, concern about unwanted pregnancy, and concern about HIV. Although concern about unwanted pregnancy has a strong effect on consistency of condom use with stable partners, concern about HIV infection has a strong effect on consistency of condom use with nonstable partners. The results suggest that HIV prevention programs need to do more than provide education about the modes of transmission and the ways to prevent infection. Improving the effectiveness of HIV prevention programs is likely to require focusing more explicitly on people's personal risk perception and condom efficacy. Focusing on these topics may further accelerate the observed positive trend in condom use.
Collapse
Affiliation(s)
- R Van Rossem
- Department of Child and Adolescent Studies, Utrecht University, Netherlands.
| | | | | |
Collapse
|
25
|
Lawoyin TO, Larsen U, Osinowo H, Walker ME. Sexual behavioural risks of married men in Oyo State, Nigeria. Int J STD AIDS 2001; 12:63-4. [PMID: 11214817 DOI: 10.1177/095646240101200114] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|