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Carlos S, Reina G, Burgueño E, Makonda B, de Irala J, Beltramo C, Díaz Herráez P, Burgo CLD. Prevalence of Paid Sex and Associated Factors Among Women and Men Attending HIV Voluntary Counseling and Testing in Kinshasa, Democratic Republic of the Congo: A Prospective Cohort. ARCHIVES OF SEXUAL BEHAVIOR 2024:10.1007/s10508-024-02939-w. [PMID: 39147958 DOI: 10.1007/s10508-024-02939-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 06/02/2024] [Accepted: 06/09/2024] [Indexed: 08/17/2024]
Abstract
Paid sex is associated with HIV and other sexually transmitted infections, which are highly prevalent in Sub-Saharan Africa (SSA). However, few data exist on this sexual practice among the general population in SSA, including the Democratic Republic of the Congo, where data on paid sex mainly comes from sex workers. In the DRC, most HIV Voluntary Counseling and Testing (VCT) centers do not discuss paid sex as a risk factor. Thus, we aimed to analyze the prevalence of paid sex, its associated factors and association with HIV among women and men attending HIV VCT at a reference hospital in Kinshasa. From 2016 to 2018, the Observational Kinshasa AIDS Initiative cohort analyzed the impact of HIV VCT on changes in HIV knowledge, attitudes, and sexual behaviors at follow-up. Participants aged 15-69 years were HIV tested and interviewed at baseline and at 6- and 12-month follow-ups. At baseline, participants were asked about their history of "ever" having had exchanged sex for money. At both follow-ups, the frequency of this practice was referred to as "the previous 6 months." Descriptive, bivariate, and multivariate logistic regression analyses were carried out to evaluate the prevalence of paid sex, its associated factors, and the association between paid sex and HIV. Statistical analyses were performed with Stata 15.1. Among 797 participants at baseline, 10% of those sexually experienced reported having ever had paid sex (18% men and 4% women, p < 0.001). At 6 and 12-month follow-ups, 5% and 2%, respectively. Paid sex was significantly and independently associated with being male (aOR = 2.7; 95% CI = 1.4-5.2), working or studying (aOR = 2.8; 95% CI = 1.5-5.0), daily newspaper reading (aOR = 4.4; 95% CI = 1.7-11.2); daily/weekly alcohol consumption (aOR = 3.3; 95% CI = 1.8-6.1), first sexual intercourse before age 15 years (aOR = 2.3; 95% CI = 1.1-5.0), multiple sexual partners (aOR = 4.1; 95% CI = 2.2-7.7), and extragenital sexual practices (aOR = 2.4; 95% CI = 1.3-4.4). A high religiosity (daily/weekly church attendance and praying) was inversely associated with paid sex (aOR = 0.1; 95% CI = 0.0-0.4). The high prevalence of paid sex among people attending HIV VCT in Kinshasa, associated with other sexual and consumption risk behaviors, highlights the need to include paid sex among the risk factors mentioned in HIV prevention counseling.
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Affiliation(s)
- Silvia Carlos
- Preventive Medicine and Public Health Department, University of Navarra, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
- Institute for Culture and Society, University of Navarra, Pamplona, Spain
| | - Gabriel Reina
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain.
- Infectious Diseases and Microbiology Department, Clínica Universidad de Navarra, Pio XII Av, 36, 31008, Pamplona, Spain.
| | - Eduardo Burgueño
- Soins Primaires Monkole, Kinshasa, Democratic Republic of Congo
- Faculté de Médecine, Université Officielle de Mbujimayi, Kinshasa, Democratic Republic of the Congo
| | - Benit Makonda
- CEFA-Monkole, Kinshasa, Democratic Republic of the Congo
| | - Jokin de Irala
- Preventive Medicine and Public Health Department, University of Navarra, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
- Institute for Culture and Society, University of Navarra, Pamplona, Spain
| | - Carlos Beltramo
- Institute for Culture and Society, University of Navarra, Pamplona, Spain
| | | | - Cristina Lopez-Del Burgo
- Preventive Medicine and Public Health Department, University of Navarra, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
- Institute for Culture and Society, University of Navarra, Pamplona, Spain
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Dadras O, El Saaidi C. Risk-stratified analysis of sex risk behaviors and correlates among school-going adolescents in Argentina: insights from a national survey. Int J Adolesc Med Health 2024; 36:291-298. [PMID: 38833625 DOI: 10.1515/ijamh-2024-0007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 05/24/2024] [Indexed: 06/06/2024]
Abstract
OBJECTIVES This study was conducted to address a critical gap in understanding adolescent sexual health risks in Argentina, a country that has undergone substantial socio-economic changes that made significant strides in education and healthcare. METHODS A secondary data analysis of the 2018 Argentina Global School-based Student Health Survey was performed. In this study, 23,262 sexually active adolescents were categorized into four risk groups based on the predicted granular risk: number of sexual partners and condom use in their last sexual encounter. RESULTS Males and older adolescents were more prone to high-risk sexual behaviors. Additionally, key psychosocial factors such as loneliness, anxiety, experiences of violence, and school absenteeism were significantly associated with high-risk sexual behaviors. Early alcohol use and recent experiences of hunger were also identified as strong predictors of heightened sexual risk behaviors. Conversely, positive parental engagement and awareness exhibited protective factors. CONCLUSIONS These findings highlight the necessity for policy interventions that focus on mental health support, parental involvement, and awareness of adolescent issues and activities.
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Affiliation(s)
- Omid Dadras
- Department of Global Public Health and Primary Care, 1658 University of Bergen , Bergen, Norway
- Bergen Addiction Research, Department of Addiction Medicine, Haukland University Hospital, Bergen, Norway
| | - Christina El Saaidi
- Metropolitan Health District - The City of San Antonio Texas, San Antonio, USA
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Jara H, Damena M, Urgessa K, Deressa A, Debella A, Mussa I, Mohammed A, Weldegebreal F. Consistent Condom Use and Associated Factors among sexually active Military Personnel in Eastern Ethiopia: Cross-Sectional Study Design. Risk Manag Healthc Policy 2022; 15:2057-2070. [PMID: 36386556 PMCID: PMC9642798 DOI: 10.2147/rmhp.s375340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 09/23/2022] [Indexed: 11/06/2022] Open
Abstract
Background A condom is a latex-based device used to prevent pregnancy and sexually transmitted infections (STIs). Despite condom availability and promotion for use in STI prevention, consistent condom use remains too low in Ethiopia. A significant proportion of Ethiopian military personnel had multiple sexual partners, with lower rates of condom use with non-regular sexual partners. As a result, determining the pattern of condom use and the factors associated with it among military personnel is critical. Objective The purpose of this study was to evaluate consistent condom use and associated factors among sexually active military personnel in Eastern Ethiopia from February 1 to 28, 2020. Methods A cross-sectional study was conducted among 327 sexually active military personnel. To select the study participants, a systematic sampling technique was used. The data were entered into EpiData and exported to the Statistical Package for Social Sciences version 20 for analysis. To identify factors associated with condom use, bivariate and multivariable logistic regression analysis were used, and the strength of the association was measured using odds ratio and 95% confidence interval (CI), with P-values less than 0.05 considered statistically significant. Results The overall prevalence of consistent condom uses over one year by the respondents was 59.9% (95% CI: 54, 65). Study participants with an age of 30–35 years old (AOR = 3.12; 95% CI: 1.43, 11.38), above 35 years old (AOR = 2.42; 95% CI: 1.83, 9.30), college and above in educational status (AOR = 1.52; 95% CI: 1.20, 5.43), Officer in military rank (AOR = 3.12; 95% CI: 1.14, 10.15) and other military ranks (AOR = 3.08; 2.33, 8.52) were factors facilitate the use of condom consistently. Conclusion In this study, two in every five military personnel use condoms inconsistently. Designing appropriate intervention and behavioral change strategies, as well as increasing the accessibility and availability of condoms around military camps, will undoubtedly have a significant impact on consistent condom utilization.
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Affiliation(s)
- Hussen Jara
- Department of Public Health, Eastern Command, Harar, Ethiopia
| | - Melake Damena
- Department of Public Health and Health Policy, Haramaya University, Harar, Ethiopia
| | - Kedir Urgessa
- Department of Medical Laboratory Sciences, Haramaya University, Harar, Ethiopia
| | - Alemayehu Deressa
- Department of Public Health and Health Policy, Haramaya University, Harar, Ethiopia
- Correspondence: Alemayehu Deressa, Public Health and Health Policy Department, Haramaya University, P. O. Box: 235, Harar, Ethiopia, Tel +251 917841709, Fax +251 256668081, Email
| | - Adera Debella
- Department of Midwifery, Haramaya University, Harar, Ethiopia
| | - Ibsa Mussa
- Department of Public Health and Health Policy, Haramaya University, Harar, Ethiopia
| | - Ahmed Mohammed
- Department of Medicine, Haramaya University, Harar, Ethiopia
| | - Fitsum Weldegebreal
- Department of Medical Laboratory Sciences, Haramaya University, Harar, Ethiopia
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