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Chea SK, Kazienga A, Oyugi EA, Menza I, Nasambu C, Ibrahim F, Abdullahi OA, Hassan AS, Abubakar A, Michielsen K, Abbeddou S. Associations between disordered eating behaviour and sexual behaviour amongst emerging adults attending a tertiary education institution in Coastal Kenya. PLoS One 2024; 19:e0301436. [PMID: 38861516 PMCID: PMC11166344 DOI: 10.1371/journal.pone.0301436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 03/16/2024] [Indexed: 06/13/2024] Open
Abstract
BACKGROUND Sexual behavior (SB) is a well-documented pathway to HIV acquisition in emerging adults and remains common amongst African emerging adults. Previous research in high-income countries indicates a correlation between disordered eating behavior (DEB) and engaging in sexual behaviors. We aimed to describe the relationship between DEB and SB amongst emerging adults attending a tertiary educational institution at the Kenyan Coast. METHODS We applied a cross-sectional design nested in a young adults' cohort study. Eligibility included sexually active emerging adults aged 18-24 years. Three DEBs (emotional, restrained and external eating) were assessed using the Dutch Eating Behavior Questionnaire and analysed using exploratory factor analysis. Seven SB indicators were assessed: non-condom use, casual sex, multiple sex partners, transactional sex, group sex, age-disparate relationship and anal sex, and grouped into low vs. high SB using latent class analysis. Logistic regression was used to assess the association between DEB and SB. RESULTS Of 273 eligible participants (female, n = 110 [40.3%]), the mean of emotional, restrained and external eating was 1.9 [0.6], 2.0 [0.6] and 3.0 [0.5] respectively. Overall, 57 (20.9%) were grouped into the latent high SB class. Emotional (Adjusted odds ratio, AOR [95% confidence interval, CI]: 1.0 [0.9-1.0], p = 0.398), restrained (AOR, 1.0 [CI: 0.9-1.1], p = 0.301) and External (AOR, 1.0 [CI: 0.8-1.2], p = 0.523) eating were not independently associated with latent high SB. CONCLUSION There was no significant association between DEB and SB in this study sample. In low- and middle-income countries like Kenya, interventions targeted at DEB among emerging adults towards controlling SB are unnecessary.
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Affiliation(s)
- Stevenson K. Chea
- Department of Nursing Sciences, School of Health and Human Sciences, Pwani University, Kilifi, Kenya
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Adama Kazienga
- Department of Translational Physiology, Infectiology and Public Health, Ghent University, Merelbeke, Belgium
| | - Eunice A. Oyugi
- Centre for Geographic Medicine Research, Kenya Medical Research Institute, Kilifi, Kenya
| | - Isaac Menza
- Centre for Geographic Medicine Research, Kenya Medical Research Institute, Kilifi, Kenya
| | - Carophine Nasambu
- Centre for Geographic Medicine Research, Kenya Medical Research Institute, Kilifi, Kenya
| | | | - Osman A. Abdullahi
- Department of Public Health, School of Health and Human Sciences, Pwani University, Kilifi, Kenya
| | - Amin S. Hassan
- Centre for Geographic Medicine Research, Kenya Medical Research Institute, Kilifi, Kenya
- Department of Public Health, School of Health and Human Sciences, Pwani University, Kilifi, Kenya
| | - Amina Abubakar
- Centre for Geographic Medicine Research, Kenya Medical Research Institute, Kilifi, Kenya
- Department of Public Health, School of Health and Human Sciences, Pwani University, Kilifi, Kenya
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Kristien Michielsen
- Department of Neurosciences, Institute for Family and Sexuality Studies, Faculty of Medicine, Catholic University of Leuven (KU Leven), Leven, Belgium
| | - Souheila Abbeddou
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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Mlandu C, Machisa M, Christofides N. Consistent condom use among Botswana's female population and associated factors. WOMEN'S HEALTH (LONDON, ENGLAND) 2024; 20:17455057241266453. [PMID: 39135506 PMCID: PMC11320669 DOI: 10.1177/17455057241266453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 05/20/2024] [Accepted: 06/18/2024] [Indexed: 08/15/2024]
Abstract
BACKGROUND Botswana is one of the countries severely impacted by the HIV/AIDS pandemic. Despite an extensive HIV prevention campaign, the incidence of HIV, particularly among women, remains high. Condoms play a significant role in preventing new HIV infections, although men and women do not consistently use them. OBJECTIVE The study assessed the individual, relationship and community factors associated with consistent condom use among women in Botswana. DESIGN A cross-sectional study using secondary data drawn from a national survey on Gender-Based Violence Indicators in 2012. METHODS The primary survey sampled 639 women, aged 18 years and older, using a multistage procedure. The final sample size for the secondary analysis included a total of 480 women who were sexually experienced and had reported using condoms with their male partners. Multivariate logistic regression analysis was employed to assess the association between consistent condom use and the explanatory variables. The multivariate logistic regression adjusted for cluster/community random effects. RESULTS About 43% of the women used condoms consistently in the past year. Consistent condom use was more likely among women who were employed in the past year (adjusted odds ratio = 1.77; 95% confidence interval = 1.25-2.50). While, women who lived with their partners (adjusted odds ratio = 0.46; 95% confidence interval = 0.28-0.74), had non-Christian beliefs (adjusted odds ratio = 0.52; 95% confidence interval = 0.29-0.92), perceived that their partners would be angry if they ask to use a condom (adjusted odds ratio = 0.19; 95% confidence interval = 0.06-0.58) and perceived that their community says women need their husband's permission to do paid work (adjusted odds ratio = 0.56; 95% confidence interval = 0.38-0.83) were less likely to use condoms consistently. CONCLUSION Consistent condom use among Botswana's female population is suboptimal. Consistent condom use was higher among women with employment, and lower among women who lived with their partners, had non-Christian beliefs, feared their partners' reaction upon asking for condom use and held inequitable community gender beliefs. To enhance women's consistent use of condoms, friendly condom use information, female economic empowerment strategies and programmes that involve religious leaders and promote progressive and healthy masculine practices in Sexual Reproductive Health/HIV interventions should be considered.
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Affiliation(s)
- Chenai Mlandu
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Mercilene Machisa
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Nicola Christofides
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
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Simelane MS, Chemhaka GB, Shabalala FS, Simelane PT, Vilakati Z. Prevalence and determinants of inconsistent condom use among unmarried sexually active youth. a secondary analysis of the 2016-2017 Eswatini HIV incidence measurement survey. Afr Health Sci 2023; 23:400-409. [PMID: 37545960 PMCID: PMC10398441 DOI: 10.4314/ahs.v23i1.42] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023] Open
Abstract
INTRODUCTION In sub-Saharan Africa, youth continue to have a high burden of sexually transmitted infections and unplanned pregnancies that could be reduced through improved condom use. We aimed to investigate inconsistent condom use with the three most recent sexual partners among unmarried sexually active youth in Eswatini. METHODS Data were analysed for 1,324 youth from the 2016-2017 Swaziland HIV incidence measurement survey (SHIMS2) using multivariable logistic regression method. RESULTS The prevalence of inconsistent condom use among youth was 56.8% in 2017. Higher odds of inconsistent condom use were observed among youth aged 20-24, residents in the Lubombo region, those aged less than 18 years at sexual debut and those who had two or more sexual partners in the last 12 months before the survey. Lower odds of inconsistent condom use were observed among males, and those that knew their partners reported HIV status to be negative. CONCLUSION Our findings highlight a notable prevalence of inconsistent condom use among youth in Eswatini. Programs that aim to reduce the incidence of HIV infections and STIs among youth in Eswatini should focus on these factors associated with inconsistent condom use.
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Affiliation(s)
- Maswati S Simelane
- Department of Statistics and Demography, Faculty of Social Sciences, University of Eswatini, Kwaluseni, Eswatini
| | - Garikayi B Chemhaka
- Department of Statistics and Demography, Faculty of Social Sciences, University of Eswatini, Kwaluseni, Eswatini
| | - Fortunate S Shabalala
- Department of Community Health Nursing Science, Faculty of Health Sciences, University of Eswatini, Mbabane, Eswatini
| | - Portia T Simelane
- Department of Human and Social Sciences, Townsville, Education Office, Queensland, Australia
| | - Zodwa Vilakati
- Department of Statistics and Demography, Faculty of Social Sciences, University of Eswatini, Kwaluseni, Eswatini
- Department of Population Studies, University of Zambia
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Envuladu EA, Massar K, de Wit JBF. Diversities of Sexual Activities and Correlates of Safe Sex Practices Among Adolescents in Plateau State, Nigeria. FRONTIERS IN REPRODUCTIVE HEALTH 2021; 3:744622. [PMID: 36303998 PMCID: PMC9580655 DOI: 10.3389/frph.2021.744622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 10/20/2021] [Indexed: 11/24/2022] Open
Abstract
Background: Unsafe sex, particularly, condomless sex exposes adolescents to sexual and reproductive health risks. This study aimed to assess the sexual experiences and to determine the most important covariates of sexual activity and consistent condom use among adolescents in Plateau State, Nigeria. Methods: A cross sectional survey was conducted among 428 adolescents selected from 6 LGAs through a multistage sampling technique. The data was analyzed using the IBM Statistical package for Social Sciences (SPSS) version 23, multiple logistic regression was conducted to determine the covariates of sexual activity and condom use. Results: About one third (38%) of the adolescents were sexually active, 5.7% had same sex partners, 70% had more than one sexual partner and majority (72.4%) were not consistently using condom during sex. Logistic regression results showed that older adolescents (OR = 5.73; CI = 3.72–8.12; p = 0.001) and out of school adolescents (OR = 2.68; CI = 1.79–4.00; p = 0.001) were more likely to be sexually active, while multivariable logistic regression analysis showed age (AOR = 0.33; CI = 0.12–0.90; p = 0.031) and gender as important covariates of being sexually active, (AOR = 6.29; CI = 3.18–12.44; p = 0.001). Inconsistent condom use was more likely among adolescents; with lower education, (OR = 2.14; CI = 1.19–3.85; p = 0.011), having sex with older partners (OR = 0.61; CI = 0.42–0.90; P = 0.013) and with low awareness of SRH issues (OR = 2.08; CI = 1.02–4.22; p = 0.044). The multivariable logistic regression however, showed gender, being male (AOR = 0.43; CI = 0.006–3.09; p = 0.023) as covariate of consistent condom use. Conclusion: Most sexually active adolescents had multiple sexual partners, some had same sex partners and majority were not consistently using condom. Older adolescents and those out of school were more likely to be sexually active. Awareness of SRH issues significantly influenced condom use while gender, specifically being male, was the independent covariate for being sexually active and for consistent condom use. We recommend sexual health intervention targeted at adolescents. In addition, gender should be mainstreamed into adolescent sexual and reproductive health programmes.
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Affiliation(s)
- Esther Awazzi Envuladu
- Department of Community Medicine, College of Health Sciences, University of Jos, Jos, Nigeria
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, Netherlands
- *Correspondence: Esther Awazzi Envuladu
| | - Karlijn Massar
- Department of Work and Social Psychology, Maastricht University, Maastricht, Netherlands
| | - John B. F. de Wit
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, Netherlands
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Wang Q, Chang R, Wang Y, Jiang X, Zhang S, Shen Q, Wang Z, Ma T, Lau JTF, Cai Y. Correlates of alcohol and illicit drug use before commercial sex among transgender women with a history of sex work in China. Sex Health 2020; 17:45-52. [DOI: 10.1071/sh18194] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Accepted: 08/13/2019] [Indexed: 12/27/2022]
Abstract
Background Research on substance use among transgender female sex workers in China is scarce. The aims of this study were to examine: (1) the prevalence of alcohol or illicit drug use before commercial sex among this population; and (2) correlates of alcohol and illicit drug use. Methods: Complete survey data were analysed from 397 transgender female sex workers recruited from three of the largest cities in China: Shenyang, Shanghai and Guangzhou. Information was collected about demographics, alcohol or illicit drug use, alone or in combination, and their psychosocial correlates using structured questionnaires. Multinomial logistic regression models were used to examine the association between substance use and its correlates. Results: Before commercial sex, approximately one-third of the sample reported exclusive alcohol use (28.5%), 9.3% reported exclusive drug use and 7.3% reported combined use of alcohol and drugs. Before commercial sex, participants with low self-esteem had twice the odds of using alcohol exclusively (adjusted odds ratio (aOR) 2.05; 95% confidence interval (CI) 1.01–4.17), those with higher levels of loneliness had almost threefold the odds of exclusive drug use (aOR 2.92; 95% CI 1.21–7.07) and those with depression (aOR 2.97; 95% CI 1.11–7.96) and unknown HIV status (aOR 3.00; 95% CI 1.02–8.87) had threefold the odds of combined use of alcohol and drugs. Conclusion: Programs aimed at reducing alcohol or drug use among transgender female sex workers in China may consider adding components that help support mental health and encouraging HIV screening.
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Ssebunya RN, Matovu JKB, Makumbi FE, Kisitu GP, Maganda A, Kekitiinwa A. Factors associated with prior engagement in high-risk sexual behaviours among adolescents (10-19 years) in a pastoralist post-conflict community, Karamoja sub-region, North eastern Uganda. BMC Public Health 2019; 19:1027. [PMID: 31366339 PMCID: PMC6670181 DOI: 10.1186/s12889-019-7352-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 07/22/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adolescent sexual risky behaviours continue to be significant drivers of the HIV epidemic globally. The objective of this study was to determine factors associated with prior engagement in high-risk sexual behaviours among adolescents (10-19 years) in Karamoja sub-region, a pastoralist and post-conflict community in North-eastern Uganda. METHODS Between August and September 2016, we conducted a cross-sectional study among 1439 adolescents receiving primary healthcare services at nine public health facilities located in five of the seven districts that make up Karamoja sub-region. High-risk sexual behaviour was defined as engaging in sex with two or more (2+) sexual partners in the 6 months preceding the survey or exchanging sex for money or gifts with no or inconsistent use of condoms over the same period of time. Factors associated with prior engagement in high-risk sexual behaviours were analysed using a modified Poison regression model with log-link and Poisson-family via a generalized linear model. RESULTS Eighty-two percent (81.8%, n = 1177) of the respondents had ever tested for HIV while 62 % (61.5%, n = 885) had ever had sex. Of those that had ever had sex, 11.4% (n = 101) reported prior engagement in high-risk sexual behaviours. Prior engagement in high-risk sexual behaviours was lower among men than women (adjusted prevalence ratio (adj. PR) = 0.46; 95% Confidence Interval (95% CI): 0.33, 0.62) and those whose sex debut was above 14 years (adj.PR = 0.63; 95% CI: 0.57, 0.69). However, prior engagement in high-risk sexual behaviours was significantly higher in adolescents who were not aware of their recent sexual partner's HIV status (adj.PR = 2.43; 95% CI: 1.68, 3.52) and those who used illicit drugs (adj.PR = 2.76; 95% CI: 1.88, 4.05). CONCLUSION Prior engagement in high-risk sexual behaviours was significantly associated with having sex with partners of unknown HIV sero-status and use of illicit drugs. These findings suggest a need for targeted interventions to improve mutual HIV status disclosure between sexual partners while minimizing their use of illicit drugs/substances.
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Affiliation(s)
- Rogers N Ssebunya
- Directorate of Research, Monitoring and Evaluation, Baylor College of Medicine Children's Foundation, P.O. Box 72052, Kampala, Uganda.
| | - Joseph K B Matovu
- Department of Disease Control and Environmental Health, School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda.,Department of Community and Public Health, Busitema University Faculty of Health Sciences, Mbale, Uganda
| | - Fredrick E Makumbi
- Department of Epidemiology and Biostatistics, School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Grace P Kisitu
- Directorate of Research, Monitoring and Evaluation, Baylor College of Medicine Children's Foundation, P.O. Box 72052, Kampala, Uganda
| | - Albert Maganda
- Directorate of Research, Monitoring and Evaluation, Baylor College of Medicine Children's Foundation, P.O. Box 72052, Kampala, Uganda
| | - Adeodata Kekitiinwa
- Directorate of Research, Monitoring and Evaluation, Baylor College of Medicine Children's Foundation, P.O. Box 72052, Kampala, Uganda
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Maenetje P, Lindan C, Makkan H, Chetty-Makkan CM, Latka MH, Charalambous S, Mlotshwa M, Malefo M, Brumskine W, Hills NK, Price MA, Edward V. HIV incidence and predictors of inconsistent condom use among adult men enrolled into an HIV vaccine preparedness study, Rustenburg, South Africa. PLoS One 2019; 14:e0214786. [PMID: 30943254 PMCID: PMC6447216 DOI: 10.1371/journal.pone.0214786] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 03/20/2019] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Understanding HIV incidence and risk behaviour among populations being considered for HIV vaccine studies is necessary for the appropriate design of trials. METHODS Between May 2012 and June 2015, we recruited men aged 18-49 years from urban and peri-urban areas of Rustenburg, a mining town in the North West Province, South Africa. Men who reported HIV-risk behaviour were followed for nine to 12 months to determine HIV incidence and factors associated with condom use. RESULTS A total of 400 HIV uninfected men were enrolled; 366 (91.5%) had at least one follow-up visit and were included in the analysis; 47.6% were under 25 years of age. HIV incidence was 1.9 per 100 person-years (95% CI: 0.79-4.56). Among heterosexual men (N = 339), 80.8% reported having vaginal intercourse with multiple partners in the past three months, among whom 74.1% reported inconsistent condom use. Sixty-eight percent reported vaginal intercourse with new female partners, of whom 40.6% reported inconsistent condom use. Over half (55.6%) of men who had sex with men (N = 27) reported anal intercourse with multiple male partners in the past three months, of whom 68.2% reported using condoms inconsistently. Men who had more than two female partners in the last three months (n = 121) were more likely to use condoms inconsistently (aOR 4.31, 95% CI: 1.34-13.8); in contrast, those with more than one new female sex partner (aOR 0.13, 94% CI 0.04-0.44), and whose sexual debut was after 19 years of age (aOR 0.39, 95% CI: 0.15-1.01) were less likely to use condoms inconsistently. CONCLUSION HIV incidence was low and similar to other studies of heterosexual men in South Africa. To identify men at high risk for HIV for enrolment in prevention trials, future researchers may need to focus on those who report early sexual debut and who report having multiple sexual partners. Men in newer relationships appear to use condoms more frequently.
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Affiliation(s)
- Pholo Maenetje
- The Aurum Institute, Johannesburg, South Africa
- Advancing Care and Treatment for TB/HIV, A Collaborating Centre of the South African Medical Research Council, Johannesburg, South Africa
- School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Christina Lindan
- Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, United States of America
| | | | | | | | - Salome Charalambous
- The Aurum Institute, Johannesburg, South Africa
- Advancing Care and Treatment for TB/HIV, A Collaborating Centre of the South African Medical Research Council, Johannesburg, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Mandla Mlotshwa
- The Aurum Institute, Johannesburg, South Africa
- Advancing Care and Treatment for TB/HIV, A Collaborating Centre of the South African Medical Research Council, Johannesburg, South Africa
- School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | | | - Nancy K. Hills
- Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, United States of America
| | - Matthew A. Price
- Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, United States of America
- International AIDS Vaccine Initiative, New York, United States of America
| | - Vinodh Edward
- The Aurum Institute, Johannesburg, South Africa
- Advancing Care and Treatment for TB/HIV, A Collaborating Centre of the South African Medical Research Council, Johannesburg, South Africa
- School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Boraya JO, Githae C, Atandi TA, Gachau A. Social and psychological factors affecting utilization of female condom among youths in Migori County, Kenya. Health Psychol Open 2018; 5:2055102918815336. [PMID: 30619618 PMCID: PMC6299911 DOI: 10.1177/2055102918815336] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The female condom is a dual protection tool for both prevention of HIV/AIDS transmission and conception of unwanted pregnancies. In Migori, HIV prevalence is 16 percent and utilization of female condom is at 0.3 percent. A descriptive cross-sectional study was conducted among 380 youths who were systematically and randomly sampled. Majority of youths (86.6%) were aged between 18 and 25 years with 83.9 percent being single, 95.3 percent were Christians, and 4.7 percent Muslim. There was a significant association between marital status, Men's role in negotiation of safe sex, incompetence in female condom insertion, and utilization of the female condom.
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Bain LE, Kongnyuy EJ. Eliminating the high abortion related complications and deaths in Cameroon: the restrictive legal atmosphere on abortions is no acceptable excuse. BMC WOMENS HEALTH 2018; 18:71. [PMID: 29793462 PMCID: PMC5968528 DOI: 10.1186/s12905-018-0564-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/24/2016] [Accepted: 05/15/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND The abortion law in Cameroon is highly restrictive. The law permits induced abortions only when the woman's life is at risk, to preserve her physical and mental health, and on grounds of rape or incest. Unsafe abortions remain rampant with however rare reported cases of persecution, even when these abortions are proven to have been carried out illegally. DISCUSSION Available public health interventions are cheap and feasible (Misoprostol and Manual Vacuum Aspiration in post abortion care, modern contraception, post-abortion counseling), and must be implemented to reduce unacceptably high maternal mortality rates in the country which still stand at as high as 596/100.000. Changes in the legal status of abortions might take a long time to come by. Albeit, advocacy efforts must be reinforced to render the law more liberal to permit women to seek safe abortion services. The frequency of abortions, generally clandestine, in this restrictive legal atmosphere has adverse economic, health and social justice implications. CONCLUSION We argue that a non-optimal or restrictive legal atmosphere is not an acceptable excuse to justify these high maternal deaths resulting from unsafe abortions, especially in Cameroon where unsafe abortions remain rampant. Implementing currently available, cheap and effective evidence based practice guidelines are possible in the country. Expansion and use of Manual Vacuum Aspiration kits in health care facilities, post-abortion misoprostol and carefully considering the content of post abortion counseling packages deserve keen attention. More large scale qualitative and quantitative studies nationwide to identify and act on context specific barriers to contraception use and abortion related stigma are urgently needed.
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Affiliation(s)
- Luchuo Engelbert Bain
- Centre for Population Studies and Health Promotion, CPSHP, Yaounde, Cameroon. .,Athena Institute for Research on Innovation and Communication in Health & Life Sciences, Faculty of Earth and Life Sciences, Vrije Universiteit, Amsterdam, The Netherlands.
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Sousa CSPD, Castro RCMB, Pinheiro AKB, Moura ERF, Almeida PC, Aquino PDS. Cross-cultural adaptation and validation of the Condom Self-Efficacy Scale: application to Brazilian adolescents and young adults. Rev Lat Am Enfermagem 2018; 25:e2991. [PMID: 29319748 PMCID: PMC5768214 DOI: 10.1590/1518-8345.1062.2991] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Accepted: 07/12/2016] [Indexed: 11/22/2022] Open
Abstract
Objective: translate and adapt the Condom Self-Efficacy Scale to Portuguese in the Brazilian
context. The scale originated in the United States and measures self-efficacy in
condom use. Method: methodological study in two phases: translation, cross-cultural adaptation and
verification of psychometric properties. The translation and adaptation process
involved four translators, one mediator of the synthesis and five health
professionals. The content validity was verified using the Content Validation
Index, based on 22 experts’ judgments. Forty subjects participated in the pretest,
who contributed to the understanding of the scale items. The scale was applied to
209 students between 13 and 26 years of age from a school affiliated with the
state-owned educational network. The reliability was analyzed by means of
Cronbach’s alpha. Results: the Portuguese version of the scale obtained a Cronbach’s alpha coefficient of
0.85 and the total mean score was 68.1 points. A statistically significant
relation was found between the total scale and the variables not having children
(p= 0.038), condom use (p= 0.008) and condom use with fixed partner (p=0.036).
Conclusion: the Brazilian version of the Condom Self-Efficacy Scale is a valid and reliable
tool to verify the self-efficacy in condom use among adolescents and young
adults.
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Affiliation(s)
| | | | | | | | - Paulo César Almeida
- PhD, Adjunct Professor, Universidade Estadual do Ceará, Fortaleza, CE, Brazil
| | - Priscila de Souza Aquino
- PhD, Adjunct Professor, Departamento de Enfermagem, Universidade Federal do Ceará, Fortaleza, CE, Brazil
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Young JR, Sawe HR, Mfinanga JA, Nshom E, Helm E, Moore CG, Runyon MS, Reynolds SL. Subdissociative intranasal ketamine plus standard pain therapy versus standard pain therapy in the treatment of paediatric sickle cell disease vaso-occlusive crises in resource-limited settings: study protocol for a randomised controlled trial. BMJ Open 2017; 7:e017190. [PMID: 28698351 PMCID: PMC5541700 DOI: 10.1136/bmjopen-2017-017190] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION Pediatric sickle cell disease, highly prevalent in sub-Saharan Africa, carries great morbidity and mortality risk. Limited resources and monitoring make management of acute vaso-occlusive crises challenging. This study aims to evaluate the efficacy and safety of subdissociative intranasal ketamine as a cheap, readily available and easily administered adjunct to standard pain therapy. We hypothesise that subdissociative, intranasal ketamine may significantly augment current approaches to pain management in resource-limited settings in a safe and cost-effective manner. METHODS AND ANALYSIS This is a multicentred, randomised, double-blind, placebo-controlled trial enrolling children 4-16 years of age with sickle cell disease and painful vaso-occlusive pain crises. Study sites include two sub-Saharan teaching and referral hospitals with acute intake areas. All patients receive standard analgesic therapy during evaluation. Patients randomised to the treatment arm receive 1 mg/kg intranasal ketamine at onset of therapy, while placebo arm participants receive volume-matched intranasal normal saline. All participants and clinical staff are blinded to the treatment allocation. Data will be analysed on an intention-to-treat basis. Primary endpoints are changes in self-report pain scales (Faces Pain Scale-Revised) at 30, 60 and 120 minutes and rates of adverse events. Secondary endpoints include hospital length of stay, total analgesia use and quality of life assessment 2-3 weeks postintervention. ETHICS AND DISSEMINATION The research methods for this study have been approved by the Cameroon Baptist Convention Health Board Institutional Review Board (IRB2015-07), the Tanzanian National Institute for Medical Research (NIMR/HQ/R.8a/Vol. IX/2299), Muhimbili National Hospital IRB (MNH/IRB/I/2015/14) and the Tanzanian Food and Drugs Authority (TFDA0015/CTR/0015/9). Data reports will be provided to the Data and Safety Monitoring Board (DSMB) periodically throughout the study as well as all reports of adverse events. All protocol amendments will also be reviewed by the DSMB. Study results, regardless of direction or amplitude, will be submitted for publication in relevant peer-reviewed journals. TRIAL REGISTRATION ClinicalTrials.Gov, NCT02573714. Date of registration: 8 October 2015. Pre-results.
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Affiliation(s)
- James R Young
- Division of Pediatric Emergency Medicine, Department of Emergency Medicine, Carolinas Medical Center, Charlotte, North Carolina, USA
| | - Hendry Robert Sawe
- Deparment of Emergency Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, United Republic of Tanzania
| | - Juma A Mfinanga
- Department of Emergency Medicine, Muhimbili National Hospital, Dar es Salaam, United Republic of Tanzania
| | - Ernest Nshom
- Department of Internal Medicine, CIMS, Mbingo Baptist Hospital, Cameroon Baptist Convention, Mbingo, Cameroon
| | - Ethan Helm
- Department of Pediatrics, Mbingo Baptist Hospital, Cameroon Baptist Convention, Mbingo, Cameroon
| | - Charity G Moore
- Center for Outcomes Research and Evaluation, Carolinas HealthCare System, Charlotte, North Carolina, USA
| | - Michael S Runyon
- Division of Pediatric Emergency Medicine, Department of Emergency Medicine, Carolinas Medical Center, Charlotte, North Carolina, USA
| | - Stacy L Reynolds
- Division of Pediatric Emergency Medicine, Department of Emergency Medicine, Carolinas Medical Center, Charlotte, North Carolina, USA
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Pilapil M, Morris L, Saito K, Kouya F, Maku V, Kwalar R, Palmer N, Tih PM, Jao J. Retrospective analysis of the prevalence of and factors associated with condom use among young HIV-infected women in Cameroon. SAGE Open Med 2016; 4:2050312115626432. [PMID: 26835019 PMCID: PMC4724765 DOI: 10.1177/2050312115626432] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Accepted: 12/15/2015] [Indexed: 12/02/2022] Open
Abstract
Objectives: Young women are more likely to be infected with HIV globally, in sub-Saharan Africa, and in Cameroon. Despite its clear clinical and public health benefits, condom use among HIV-infected women continues to be low. The objective of this study was to describe the prevalence of inconsistent condom use among HIV-infected women in Cameroon and the factors associated with it. Methods: We conducted a cross-sectional study of HIV-infected young women aged 17–26 years from three semi-urban HIV clinics in the Northwest Region of Cameroon. This study was a subgroup analysis of a previously reported study on inconsistent condom use in HIV-infected and -uninfected youth. Inconsistent condom use was defined as reporting “sometimes” or “never” to questions regarding frequency of condom use. Logistic regression modeling was used to determine factors associated with inconsistent condom use. Results: A total of 84 participants were recruited and submitted completed questionnaires for analysis. Median age was 24 years (interquartile range = 22–25) and the median age at HIV diagnosis was 21 years (interquartile range = 20–23). Fifty percent of the participants reported no prior schooling or only primary school education. Overall, 61/84 (73%) reported inconsistent condom use. After adjusting for potential confounders, education to the secondary school level was protective against inconsistent condom use (odds ratio = 0.19; confidence interval: 0.04–0.95), and having ≥2 pregnancies was associated with inconsistent condom use (odds ratio = 7.52; confidence interval: 1.67–34.00). Conclusion: There is a high prevalence of inconsistent condom use among young HIV-infected women in Cameroon, which appears to be associated with lower levels of educational attainment and higher parity. Further larger studies assessing the factors associated with poor condom use in this population are warranted and may inform public health policy in resource-limited settings with high HIV prevalence.
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Affiliation(s)
- Mariecel Pilapil
- Division of General Internal Medicine, Department of Medicine and Division of General Pediatrics, Department of Pediatrics, Hofstra Northwell School of Medicine, Lake Success, NY, USA
| | - Lee Morris
- Division of Pediatric Infectious Disease and Immunology, Department of Pediatrics, Levine Children's Hospital, Carolinas Healthcare System, Charlotte, NC, USA
| | - Kohta Saito
- Division of Infectious Diseases, Department of Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Francine Kouya
- Cameroon Baptist Convention Health Services, Bamenda, Cameroon
| | - Vivian Maku
- Cameroon Baptist Convention Health Services, Bamenda, Cameroon
| | - Rene Kwalar
- Cameroon Baptist Convention Health Services, Bamenda, Cameroon
| | - Nancy Palmer
- Cameroon Baptist Convention Health Services, Bamenda, Cameroon
| | - Pius Muffih Tih
- Cameroon Baptist Convention Health Services, Bamenda, Cameroon
| | - Jennifer Jao
- Division of Infectious Diseases, Department of Medicine and Division of General Internal Medicine, Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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