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Tesema GA, Gbagbo FY, Okeke SR, Ameyaw EK, Yaya S. Is sexual autonomy a protective factor against intimate partner violence? Evidence from 27 sub-Saharan African countries. PLoS One 2024; 19:e0308108. [PMID: 39074128 DOI: 10.1371/journal.pone.0308108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 07/15/2024] [Indexed: 07/31/2024] Open
Abstract
BACKGROUND Though women in sub-Saharan Africa have increased risk of intimate sexual violence, research on the association between sexual autonomy and intimate partner violence among this population has not received the requisite attention. Consequently, we investigated if sexual autonomy is a protective factor against intimate partner violence among women in sub-Saharan Africa. METHODS Secondary data analysis was conducted based on the Demographic and Health Surveys (DHSs) of 27 sub-Saharan African countries from 2008 to 2021. A total of 104,523 married or cohabitating women were included in the study. We applied a multilevel Poisson regression model with robust variance to identify associated factors. Variables with a p-value<0.2 in the bi-variable multilevel Poisson regression analysis were considered for the multivariable analysis. The Adjusted Prevalence Ratio (APR) with its 95% confidence interval (CI) was reported, and variables with a p-value <0.05 were included in the multivariable analysis. RESULTS The prevalence of intimate partner violence and sexual autonomy among women in SSA were 32.96% [95% CI: 32.68%, 33.25%] and 88.79% [95% CI: 88.59%, 88.97%], respectively. Women in Sierra Leone had the highest prevalence of IPV (52.71%) while Comoros had the lowest prevalence of IPV (8.09%). The prevalence of sexual autonomy was highest in Namibia (99.22%) and lowest in Mali (61.83%). The MOR value in the null model was 1.26. We found that women who had sexual autonomy are 1.28 times [APR = 1.28, 95% CI: 1.17, 1.40] more likely to experience IPV than women who had no sexual autonomy. CONCLUSION This study has demonstrated that sexual autonomy is significantly associated with intimate partner violence, however, it does not necessarily act as a protective factor. The study suggests the need for more education on intimate partner violence targeting women's partners. This can help secure the commitment of the perpetrators to rather become proponents of anti-intimate partner violence and further offer women the necessary support for them to attain their full fundamental rights in all spheres of life.
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Affiliation(s)
- Getayeneh Antehunegn Tesema
- Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Fred Yao Gbagbo
- Department of Health Administration and Education University of Education Winneba, Kumasi, Ghana
| | - Sylvester R Okeke
- Centre for Social Research in Health, UNSW Sydney, Kensington, Australia
| | - Edward Kwabena Ameyaw
- Institute of Policy Studies and School of Graduate Studies, Lingnan University, Tuen Mun, Hong Kong
- L & E Research Consult Ltd, Wa, Upper West Region, Ghana
| | - Sanni Yaya
- The George Institute for Global Health, Imperial College London, London, United Kingdom
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2
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Stevenson EL, Rojas M, Lantiere A, Meekins M, Fitch ER, Maralit JR, Holt L, Dela Rosa JJ. Qualitative Analysis of Men's Involvement in Family Planning in The Philippines: An Ecological Assessment. Am J Mens Health 2023; 17:15579883231191359. [PMID: 37586023 PMCID: PMC10416658 DOI: 10.1177/15579883231191359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 07/09/2023] [Accepted: 07/11/2023] [Indexed: 08/18/2023] Open
Abstract
While family planning (FP) programs have the capacity to empower women, support gender equality, and reduce poverty, male involvement is an influential factor for the uptake of FP that has been lacking. In the past decade, there have been more progressive FP policies and growing attention on male involvement in FP in the Philippines, providing an opportunity to develop evidence-based interventions to better integrate men into FP services by approaching care delivery from a family-focused perspective. This paper sought to understand the current role of men in FP services and explore how to strengthen facilitators and overcome barriers to optimize men's involvement in FP in the Philippines. Using the Ecological Model for Health Promotion, this qualitative study used convenience sampling to collect data through in-depth interviews and focus group discussions at all levels of the ecosystem. All data were collected in the Albay area, with the exception of some policy data collected in Manila. Qualitative analysis was guided by content analysis. The final sample included 66 participants across the ecosystem. Two primary themes emerged: (1) Resources and health care systems structure impact on male involvement in FP and (2) Education and training that support male involvement in FP. The findings of our qualitative study suggest that while men in the Philippines and their ecosystems support men's FP involvement, the inconsistent health care systems and protocols are not yet reaching men with information and education they need to help them make informed FP decisions with their female partners.
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Affiliation(s)
| | | | | | | | | | - Jomel R. Maralit
- Bicol Region General Hospital and Geriatric Medical Center, San Pedro, Philippines
| | - Lauren Holt
- Duke University School of Nursing, Durham, NC, USA
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3
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Gangcuangco LMA, Eustaquio PC. The State of the HIV Epidemic in the Philippines: Progress and Challenges in 2023. Trop Med Infect Dis 2023; 8:tropicalmed8050258. [PMID: 37235306 DOI: 10.3390/tropicalmed8050258] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 04/14/2023] [Accepted: 04/28/2023] [Indexed: 05/28/2023] Open
Abstract
In the past decade, the Philippines has gained notoriety as the country with the fastest-growing human immunodeficiency virus (HIV) epidemic in the Western Pacific region. While the overall trends of HIV incidence and acquired immunodeficiency syndrome (AIDS)-related deaths are declining globally, an increase in new cases was reported to the HIV/AIDS and ART Registry of the Philippines. From 2012 to 2023, there was a 411% increase in daily incidence. Late presentation in care remains a concern, with 29% of new confirmed HIV cases in January 2023 having clinical manifestations of advanced HIV disease at the time of diagnosis. Men having sex with men (MSM) are disproportionately affected. Various steps have been taken to address the HIV epidemic in the country. The Philippine HIV and AIDS Policy Act of 2018 (Republic Act 11166) expanded access to HIV testing and treatment. HIV testing now allows for the screening of minors 15-17 years old without parental consent. Community-based organizations have been instrumental in expanding HIV screening to include self-testing and community-based screening. The Philippines moved from centralized HIV diagnosis confirmation by Western blot to a decentralized rapid HIV diagnostic algorithm (rHIVda). Dolutegravir-based antiretroviral therapy is now the first line. Pre-exposure prophylaxis in the form of emtricitabine-tenofovir disoproxil fumarate has been rolled out. The number of treatment hubs and primary HIV care facilities continues to increase. Despite these efforts, barriers to ending the HIV epidemic remain, including continued stigma, limited harm reduction services for people who inject drugs, sociocultural factors, and political deterrents. HIV RNA quantification and drug resistance testing are not routinely performed due to associated costs. The high burden of tuberculosis and hepatitis B virus co-infection complicate HIV management. CRF_01AE is now the predominant subtype, which has been associated with poorer clinical outcomes and faster CD4 T-cell decline. The HIV epidemic in the Philippines requires a multisectoral approach and calls for sustained political commitment, community involvement, and continued collaboration among various stakeholders. In this article, we outline the current progress and challenges in curbing the HIV epidemic in the Philippines.
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Affiliation(s)
- Louie Mar A Gangcuangco
- Hawaii Center for AIDS, John A Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI 96813, USA
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4
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Cordero DA. Enhancing Male Participation in Reproductive Health care in the Philippines: A Multisectoral Approach. Am J Mens Health 2022; 16:15579883221127559. [PMID: 36154527 PMCID: PMC9515525 DOI: 10.1177/15579883221127559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Affiliation(s)
- Dalmacito A. Cordero
- Department of Theology and Religious
Education, De La Salle University, Manila, Philippines,Dalmacito A. Cordero Jr., Department of Theology
and Religious Education, De La Salle University, 2401 Taft Avenue, Manila 1004,
Philippines.
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5
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Pepito VCF, Amit AML, Tang CS, Molen RGC, Co LMB, Aliazas NAK, De Los Reyes SJ, Tanchanco LBS. Determinants of consistent condom use among Filipino women: Results from the 2017 Philippine National Demographic and Health Survey. BMC Public Health 2022; 22:1643. [PMID: 36042428 PMCID: PMC9426009 DOI: 10.1186/s12889-022-14040-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 08/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Consistent condom use in women, defined as the self-reported usage of male condom in every sexual encounter of the respondent with her most recent partner in the last 12 months, had been perennially low in the Philippines. This is despite consistent condom use being a tested and proven public health intervention to prevent unwanted pregnancy and sexually transmitted infections. Considering the high fertility rate, teenage pregnancy rate, and the rapidly increasing incidence of HIV in the country, we identified the determinants of consistent condom use in the Philippines. METHODS We used data from the individual recode of the 2017 Philippine National Demographic and Health Survey. We used logistic regression for survey data to identify factors associated with consistent condom use. RESULTS Out of 25,074 respondents, only 261 (1.13%) have used condoms consistently with their most recent partner. Reach of information and education campaigns on contraceptive use via different media ranged from 62% via television to 7% via short messaging service. After adjusting for confounders, those who were able to ask their partners to use condoms during sexual intercourse have 6.18 times (adjusted odds ratio (aOR): 6.18; 95% Confidence Interval (95% CI): 2.02. 18.94) greater odds of consistent condom use than those who were unable to ask their partners to use condoms during sexual intercourse. Meanwhile, HIV knowledge (aOR: 1.16; 95% CI: 0.98, 1.38) and hearing about contraception in television (aOR: 1.54; 95% CI: 1.00, 2.38) have weaker associations with consistent condom use. CONCLUSIONS The low percentage of those who use condoms consistently, together with the low reach of information and education campaigns, highlight the need to implement multi-faceted and context-specific interventions to promote sexual agency and/or consistent condom use to address the burden of unwanted pregnancies and HIV in the Philippines.
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Affiliation(s)
| | - Arianna Maever L Amit
- School of Medicine and Public Health, Ateneo de Manila University, Pasig City, Philippines.,National Clinical Trials and Translation Center, National Institutes of Health, University of the Philippines Manila, Manila, Philippines
| | - Clinton S Tang
- School of Medicine and Public Health, Ateneo de Manila University, Pasig City, Philippines
| | - Ryan Gabriel C Molen
- School of Medicine and Public Health, Ateneo de Manila University, Pasig City, Philippines
| | - Luis Miguel B Co
- School of Medicine and Public Health, Ateneo de Manila University, Pasig City, Philippines
| | | | - Sarah J De Los Reyes
- School of Medicine and Public Health, Ateneo de Manila University, Pasig City, Philippines.,Dr. Fe del Mundo Medical Center, Banawe St., Quezon City, Philippines
| | - Lourdes Bernadette S Tanchanco
- School of Medicine and Public Health, Ateneo de Manila University, Pasig City, Philippines.,The Medical City, Ortigas Ave., Pasig City, Philippines.,MedMom Institute for Human Development, Pasig City, Philippines
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Lantiere AE, Rojas MA, Bisson C, Fitch E, Woodward A, Stevenson EL. Men's Involvement in Sexual and Reproductive Health Care and Decision Making in the Philippines: A Systematic Review of the Literature. Am J Mens Health 2022; 16:15579883221106052. [PMID: 35815925 PMCID: PMC9277450 DOI: 10.1177/15579883221106052] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Sexual and reproductive health care (SRH) and family planning (FP) services have
been primarily female centered. In recent decades, international groups have
advocated for men’s involvement in SRH and FP, yet related research remains
limited and implementation not fully realized in many countries. This systematic
review of literature seeks to summarize the barriers and facilitators to men’s
involvement in SRH/FP services in the Philippines. It is limited to publications
in English from 1994 to 2021 regarding studies conducted in the Philippines
whose research questions focused on men’s involvement in SRH/FP. Eligible
studies were assessed for methodological quality using the Johns Hopkins Nursing
Evidence-Based Practice (JHNEBP) Evidence Rating Scale. The Ecological Model for
Health Promotion was used as the guiding theoretical framework for analysis and
to report findings. Barriers and facilitators were identified at every
ecological level except that of policy. The most common barrier identified was
men’s deficit in knowledge about SRH/FP; the most common facilitator was the
positive influence of their social network on men’s attitudes, beliefs, and
practices pertaining to SRH/FP. A range of factors from the individual to the
community level influenced men’s involvement, including religious beliefs,
economic means, and cultural gender roles. More studies are needed to provide a
fuller understanding of the multilevel ecological factors influencing men’s
involvement in SRH/FP and inform interventions with men that can positively
affect their behavior related to SRH/FP decision making.
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Okeke SR. "I always prefer to withdraw than use a condom": contextualising condomless sex among East Asian and sub-Saharan African international students in Sydney. Arch Public Health 2022; 80:20. [PMID: 34986875 PMCID: PMC8729151 DOI: 10.1186/s13690-021-00777-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 12/21/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Incidence and prevalence of blood-borne viruses and sexually transmissible infections among young people continue to necessitate population-based studies to understand how contextualised sexual health services can be developed and implemented to promote protective behaviours such as consistent condom use. This study examined condomless sexual practice among a sample of East Asian and sub-Saharan African international university students in Sydney, Australia. METHODS This qualitative study was methodologically guided by interpretative phenomenological analysis. Data was provided by 20 international students sampled from five universities in Sydney, who participated in either face-to-face or telephone semi-structured in-depth interviews. The interview sessions were audio-recorded, transcribed verbatim, coded in NVivo and analysed using reflexive thematic analysis. RESULTS Condomless sexual practices appear to be common among the study group based on participants' self-reports of their own practices and the practices of friends and peers. Three themes contextualising condomless among the study participants were generated from the interview transcripts: (1) unanticipated sex, condom related stigma and alcohol use (2) pleasure-seeking, curiosity and intimacy (3) condomless sex as a gendered practice. CONCLUSIONS The result of this study has implications for public health research, practice and policy around design, implementation and evaluation of multi-layered and population-specific sexual health services that are tailored to addressing the needs of international students, who migrate from traditional sexual cultures to Australia, where sexual norms are more liberal.
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8
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Exploring condom use decision-making among adolescents: the synergistic role of affective and rational processes. BMC Public Health 2021; 21:1894. [PMID: 34666719 PMCID: PMC8527692 DOI: 10.1186/s12889-021-11926-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 09/20/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Condom use remains the most effective behavioural method for the prevention of HIV and unplanned pregnancies. However, condom use remains inconsistent among young people. Exploring the condom use decision-making processes that adolescents engage in might provide information that would assist in the prevention of many challenges related to poor sexual and reproductive health outcomes. This study therefore aimed to explore the factors that influenced decision-making about sexual debut and condom use of adolescents from two schools in the Western Cape, South Africa. METHODS A sample of 16 adolescents were selected using purposive sampling. Data were collected using semi-structured, individual interviews. Thematic analysis was used to analyse the data generated. RESULTS The link between sexual debut and affective processes was frequently discussed in condom use decision-making. Decisions about sexual debut were influenced by the belief that sex was a perceived symbol of 'true love' on the one hand, and respect for perceived parental expectations of age-appropriate sex, on the other. Condom use decision-making was shaped by adolescents' concerns about their future and lack of stability in their lives. Adolescents' fears of pregnancy, parenthood and disease shaped their condom use decision-making. It became evident that rational and affective decision-making in condom use choice were not mutually exclusive, but that these processes happened simultaneously. CONCLUSIONS The study highlighted the role of affective states as part of the process of examining alternatives when deciding to use a condom or not. Interventions to strengthen condom use decision-making should therefore incorporate not only rational but also affective processes to improve adolescent sexual and reproductive outcomes.
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9
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Body Dissatisfaction, Weight-Related Behaviours, and Health Behaviours: A Comparison Between Australian and Malaysian in Female Emerging Adults. BEHAVIOUR CHANGE 2021. [DOI: 10.1017/bec.2021.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractThe presence of body dissatisfaction (BD) in non-Western countries is an important area of empirical enquiry. The results reflect collectivistic and individualistic cultures of Malaysians and Australians, respectively, whereby social approval, social acceptance, and cultural values are of high importance to Malaysians compared with the more liberal attitudes of Australians with respect to health behaviours. This study sought to compare: (1) Australian and Malaysian women on BD, thin ideal internalisation, sociocultural influences, problematic weight-related behaviours, and health behaviours; and (2) the degree to which BD is associated with health behaviours (smoking, alcohol consumption, drug use, and sexual behaviours) across the two cultures. Participants were 428 Australian females and 402 Malaysian females aged 18–25 years old. Australians had higher BD, thin ideal internalisation, family and media influences, restrained eating, and poorer health behaviours, while Malaysians had higher peer influence. There was no difference for bulimic behaviours across the two countries. BD was found to have an association with use of drugs, smoking, and sexual behaviours among Malaysian women, but not for Australian participants. The permeation of Western standards of the thin ideal due to increased industrialisation, Westernisation, and modernisation has brought about bulimic behaviours in Malaysian women, similar to that of Australian women.
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10
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Narasimhan S, Gipson JD. An application of Systematic Anomalous Case Analysis to improve models predicting contraceptive use in the Philippines. J Biosoc Sci 2021; 54:1-14. [PMID: 33818334 PMCID: PMC10061339 DOI: 10.1017/s0021932021000122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Amidst persistently high unintended pregnancy rates and lags in contraceptive use, novel methodological approaches may prove useful in investigating sexual and reproductive health outcomes in the Philippines. Systematic Anomalous Case Analysis (SACA) - a mixed-methods technique - was employed to examine predictors of women's lifetime contraceptive use. First, multivariable, longitudinal Poisson regression models predicted fertility and sexual debut using the 1998-2009 Cebu Longitudinal Health and Nutrition Surveys (CLHNS), then regression outliers and normative cases were used to identify 48 participants for in-depth interviews (2013-2014) for further examination. Qualitative findings from 24 women highlighted 'control over life circumstances' was critical, prompting the addition of two items to the original quantitative models predicting any contraceptive use (n=532). Each of the items, 'what happens to [them] is their own doing' and '[I] do not [have] enough control over direction life is taking [me]', significantly and independently predicted any contraceptive use (aOR: 2.37 (CI: 1.24-4.55) and aOR: 0.46 (CI: 0.28-0.77), respectively). The findings demonstrate the utility of SACA to improve the understanding and measurement of sexual and reproductive health outcomes and underscore the importance of integrating psychosocial constructs into existing models of fertility and reproductive behaviour in the Philippines to improve sexual and reproductive health outcomes.
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Affiliation(s)
- Subasri Narasimhan
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
- Center for Reproductive Health Research in the Southeast, Emory University, Atlanta, GA, USA
| | - Jessica D. Gipson
- Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles, CA, USA
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Kim Y, Min HY, Lee J, Kim SJ. An integrative review of studies of condom use among Korean college students. CHILD HEALTH NURSING RESEARCH 2021; 27:43-55. [PMID: 35004496 PMCID: PMC8650878 DOI: 10.4094/chnr.2021.27.1.43] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 12/27/2020] [Accepted: 12/29/2020] [Indexed: 11/07/2022] Open
Abstract
PURPOSE The purpose of this study was (a) to synthesize studies of condom use among South Korean college students, and (b) to appraise the quality of each article using Gough's weight of evidence. METHODS Studies published in English and Korean were searched in electronic databases using the terms "student or college student or university student or undergraduate", "condom", and "Korea*". RESULTS Twenty studies met the inclusion criteria, showed appropriate quality, and were therefore selected for review. The variables related to condom use were measured in terms of condom-related factors, factors related to non-condom-related knowledge and attitudes, and other factors. Knowledge, attitudes, and self-efficacy were associated with condom use, and there were differences in condom-related factors among men and women. CONCLUSION Based on these findings, it was confirmed that sexual education is needed for both men and women to promote condom use. Education on condom use should not only focus directly on condoms, but should also address other aspects of knowledge and attitudes to influence health beliefs. In addition, developing educational programs targeting adolescents and parents will have a positive effect on college students' condom use.
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Affiliation(s)
- Yoonjung Kim
- Doctoral Candidate, College of Nursing, Ewha Womans University, Seoul, Korea
| | - Hye Young Min
- Doctoral Candidate, College of Nursing, Ewha Womans University, Seoul, Korea
| | - Jungmin Lee
- Lecturer, School of Nursing, Hallym University, Chuncheon, Korea
| | - Shin-Jeong Kim
- Professor, School of Nursing, Research Institute of Nursing Science, Hallym University, Chuncheon, Korea
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12
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De Torres RQ. Facilitators and barriers to condom use among Filipinos: A systematic review of literature. Health Promot Perspect 2020; 10:306-315. [PMID: 33312926 PMCID: PMC7722996 DOI: 10.34172/hpp.2020.49] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 08/18/2020] [Indexed: 11/18/2022] Open
Abstract
Background: Between 2010 and 2018, the Philippines had a 203% increase in new human immunodeficiency virus (HIV) infections. The use of condoms is an effective and practical means to prevent HIV transmission. The purpose of this study was to identify facilitators and barriers to condom use among Filipinos guided by the Ecological Model of Health Promotion. Methods: A systematic review of literature using electronic databases was performed using the following keywords: "condom," "Filipinos," and "Philippines." To be included in this review, papers should be (1) research studies, (2) studies that examined condom use, and (3) studies that sampled Filipinos residing in the Philippines. The final sample comprised of 27 articles. Results: Multiple and interrelated factors at the individual and social environment levels influence condom use among different groups of Filipinos. Majority of these factors originated at the intrapersonal level. Some of the facilitators to condom use were knowledge on HIV, higher perceived HIV risk, peer support, positive manager attitude, health provider engagement, and city ordinances. In contrast, some of the barriers to condom use were discomfort and displeasure on condom use, low parental communication, lack of sex education, social stigma, and the high price of condoms. Conclusion: A collaborative, culturally-sensitive, and population-specific approach is essential to develop and implement acceptable, sustainable, and successful condom use interventions.
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Affiliation(s)
- Ryan Q De Torres
- College of Nursing, University of the Philippines Manila, Manila, Philippines
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13
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Siegler AJ, Rosenthal EM, Sullivan PS, Ahlschlager L, Kelley CF, Mehta CC, Moore RH, Rosenberg ES, Cecil MP. Double-Blind, Single-Center, Randomized Three-Way Crossover Trial of Fitted, Thin, and Standard Condoms for Vaginal and Anal Sex: C-PLEASURE Study Protocol and Baseline Data. JMIR Res Protoc 2019; 8:e12205. [PMID: 31012862 PMCID: PMC6658242 DOI: 10.2196/12205] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 01/04/2019] [Accepted: 02/14/2019] [Indexed: 11/21/2022] Open
Abstract
Background Male condoms are underused despite their ability to prevent transmission of HIV and other sexually transmitted infections. The perception of decreased sexual pleasure and poor condom fit are major contributors to condom nonuse. Objective The purpose of this study was to compare event-level performance and pleasure using fitted, thin, and standard condoms among men who have sex with men (MSM) and men who have sex with women (MSW). We also sought to assess condom type preference. We present the study design and enrollment data from the trial. Methods This study recruited sexually active men aged 18 to 54 years in Atlanta, Georgia, United States. We enrolled 252 MSM and 252 MSW in a double-blind, 3-way randomized crossover trial with conditions of fitted, thin, and standard condoms. A permuted block randomization scheme was used to assign each participant to the sequence in which they received each type of study condom. After a baseline screening and enrollment visit, randomized participants were followed for at least 6 and up to 12 weeks depending on their use of study condoms in each 2-week period between scheduled, in-person study visits. Participants were instructed to complete mobile-optimized coital logs as soon as possible after using condoms for anal or vaginal sex acts. The logs collected event-level pleasure and performance measures for the study condoms as well as other relevant data. A questionnaire was administered at the final study visit to assess overall study condom preference. Results The study enrolled 252 MSM and 252 MSW, a total of 504 participants. MSM and MSW study arms were similar for a number of key traits including race and ethnicity, marital status, self-rated condom experience, and recent experience of condom failure. Men in the MSM arm were older, however, and fewer MSM were students. The majority of participants in both arms rated themselves as very experienced with using condoms, and the majority had used condoms recently. Over one-third of participants in each arm reported experiencing condom failure in the last 6 months. Conclusions This is the first condom trial to compare the performance of standard, thin, and fitted condoms and to use pleasure and preference as primary outcomes. Given the disparate impact of HIV on MSM, equal enrollment of MSM and MSW was a key feature of this study. Trial results may inform an FDA label indication for anal sex and provide new information regarding the relative performance of different types of condoms. Trial Registration ClinicalTrials.gov NCT02753842; https://clinicaltrials.gov/ct2/show/NCT02753842 (Archived by WebCite at http://www.webcitation.org/76RLTFyf0) International Registered Report Identifier (IRRID) DERR1-10.2196/12205
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Affiliation(s)
- Aaron J Siegler
- Rollins School of Public Health, Department of Behavioral Sciences and Health Educaiton, Emory University, Atlanta, GA, United States
| | - Elizabeth M Rosenthal
- University at Albany School of Public Health, Department of Epidemiology, State University of New York, Albany, NY, United States
| | - Patrick S Sullivan
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Lauren Ahlschlager
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Colleen F Kelley
- School of Medicine, Emory University, Atlanta, GA, United States
| | - C Christina Mehta
- Rollins School of Public Health, Department of Biostatistics and Bioinformatics, Emory University, Atlanta, GA, United States
| | - Reneé H Moore
- Rollins School of Public Health, Department of Biostatistics and Bioinformatics, Emory University, Atlanta, GA, United States
| | - Eli S Rosenberg
- University at Albany School of Public Health, Department of Epidemiology, State University of New York, Albany, NY, United States
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Somefun OD. Religiosity and sexual abstinence among Nigerian youths: does parent religion matter? BMC Public Health 2019; 19:416. [PMID: 30999890 PMCID: PMC6472019 DOI: 10.1186/s12889-019-6732-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 03/31/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Religion plays an important role in youth behaviours, making it a significant factor in the discourse on youth sexuality in sub-Saharan Africa. Several studies have found that religion and religiosity play an important role in the sexual behaviours of young people. However, little research in Nigeria has examined the mechanisms through which religiosity influences youth sexual behaviour and if parents' religion moderates this relationship. Guided by the social control theory, this paper contributes to the existing literature by examining the relationship between religiosity and youth sexual behaviour. METHODS Data for the study came from 2399 male and female youth aged 16-24 years in four states purposively selected from four regions in Nigeria. Abstinence was the sexual behaviour of interest. Logistic regression was used to examine this relationship. RESULTS Results showed that 68% of the youth had never had sex. Religiosity was a protective factor for youth sexual behaviour and this positive association was still evident even after controlling for other covariates. Youth who were highly religious (OR - 1.81, CI- 1.13-2.88) had significantly higher odds of abstaining compared to their counterparts who were not religious. CONCLUSION Religiosity is a protective factor for sexual abstinence among youth in Nigeria. Policy makers can work around using religious institutions for behavioural change among youth in Nigeria.
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Affiliation(s)
- Oluwaseyi Dolapo Somefun
- Demography and Population Studies Programme, Schools of Public Health and Social Sciences, Faculties of Health Sciences and Humanities, University of the Witwatersrand, Johannesburg, South Africa.
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Gangcuangco LMA, Izutsu S. Medical School Hotline: Dying of AIDS in 2018: Urgent Interventions to Curb the Fastest-Growing HIV Epidemic in the Western Pacific. HAWAI'I JOURNAL OF MEDICINE & PUBLIC HEALTH : A JOURNAL OF ASIA PACIFIC MEDICINE & PUBLIC HEALTH 2019; 78:108-110. [PMID: 30854257 PMCID: PMC6401200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Louie Mar A Gangcuangco
- Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI
- Hawai'i Center for AIDS, John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI
| | - Satoru Izutsu
- it is a monthly column from the University of Hawai'i John A. Burns School of Medicine
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Patrão AL, McIntyre T. Socio-demographic, marital and psychosocial predictors of safe sex behaviour among Mozambican women at risk for HIV/AIDS. AJAR-AFRICAN JOURNAL OF AIDS RESEARCH 2018; 17:323-331. [PMID: 30466355 DOI: 10.2989/16085906.2018.1536672] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Heterosexual encounters remain the primary route for HIV transmission in Africa. Safer sex behaviour is not adopted by many women due to several social and psychological factors. This paper aims to identify socio-demographic, marital and psychosocial predictors associated with current sexual activity and condom use in Mozambican women at sexual risk for HIV/AIDS. Women (173), patients at a public hospital and at risk for HIV infection, completed measures of condom use negotiation self-efficacy, perceived barriers against safer sex, current sexual activity and condom use. Having more than 6 years of education and being younger and single were significant predictors for current sexual activity and condom use. Regarding psychosocial factors, talking about AIDS with partners, condom use negotiation self-efficacy and fewer perceived barriers to safer sex were significant predictors for current sexual activity (intention to use and buy/get condoms). Condom use negotiation self-efficacy is a significant predictor for condom use. These results should be considered in new HIV prevention intervention design in Mozambique.
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Affiliation(s)
- Ana Luísa Patrão
- a Institute of Collective Health , Federal University of Bahia , Salvador , Brazil
| | - Teresa McIntyre
- b School of Social Work , University of Texas at Arlington , USA
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Nascimento EGCD, Fernandes Cavalcanti MA, Alchieri JC. [Adherence to condom use: the real behavior in the Northeast of Brazil]. ACTA ACUST UNITED AC 2017; 19:39-44. [PMID: 30137153 DOI: 10.15446/rsap.v19n1.44544] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Accepted: 09/02/2016] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To investigate the socioeconomic, demographic and cultural elements that interfere in the adherence to the use of condoms in an open population. METHODOLOGY A cross-sectional study with a quantitative approach was conducted through an explanatory household survey, in the municipality of Caraúbas, West Potiguar mesoregion, with 3 482 individuals older than 18. A Likert questionnaire was administered by community health agents in a household setting. Descriptive statistics were performed, followed by univariate and bivariate analyzes, using the Chi-square test. RESULTS The most receptive groups to condom use are the earliest age groups, male subjects, participants who do not have a stable relationship, and those with a higher education level. The association between condom and condom use showed that the more affluent strata represented less condom adoption. The reasons for condom abandonment were the preference for another contraceptive method and the confidence in the partner, and the main reason for its use was prevention against sexually transmitted diseases. DISCUSSION Adherence to condom use is scarce in all the groups considered. The popularization of the method must be fostered by individual and collective measures directed to consider the use of condoms for a dual purpose, by expanding information through sex education campaigns and overcoming gender conflicts.
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Affiliation(s)
| | | | - João Carlos Alchieri
- Psic. Doutor em Psicologia. Universidade Federal do Rio Grande do Norte (UFRN). Natal (RN), Brasil.
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Ubrihien A, Davies SC, Driscoll T. Is cost a structural barrier preventing men who have sex with men accessing condoms? A systematic review. AIDS Care 2016; 28:1473-80. [PMID: 27240970 DOI: 10.1080/09540121.2016.1189999] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
A systematic review was undertaken to determine whether cost is a structural barrier preventing men who have sex with men (MSM) accessing condoms. Studies were examined from a range of countries where condoms have been distributed free to particular populations and also those where condoms were available at a cost to the individual. The study inclusion criteria were: published between January 1990 and September 2014 inclusive; published in any language, discussed cost as a barrier to condom use, discussed cost barriers to MSM accessing condoms and included a measure of outcome. Articles were systematically extracted from MEDLINE, Embase, PyschINFO and Informat using the five search terms; Male Homosexuality, Access, Cost, Cost and Cost analysis, Condoms. Sixty-four articles were initially identified and 11 included in the final review. The included studies used cost-utility analysis, qualitative, cross-sectional, cohort or randomised control trial design. Large-scale free distribution programmes and smaller targeted programmes showed positive correlations in reducing the burden of disease from HIV and other sexually transmitted infections through eliminating the issue of cost. Decreasing the cost of condoms, and providing them for no cost, appears to increase their utilisation amongst MSM and possibly reduce the burden from HIV and other sexually transmitted infections. Inequality and stigma remain important barriers to MSM accessing and using condoms particularly in the developing world.
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Affiliation(s)
- Ashley Ubrihien
- a Northern Sydney Sexual Health Service, Royal North Shore Hospital , St Leonards , NSW , Australia.,b School of Public Health, Sydney Medical School, University of Sydney , Sydney , NSW , Australia
| | - Stephen C Davies
- a Northern Sydney Sexual Health Service, Royal North Shore Hospital , St Leonards , NSW , Australia.,c Sydney Medical School, University of Sydney , Sydney , NSW , Australia
| | - Tim Driscoll
- b School of Public Health, Sydney Medical School, University of Sydney , Sydney , NSW , Australia
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Blomquist PB, Miari VF, Biddulph JP, Charalambous BM. Is gonorrhea becoming untreatable? Future Microbiol 2014; 9:189-201. [PMID: 24571073 DOI: 10.2217/fmb.13.155] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
An estimated 498 million new cases of curable sexually transmitted infections occur worldwide annually. Of these, 106 million are gonococcal infections, rendering gonorrhea the second most prevalent bacterial sexually transmitted infection after chlamydia. A decline in susceptibility to extended-spectrum cephalosporins, as well as treatment failures, have been identified worldwide. This, together with the associated epidemiological and socioeconomic burden, is of increasing concern. Currently, the effectiveness of antibiotic resistance control measures is limited. Barriers include the lack of therapeutic options, the difficulties of reducing high-risk sexual behavior and Neisseria gonorrhoeae's propensity to rapidly acquire resistance determinants. While the disease remains treatable for the moment, we need to anticipate and be prepared for the arrival and spread of untreatable gonorrhea by using a multifaceted approach and search for other, perhaps novel control strategies.
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Affiliation(s)
- Paula Bianca Blomquist
- University College London Medical School Centre for Clinical Microbiology, Royal Free Campus, University College London, Rowland Hill Street, London, NW3 2PF, UK
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