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Wogayehu B, Demissie T, Wolka E, Alemayehu M, Daka K. Individual and community-level factors associated with khat ( Catha edulis) use among women of reproductive age in Halaba zone, South Ethiopia: a multilevel mixed effect analysis. Front Psychiatry 2024; 15:1333556. [PMID: 38439793 PMCID: PMC10910081 DOI: 10.3389/fpsyt.2024.1333556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 01/30/2024] [Indexed: 03/06/2024] Open
Abstract
Introduction There is a paucity of data on factors associated with khat chewing among women of reproductive age using multilevel analysis. Furthermore, the effects of some potential factors like stressful life events, knowledge about and attitude toward the effects of khat have been given little attention and are not well understood. Therefore, this study aimed to examine the prevalence and multilevel factors associated with khat use among women of reproductive age in Halaba zone, South Ethiopia. Methods A community-based cross sectional study was conducted in Halaba zone from February to July, 2023. Systematic random sampling technique was used to include 1573 study participants. The dependent variable was current khat use, which is operationalized as using khat within 30 days preceding the study. An interviewer administered questionnaire was used for the data collection. Results The prevalence of current khat use among women of reproductive age was 65.9% [95%CI (63.5-68.2%)]. Factors significantly associated with khat use were; ages of women 35 and above years [Adjusted Odds Ratio (AOR) = 6.35, 95% CI: (3.62, 11.13)], ever married [AOR = 2.41, 95% CI: (1.10, 5.31)], secondary and above education [AOR = 0.28, 95% CI: (0.15, 0.49)], belong to richer household [AOR = 1.75, 95% CI: (1.12, 2.75)], mass media use [AOR = 3.12, 95% CI: (1.85, 4.81)], low knowledge about khat effects [AOR = 3.12, 95% CI: (1.85, 5.24)], positive attitude towards khat use [AOR = 11.55, 95% CI: (6.76, 19.71)], and strong social support [AOR = 0.43, 95% CI: (0.28, 0.64)] and non-user friend [AOR = 0.31, 95% CI: (0.20, 0.48)]. From the community level variables: rural residence [AOR = 5.06, 95% CI: (1.82, 14.09)] was significantly associated with khat use. Conclusion Khat use among women of reproductive age was found to be very high. From individual-level factors: advanced ages of women, secondary and above education, live in the richer wealth quintile, mass media exposure, low knowledge on khat effects, positive attitude towards khat use, strong social support, and from community-level variables: residing in rural area were significantly associated with khat use. Khat use screening for all women of childbearing age, as well as referral to substance use disorder centers for those women identified as having khat use disorder, should become a standard of care in all health facilities.
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Affiliation(s)
- Biruk Wogayehu
- Department of Public Health, Arbaminch College of Health Sciences, Arbaminch, South Region, Ethiopia
- Department of Public Health, School of Public Health, College of Medicine and Health Sciences, Wolaita Sodo University, Sodo, South Region, Ethiopia
| | - Tsegaye Demissie
- Department of Public Health, School of Public Health, College of Medicine and Health Sciences, Wolaita Sodo University, Sodo, South Region, Ethiopia
| | - Eskinder Wolka
- Department of Public Health, School of Public Health, College of Medicine and Health Sciences, Wolaita Sodo University, Sodo, South Region, Ethiopia
| | - Mekuriaw Alemayehu
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Amhara Region, Ethiopia
| | - Kassa Daka
- Department of Public Health, School of Public Health, College of Medicine and Health Sciences, Wolaita Sodo University, Sodo, South Region, Ethiopia
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Mostafa T, Alghobary M. Substance abuse and male sexual dysfunction: what lies beneath? Sex Med Rev 2023; 11:395-411. [PMID: 37085960 DOI: 10.1093/sxmrev/qead011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 01/23/2023] [Accepted: 01/29/2023] [Indexed: 04/23/2023]
Abstract
INTRODUCTION Substance abuse has become a worldwide health problem, leading to numerous consequences such as social problems among family members, abnormal behavior, adverse health effects, and psychological problems as well as economic consequences. OBJECTIVES We sought to assess the relationship between substance abuse and male sexual health. METHODS A search was carried out in the following databases: PubMed, MeSH (Medical Subject Headings), Science Direct, Scopus, Cochrane Library, EMBASE, CINAHL, Academic Search Complete, and the Egyptian Knowledge Bank. The following keywords were used to assess the outcomes for relevant associations: illicit drugs, addiction, substance abuse, sexual health, erectile dysfunction, ejaculatory disorders, impotence, orgasm disorders, and sexual performance. RESULTS The initial literature search identified a total of 148 articles in all searched databases. After removal of duplicate studies and application of inclusion/exclusion criteria, 75 reported studies were retained for review, including 38 case-control studies and 37 cross-sectional studies. These articles were classified into the following categories according to the type of abused substance addressed: cannabis/marihuana, 16 articles; opioids, 13 articles; heroin, 11 articles; cocaine, 5 articles; tramadol, 6 articles; ketamine, 2 articles; ecstasy, 4 articles; amphetamine, 2 articles; khat, 7 articles; androgen anabolic steroids, 2 articles; and polydrugs, 7 articles. Most of these recruited articles demonstrated a negative impact of the addressed substance on male sexual health, with variable levels. CONCLUSION Substance abuse has negative impacts on male sexual health that should be addressed. More studies conducted with proper methodological and statistical approaches, including logistic regression analysis, are needed to predict the effects of specific substances, considering the rapidly growing effects of non-substance-use disorders on male sexual health.
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Affiliation(s)
- Taymour Mostafa
- Department of Andrology, Sexology, & STIs, Faculty of Medicine, Cairo University, Cairo 11562, Egypt
| | - Moheiddin Alghobary
- Department of Dermatology, Andrology & STIs, Faculty of Medicine, Mansoura University, Mansoura 35516, Egypt
- Department of Clinical Science, Fakeeh College of Medical Sciences, Jeddah, KSA
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Ssekamatte T, Nalugya A, Mugambe RK, Wagaba B, Nakalembe D, Mutebi A, Bagonza RA, Tigaiza A, Kansiime WK, Ssempala R, Wafula ST, Isunju JB, Buregyeya E. Prevalence and predictors of sex under the influence of psychoactive substances among young people in informal settlements in Kampala, Uganda. BMC Public Health 2023; 23:801. [PMID: 37131127 PMCID: PMC10152422 DOI: 10.1186/s12889-023-15679-8] [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: 05/21/2022] [Accepted: 04/14/2023] [Indexed: 05/04/2023] Open
Abstract
BACKGROUND The use of psychoactive substances such as alcohol, heroin and marijuana is associated with negative health outcomes such as sexual violence and unintended pregnancies, and risky sexual behaviours. Although there is evidence linking psychoactive substance use and risky sexual behaviours such as inconsistent condom use and multiple sexual relationships, there is limited data on sex under the influence of psychoactive substances among young people. This study aimed to investigate the prevalence and predictors of sex under the influence of psychoactive substances among young people in informal settlements in Kampala, Uganda. METHODS A cross-sectional study was conducted among 744 sexually active young psychoactive substance users in informal settlements in Kampala, Uganda. Data were collected through face-to-face interviews using a digitalized structured questionnaire, preloaded on the Kobocollect mobile application. The questionnaire captured data on the socio-demographic characteristics of the respondents, history of psychoactive substance use, and sexual behaviours. Data were analysed using STATA Version 14.0. A modified Poisson regression model was used to determine the predictors of sex under the influence of psychoactive substances.. Adjusted prevalence ratios at a p-value value ≤ 0.05 with a 95% confidence interval were considered. RESULTS About 61.0% (454/744) of the respondents had had sex under the influence of psychoactive substances in the last 30 days. The predictors of sex under the influence of psychoactive substances were being female (PR 1.18, 95% CI: 1.04-1.34), being 20-24 years of age (PR: 1.22, 95% CI: 1.04-1.44), being married (PR 1.15, 95% CI: 1.01-1.31) or divorced/separated (PR 1.43, 95% CI: 1.26-1.61), not living with biological parents or guardians (PR 1.22, 95% CI: 0.99-1.50), earning 71 USD and below (PR 0.86, 95% CI: 0.79-1.03) and using alcohol (PR 1.43, 95% CI: 1.25-1.69), marijuana (PR 1.16, 95% CI: 1.02-1.31) and khat (PR 1.25, 95% CI: 1.10-1.42) in the last 30 days. CONCLUSION The study found that a high proportion of sexually active young people in informal settlements in Kampala, Uganda had engaged in sex under the influence of psychoactive substances in the past 30 days. The study also identified several factors associated with sex under the influence of psychoactive substances, including being female, being aged 20-24 years, being married or divorced or separated, not living with biological parents or guardians, and using alcohol, marijuana, or khat in the past 30 days. Our findings suggest the need for targeted sexual and reproductive health programs that incorporate risk-reduction interventions aimed at reducing sex under the influence of psychoactive substances, especially among females and those who do not live with their parents.
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Affiliation(s)
- Tonny Ssekamatte
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University , P.o Box 7072, Kampala, Uganda
| | - Aisha Nalugya
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University , P.o Box 7072, Kampala, Uganda
| | - Richard K. Mugambe
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University , P.o Box 7072, Kampala, Uganda
| | - Brenda Wagaba
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University , P.o Box 7072, Kampala, Uganda
| | - Doreen Nakalembe
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University , P.o Box 7072, Kampala, Uganda
| | - Aloysius Mutebi
- Department of Health Policy Planning and Management, School of Public Health, College of Health Sciences, Makerere University, P.o Box 7072, Kampala, Uganda
| | - Richard Asaba Bagonza
- School of Women & Gender Studies, College of Humanities and Social Sciences, Makerere University, P.o Box 7062, Kampala, Uganda
| | - Arnold Tigaiza
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University , P.o Box 7072, Kampala, Uganda
| | - Winnifred K. Kansiime
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University , P.o Box 7072, Kampala, Uganda
| | - Richard Ssempala
- Department of Economic Theory and Analysis, School of Economics, College of Business and Management Sciences, Makerere University, P.o Box 7062, Kampala, Uganda
| | - Solomon T. Wafula
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University , P.o Box 7072, Kampala, Uganda
| | - John Bosco Isunju
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University , P.o Box 7072, Kampala, Uganda
| | - Esther Buregyeya
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University , P.o Box 7072, Kampala, Uganda
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Ssekamatte T, Mugambe RK, Nalugya A, Isunju JB, Matovu JK, Kansiime WK, Balugaba BE, Oputan P, Tigaiza A, Wafula ST, Kibira SP, Wanyenze RK. Predictors of consistent condom use among young psychoactive substance users in Kampala's informal settlements, Uganda. DIALOGUES IN HEALTH 2022; 1:100080. [PMID: 38515898 PMCID: PMC10953897 DOI: 10.1016/j.dialog.2022.100080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 10/30/2022] [Accepted: 11/13/2022] [Indexed: 03/23/2024]
Abstract
Introduction The use of psychoactive substances increases the likelihood of unprotected sexual intercourse with individuals whose health status is not known, and consequently sexually transmitted infections, especially among young people. Despite this risk, there is limited evidence of the predictors of consistent condom use among young psychoactive substance users (YPSUs) in informal settings. This study examined the predictors of condom use among YPSUs in Kampala's informal settlements, Uganda. Methods A cross-sectional study was conducted among 768 YPSUs. Respondent-driven sampling was used to recruit respondents. A structured questionnaire was used to collect respondent data on condom use. Data were analysed using Stata version 15.0. Prevalence ratios (PR) were used to determine the predictors of consistent condom use. Results Out of the 744 YPSUs, only 37.4% of the respondents reported consistent condom use in the last 30 days. The prevalence of condom use was statistically lower among young people aged 20-24 years (35.4%) compared to those aged 18-19 years (43.7%), and among the married (17.3%) compared to respondents with a "single" marital status (43.0%). Being married (PR 0.42, 95% CI: 0.30-0.59), longer duration between meeting the most recent partner and having initial sexual contact with them (7 months to 1 year: PR 0.56, 95% CI: 0.36-0.88; more than a year: PR 0.36, 95% CI: 0.17-0.75) was negatively associated with consistent condom use. Spending less than 24 h between meeting the most recent partner and having initial sexual contact was positively associated with consistent condom use (PR 1.60, 95% CI: 1.24-2.08). Conclusion The prevalence of consistent condom use in the last 30 days among YPSUs was low. Marital status and the duration between meeting the most recent partner and initial sexual contact predicted consistent condom use. There is a need to intensify awareness on the importance of consistent condom use among young people.
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Affiliation(s)
- Tonny Ssekamatte
- Makerere University College of Health Sciences, School of Public Health, Department of Disease Control and Environmental Health, New Mulago Gate Rd, P.o Box 7072, Kampala, Uganda
| | - Richard K. Mugambe
- Makerere University College of Health Sciences, School of Public Health, Department of Disease Control and Environmental Health, New Mulago Gate Rd, P.o Box 7072, Kampala, Uganda
| | - Aisha Nalugya
- Makerere University College of Health Sciences, School of Public Health, Department of Disease Control and Environmental Health, New Mulago Gate Rd, P.o Box 7072, Kampala, Uganda
| | - John Bosco Isunju
- Makerere University College of Health Sciences, School of Public Health, Department of Disease Control and Environmental Health, New Mulago Gate Rd, P.o Box 7072, Kampala, Uganda
| | - Joseph K.B. Matovu
- Makerere University College of Health Sciences, School of Public Health, Department of Disease Control and Environmental Health, New Mulago Gate Rd, P.o Box 7072, Kampala, Uganda
| | - Winnie K. Kansiime
- Makerere University College of Health Sciences, School of Public Health, Department of Disease Control and Environmental Health, New Mulago Gate Rd, P.o Box 7072, Kampala, Uganda
| | - Bonny E. Balugaba
- Makerere University College of Health Sciences, School of Public Health, Department of Disease Control and Environmental Health, New Mulago Gate Rd, P.o Box 7072, Kampala, Uganda
| | - Patience Oputan
- Makerere University College of Health Sciences, School of Public Health, Department of Disease Control and Environmental Health, New Mulago Gate Rd, P.o Box 7072, Kampala, Uganda
| | - Arnold Tigaiza
- Makerere University College of Health Sciences, School of Public Health, Department of Disease Control and Environmental Health, New Mulago Gate Rd, P.o Box 7072, Kampala, Uganda
| | - Solomon Tsebeni Wafula
- Makerere University College of Health Sciences, School of Public Health, Department of Disease Control and Environmental Health, New Mulago Gate Rd, P.o Box 7072, Kampala, Uganda
| | - Simon P.S. Kibira
- Makerere University College of Health Sciences, School of Public Health, Department of Community Health and Behavioural Sciences, New Mulago Gate Rd, P.o Box 7072, Kampala, Uganda
| | - Rhodah K. Wanyenze
- Makerere University College of Health Sciences, School of Public Health, Department of Disease Control and Environmental Health, New Mulago Gate Rd, P.o Box 7072, Kampala, Uganda
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5
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Ssekamatte T, Mugambe RK, Nalugya A, Isunju JB, Kalibala P, Musewa A, Bikaako W, Nattimba M, Tigaiza A, Nakalembe D, Osuret J, Wafula ST, Okech S, Buregyeya E, Tsiouris F, Michaels-Strasser S, Kabasa JD, Bazeyo W. Employment status of AFROHUN-Uganda one health alumni, and facilitators and barriers to application of the one health approach: a tracer study. BMC Health Serv Res 2022; 22:1205. [PMID: 36167534 PMCID: PMC9513298 DOI: 10.1186/s12913-022-08537-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 09/07/2022] [Indexed: 12/05/2022] Open
Abstract
Background The One Health (OH) approach integrates multiple competencies in the prevention and control of disease outbreaks. Through a range of OH competence-based activities, the Africa One Health University Network (AFROHUN) built the capacity of selected students at Makerere University and Mbarara University of Science and Technology. This study applied the Systems Theoretical Framework (STF) of career development to establish the employment status of AFROHUN-Uganda alumni, and the facilitators and barriers to application of the OH approach in their organisations. Methods We conducted an embedded mixed-methods study among a random sample of 182 AFROHUN-Uganda alumni of the 2013–2018 cohorts. For quantitative data, descriptive statistics were computed using Stata 14.0 statistical software. A total of 12 in-depth interviews were conducted, and NVivo 12 Pro was used to organise data during thematic analysis. Results While the majority, 87.4% were or got employed after participating in the AFROHUN Uganda capacity building programme, 68.1% were employed at the time of the survey, 57.7% had worked with their current employer for at least a year, and 39% held managerial positions. The facilitators of applying the OH approach into employing organisations included being knowledgeable about OH, the presence of a multidisciplinary workforce, the nature of activities implemented, and existing partnerships and collaborations between organisations. The barriers to the application of the OH approach included limited funding, a negative attitude towards working with people from other disciplines, and limited knowledge of the One Health approach. Conclusion Notably, more than two-thirds of the OH alumni were employed, and more than a third held managerial position. While these findings portray a fairly good absorption rate of the OH alumni into the workforce, they also highlight the facilitators of application of the OH approach that need to be promoted as well as the barriers that need to be addressed if the application of the OH approach is to be improved within the workforce. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08537-7.
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Affiliation(s)
- Tonny Ssekamatte
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P. O Box, 7072, Kampala, Uganda. .,Africa One Health University Network, Plot 20B Kawalya Kagwa Cl, Kololo, Kampala, Uganda.
| | - Richard K Mugambe
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P. O Box, 7072, Kampala, Uganda
| | - Aisha Nalugya
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P. O Box, 7072, Kampala, Uganda
| | - John Bosco Isunju
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P. O Box, 7072, Kampala, Uganda.,Africa One Health University Network, Plot 20B Kawalya Kagwa Cl, Kololo, Kampala, Uganda
| | - Patrick Kalibala
- Africa One Health University Network, Plot 20B Kawalya Kagwa Cl, Kololo, Kampala, Uganda.,Makerere University College of Veterinary Medicine, Animal Resources and Biosecurity, Kampala, Uganda
| | - Angella Musewa
- Africa One Health University Network, Plot 20B Kawalya Kagwa Cl, Kololo, Kampala, Uganda.,Makerere University College of Veterinary Medicine, Animal Resources and Biosecurity, Kampala, Uganda
| | - Winnie Bikaako
- Makerere University College of Veterinary Medicine, Animal Resources and Biosecurity, Kampala, Uganda
| | - Milly Nattimba
- Makerere University College of Veterinary Medicine, Animal Resources and Biosecurity, Kampala, Uganda
| | - Arnold Tigaiza
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P. O Box, 7072, Kampala, Uganda
| | - Doreen Nakalembe
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P. O Box, 7072, Kampala, Uganda
| | - Jimmy Osuret
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P. O Box, 7072, Kampala, Uganda.,Africa One Health University Network, Plot 20B Kawalya Kagwa Cl, Kololo, Kampala, Uganda
| | - Solomon T Wafula
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P. O Box, 7072, Kampala, Uganda
| | - Samuel Okech
- Africa One Health University Network, Plot 20B Kawalya Kagwa Cl, Kololo, Kampala, Uganda.,Makerere University College of Veterinary Medicine, Animal Resources and Biosecurity, Kampala, Uganda
| | - Esther Buregyeya
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P. O Box, 7072, Kampala, Uganda
| | - Fatima Tsiouris
- Columbia University, Columbia University Mailman School of Public Health, New York, NY, USA
| | | | - John David Kabasa
- Africa One Health University Network, Plot 20B Kawalya Kagwa Cl, Kololo, Kampala, Uganda.,Makerere University College of Veterinary Medicine, Animal Resources and Biosecurity, Kampala, Uganda
| | - William Bazeyo
- Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P. O Box, 7072, Kampala, Uganda.,Africa One Health University Network, Plot 20B Kawalya Kagwa Cl, Kololo, Kampala, Uganda
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Liga AD, Jabir YN, Wobse BA, Bacha RH. Predictors of Multiple Sexual Partners among Men in Ethiopia: A Multilevel Analysis. Ethiop J Health Sci 2022; 32:689-698. [PMID: 35950063 PMCID: PMC9341023 DOI: 10.4314/ejhs.v32i4.4] [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: 03/01/2022] [Accepted: 04/30/2022] [Indexed: 11/30/2022] Open
Abstract
Background Multiple sexual partnerships were one of the public health issues in the spread of high rates of sexually transmitted infections in sub-Saharan regions. An increase in the number of non-marital sexual partners can lead to a loss of satisfaction as well as other mental health repercussions such as greater rates of anxiety, depression, etc. This study examined the predictors of multiple sexual partners among men in Ethiopia. Methods This study used 2016 nationally representative data which was conducted using a multistage stratified cluster sampling method. Multilevel binary logistic regression models were employed to estimate the predictors of multiple sexual partners among men in Ethiopia with the assistance of the STATA software. Results In this study 6778 participants were considered with an overall prevalence rate of multiple sexual partners of 6.5% during the 12 months preceding the survey. The findings showed that older-age, urban-resident, inconsistent use of a condom, exposure to any media, abuse of alcohol, early-time first-sex, and religion were predictors of multiple sexual partners among men in Ethiopia. Conclusions The findings revealed that the prevalence rate of men's multiple sexual partners in Ethiopia was very high. Therefore, the country needs to re-examine the behavioral change strategies periodically to adapt to the contextual realities and engage relevant stakeholders. Specifically, health sectors and religious organizations should develop strategies to create awareness in society on the risk of having multiple sexual partnerships. In addition, we highly recommend stakeholders prepare risk reduction interventions that take the significant predictors of multiple sexual partners.
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Affiliation(s)
- Abebe Debu Liga
- Department of Statistics, College of Natural and Computational Sciences, Wolkite University, Ethiopia
| | - Yasin Negash Jabir
- Department of Statistics, College of Natural Science, Jimma University, Ethiopia
| | - Belete Adelo Wobse
- Department of Statistics, College of Natural and Computational Sciences, Wolkite University, Ethiopia
| | - Reta Habtamu Bacha
- Department of Statistics, College of Natural Science, Jimma University, Ethiopia
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Ssekamatte T, Isunju JB, Mutyoba JN, Tetui M, Mugambe RK, Nalugya A, Kansiime WK, Kitchen C, Brenda W, Oputan P, Bukenya JN, Buregyeya E, Kibira SPS. Predictors of Hepatitis B screening and vaccination status of young psychoactive substance users in informal settlements in Kampala, Uganda. PLoS One 2022; 17:e0267953. [PMID: 35588113 PMCID: PMC9119510 DOI: 10.1371/journal.pone.0267953] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 04/19/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Young psychoactive substance users exhibit high-risk behaviours such as unprotected sexual intercourse, and sharing needles and syringes, which increases their risk of Hepatitis B infection. However, there is limited evidence of screening, and vaccination status of this subgroup. The aim of this study was to establish the predictors of screening and completion of the hepatitis B vaccination schedule. METHODS A cross-sectional study using respondent driven sampling was used to enrol respondents from twelve out of fifty-seven informal settlements in Kampala city. Data were collected using an electronic structured questionnaire uploaded on the KoboCollect mobile application, and analysed using Stata version 14. A "modified" Poisson regression analysis was done to determine the predictors of screening while logistic regression was used to determine the predictors of completion of the Hepatitis B vaccination schedule. RESULTS About 13.3% (102/768) and 2.7% (21/768) of the respondents had ever screened for Hepatitis B, and completed the Hepatitis B vaccination schedule respectively. Being female (aPR 1.61, 95% CI: 1.11-2.33), earning a monthly income >USD 136 (aPR 1.78, 95% CI: 1.11-2.86); completion of the Hepatitis B vaccination schedule (aPR 1.85, 95% CI: 1.26-2.70); lack of awareness about the recommended Hepatitis B vaccine dose (aPR 0.43, 95% CI: 0.27-0.68); and the belief that the Hepatitis B vaccine is effective in preventing Hepatitis B infection (aPRR 3.67, 95% CI: 2.34-5.73) were associated with "ever screening" for Hepatitis B. Knowledge of the recommended Hepatitis B vaccine dose (aOR 0.06, 95% CI: 0.01-0.35); "ever screening" for hepatitis B (aOR 9.68, 95% CI: 2.17-43.16) and the belief that the hepatitis B vaccine is effective in preventing Hepatitis B infection (aOR 11.8, 95% CI: 1.13-110.14) were associated with completion of the hepatitis B vaccination schedule. CONCLUSIONS Our findings indicate a low prevalence of Hepatitis B screening and completion of the Hepatitis B vaccination schedule among young psychoactive substance users in informal settings. It is evident that lack of awareness about Hepatitis B is associated with the low screening and vaccination rates. We recommend creation of awareness of Hepatitis B among young people in urban informal settlements.
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Affiliation(s)
- Tonny Ssekamatte
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - John Bosco Isunju
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Joan Nankya Mutyoba
- Department of Epidemiology and Biostatistics, Makerere University School of Public Health, Kampala, Uganda
| | - Moses Tetui
- Department of Health Policy Planning and Management, Makerere University School of Public Health, Kampala, Uganda
| | - Richard K. Mugambe
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Aisha Nalugya
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Winnifred K. Kansiime
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Chenai Kitchen
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, China
| | - Wagaba Brenda
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Patience Oputan
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Justine Nnakate Bukenya
- Department of Community Health and Behavioural Sciences, Makerere University School of Public Health, Kampala, Uganda
| | - Esther Buregyeya
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Simon P. S. Kibira
- Department of Community Health and Behavioural Sciences, Makerere University School of Public Health, Kampala, Uganda
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Perkins JM, Kakuhikire B, Baguma C, Meadows M, Evans CQ, Jurinsky J, Rasmussen JD, Satinsky EN, Ayebare P, Kyokunda V, Juliet M, Bangsberg DR, Tsai AC. Perceived and misperceived norms about khat and/or cannabis use among adults in southwest Uganda. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 101:103527. [PMID: 34890907 PMCID: PMC9272912 DOI: 10.1016/j.drugpo.2021.103527] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 10/31/2021] [Accepted: 11/01/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Studies from high-income contexts have found evidence that norms about substance use are misperceived. The accuracy of perceived norms about khat and cannabis use in Uganda have not previously been described. METHODS We conducted a population-based study targeting all resident adults across eight villages in southwestern Uganda. Personal khat and/or cannabis use frequency was based on self-report. We measured perceived norms about substance use by eliciting individuals' perceptions about how often most other adult men and most other adult women in their villages used these substances. We compared perceived norms to aggregated village rates of use to assess the extent to which norms were misperceived. We used multivariable Poisson regression to estimate correlates of misperceived norms. RESULTS Among 1626 participants (91% response rate), only 29 men (4%) and 9 women (1%) reported any lifetime use of khat and/or cannabis. However, 695 participants (43%) did not think lifetime abstinence was the norm among men in their villages, and 256 participants (16%) did not think lifetime abstinence was the norm among women. Moreover, 219 participants (13%) incorrectly believed most men in their village regularly used khat and/or cannabis (≥4 times per week). Misperceived norms were present across subgroups and were correlated with larger social networks, symptoms of depression, loneliness, and younger age. CONCLUSION In this study of all adults across 8 villages in rural Uganda, many participants misperceived norms about khat and/or cannabis use. Providing accurate information about prevailing norms in the local population may help prevent initiation of khat and/or cannabis use among adults in this context.
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Affiliation(s)
- Jessica M Perkins
- Peabody College, Vanderbilt University, 230 Appleton Place, Nashville, TN 37203, USA; Vanderbilt Institute of Global Health, 2525 West End Avenue, Nashville, TN 37203, USA.
| | - Bernard Kakuhikire
- Mbarara University of Science and Technology, P.O BOX 1410, Mbarara, Uganda
| | - Charles Baguma
- Mbarara University of Science and Technology, P.O BOX 1410, Mbarara, Uganda
| | - Meredith Meadows
- Peabody College, Vanderbilt University, 230 Appleton Place, Nashville, TN 37203, USA
| | - Claire Q Evans
- Peabody College, Vanderbilt University, 230 Appleton Place, Nashville, TN 37203, USA
| | - Jordan Jurinsky
- Peabody College, Vanderbilt University, 230 Appleton Place, Nashville, TN 37203, USA
| | | | - Emily N Satinsky
- Center for Global Health, Massachusetts General Hospital, 125 Nashua St, Boston, MA 02114, USA
| | - Patience Ayebare
- Mbarara University of Science and Technology, P.O BOX 1410, Mbarara, Uganda
| | - Viola Kyokunda
- Mbarara University of Science and Technology, P.O BOX 1410, Mbarara, Uganda
| | - Mercy Juliet
- Mbarara University of Science and Technology, P.O BOX 1410, Mbarara, Uganda
| | - David R Bangsberg
- Mbarara University of Science and Technology, P.O BOX 1410, Mbarara, Uganda; Oregon Health & Science University-Portland State University School of Public Health, 1880 SW 6th Ave, Portland, OR 97201, USA
| | - Alexander C Tsai
- Mbarara University of Science and Technology, P.O BOX 1410, Mbarara, Uganda; Center for Global Health, Massachusetts General Hospital, 125 Nashua St, Boston, MA 02114, USA; Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA; Mongan Institute, Massachusetts General Hospital, 100 Cambridge St Suite 1600, Boston, MA 02114, USA
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Ssekamatte T, Kibira SPS, Tetui M, Isunju JB, Mugambe RK, Wafula ST, Buregyeya E, Nalwadda CK, Bukenya JN, Wanyenze RK. Do sexual expectancies and inhibitions predict high-risk sexual behaviours? Evidence from a cross-sectional survey among young psychoactive substance users in informal settlements in Kampala, Uganda. BMC Public Health 2021; 21:1506. [PMID: 34348701 PMCID: PMC8336356 DOI: 10.1186/s12889-021-11536-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 07/23/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Psychoactive substance use is a public health challenge among young people in informal settlements. Though rarely examined, psychoactive substance use is linked to sexual expectancies and inhibitions, and consequently high-risk sexual behaviours. This study examined the association between sexual expectancies and inhibitions, and high-risk sexual behaviours among young psychoactive substance users (PSUs) in informal settlements in Kampala, Uganda. METHODS This cross-sectional study recruited 744 young PSUs from informal settlements in Kampala. Respondent driven sampling was used to recruit respondents. A 'modified' Poisson regression model was used for inferential statistics. Data were analysed using the Stata 14 software. RESULTS Of the 744 study participants, 45.6% believed that psychoactive substance use improves sexual performance; 43.3% believed that psychoactive substances make sex more pleasurable, and 53.3% believed that psychoactive substances give courage or confidence to approach a partner for sex. The belief that psychoactive substance use improves sexual performance (PR 1.14, 95% CI: 1.01-1.30), increases the likelihood of engaging in sex (PR 1.20, 95% CI: 1.04-1.40) or gives courage or confidence to approach a sexual partner (PR 1.21, 95% CI: 1.05-1.39) were associated with having sex while under the influence of psychoactive substances. The belief that a psychoactive substance user under the influence of psychoactive substances is more likely to engage in sex (PR 1.48, 95% CI: 1.15-1.90), and likely to find it difficult to refuse sex (PR 1.28, 95% CI: 1.06-1.55) were positively associated with engaging in multiple sexual partnerships. The belief that one easily forgets to use a condom when under the influence of psychoactive substances was positively associated with inconsistent condom use (PR 1.26, 95% CI: 1.09-1.45). CONCLUSION Psychoactive substance use expectancies associated with high-risk sexual behaviours included the belief that psychoactive substances improve sexual performance and improve confidence in approaching a sexual partner. Psychoactive substance use inhibitions associated with high-risk sexual behaviours included an increased likelihood of engaging in sexual intercourse, difficulties in refusing to engage in sexual intercourse, and forgetting to use condoms while intoxicated. Interventions targeting a reduction in high-risk sexual behaviour should integrate the impact of psychoactive substance use on sexual behaviour.
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Affiliation(s)
- Tonny Ssekamatte
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Simon P. S. Kibira
- Department of Community Health and Behavioural Sciences, Makerere University School of Public Health, Kampala, Uganda
| | - Moses Tetui
- School of Pharmacy, University of Waterloo, Waterloo, Canada
- Departement of Epidemiology and Global Health, Umeå University, 901 87 Umeå, Sweden
- Department of Health Policy, Planning and Management, Makerere University School of Public Health, Kampala, Uganda
| | - John Bosco Isunju
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Richard K. Mugambe
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Solomon Tsebeni Wafula
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Esther Buregyeya
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Christine Kayemba Nalwadda
- Department of Community Health and Behavioural Sciences, Makerere University School of Public Health, Kampala, Uganda
| | - Justine Nnakate Bukenya
- Department of Community Health and Behavioural Sciences, Makerere University School of Public Health, Kampala, Uganda
| | - Rhoda K. Wanyenze
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
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Masanja V, Wafula ST, Ssekamatte T, Isunju JB, Mugambe RK, Van Hal G. Trends and correlates of sexually transmitted infections among sexually active Ugandan female youths: evidence from three demographic and health surveys, 2006-2016. BMC Infect Dis 2021; 21:59. [PMID: 33435882 PMCID: PMC7805221 DOI: 10.1186/s12879-020-05732-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 12/22/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Female adolescents and young women have the highest risk of curable sexually transmitted infections (STIs) globally. Data on the prevalence of STIs among young women in Uganda are limited. In this study, we investigated the time trends and correlates of STIs among adolescent girls and young women (15-24 years) in Uganda. METHODS We estimated the percentage of women 15-24 years from three recent consecutive Uganda Demographic and Health Surveys (2006, 2011, and 2016), who reported suffering from genital sores, and or genital discharge or any other varginal complaints acquired after sexual intercourse within 12 months of the studies and examined the changes over time. A pooled multivariable logistic regression was used to examine the correlates of reporting an STI in the last 12 months preceding the study. Svyset command in Stata was used to cater for the survey sample design. RESULTS The pooled self-reported STI prevalence was 26.0%. Among these young women, 22.0, 36.3, and 23.1% reported a sexually transmitted infection in 2006, 2011, and 2016 respectively. Between 2006 and 2011, there was evidence of change (+ 14.3%, p < 0.001) in STI prevalence before a significant reduction (- 12.0%, p< 0.001) in 2016. Youths aged 20-24 years reported a higher STI prevalence (27.3%) compared to young participants (23.6%). Correlates of reporting an STI among rural and urban young women were: having multiple total lifetime partners (adjusted odds ratio (aOR 1.6, 95% CI 1.4-1.6), being sexually active in the last 4 weeks (aOR 1.3, 95% CI 1.1-1.6), and being affiliated to Muslim faith (aOR 1.3, 95% CI 1.1-1.6) or other religions (aOR 1.8, 95% CI 1.1-2.9) as compared to Christian were more likely to report an STI. Living in Northern Uganda compared to living in Kampala city was found protective against STIs (aOR 0.5, 95% CI 0.3-0.7). CONCLUSION The prevalence of STIs was high among female youths, 15-24 years. This highlights the need for a comprehensive STIs screening, surveillance, and treatment programme to potentially reduce the burden of STIs in the country.
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Affiliation(s)
- Veronicah Masanja
- Department of Epidemiology and social medicine, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Solomon Tsebeni Wafula
- Department of Epidemiology and social medicine, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
- Department of Disease Control and Environmental Health, Makerere University, Kampala, Uganda.
| | - Tonny Ssekamatte
- Department of Disease Control and Environmental Health, Makerere University, Kampala, Uganda
| | - John Bosco Isunju
- Department of Disease Control and Environmental Health, Makerere University, Kampala, Uganda
| | - Richard K Mugambe
- Department of Disease Control and Environmental Health, Makerere University, Kampala, Uganda
| | - Guido Van Hal
- Department of Epidemiology and social medicine, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
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Eyam S, Eyam L, Ekpeyong B, Ndep A, Akpan M, Ekanem E. Determinants of risky sexual behavior among secondary school adolescents in cross River State, Nigeria. NIGERIAN JOURNAL OF MEDICINE 2021. [DOI: 10.4103/njm.njm_126_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Ssekamatte T, Isunju JB, Naume M, Buregyeya E, Mugambe RK, Wanyenze RK, Bukenya JN. Barriers to access and utilisation of HIV/STIs prevention and care services among trans-women sex workers in the greater Kampala metropolitan area, Uganda. BMC Infect Dis 2020; 20:932. [PMID: 33287723 PMCID: PMC7720523 DOI: 10.1186/s12879-020-05649-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 11/22/2020] [Indexed: 12/03/2022] Open
Abstract
Background Trans-women sex workers bear the greatest brunt of HIV and other sexually transmitted infections (STI). Trans-women are 49 times more at risk of HIV infections compared to the general population. However, they remain underserved and continue to grapple with access to and utilisation of HIV/STI prevention services. This study explored barriers to access and utilisation of HIV/STI prevention services and associated coping mechanisms. Methods This exploratory qualitative study was conducted among trans-women sex workers in the Greater Kampala Metropolitan area, Uganda. A total of 22 in-depth interviews, 6 key informant interviews and 9 focus group discussions were conducted to obtain data on barriers to access and utilisation of HIV and other STI prevention and care services, and coping strategies of trans-women sex workers. Data were analysed through thematic analysis using a hybrid of inductive and deductive approaches. Results Individual level barriers to access and utilisation of HIV/STI prevention and care services included internalised stigma and low socio-economic status. Healthcare system barriers included social exclusion and lack of recognition by other key population groups; stigmatisation by some healthcare providers; breach of confidentiality by some healthcare providers; limited hours of operation of some key population-friendly healthcare facilities; discrimination by straight patients and healthcare providers; stockout of STI drugs; inadequate access to well-equipped treatment centres and high cost of drugs. At community level, transphobia hindered access and utilisation of HIV/STI prevention and care services. The coping strategies included use of substitutes such as lotions, avocado or yoghurt to cope with a lack of lubricants. Herbs were used as substitutes for STI drugs, while psychoactive substances were used to cope with stigma and discrimination, and changing the dress code to hide their preferred gender identity. Conclusions Individual, community and healthcare system barriers hindered access and utilisation of HIV/STI prevention and care services among the trans-women sex workers. There is a need to create an enabling environment in order to enhance access to and utilisation of HIV/STI prevention and care services for trans-women sex workers through sensitisation of healthcare providers, other key population groups and the community at large on the transgender identity.
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Affiliation(s)
- Tonny Ssekamatte
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda.
| | - John Bosco Isunju
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Muyanga Naume
- Programs Department, Transgender Equality Uganda, Kampala, Uganda
| | - Esther Buregyeya
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Richard K Mugambe
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Rhoda K Wanyenze
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Justine N Bukenya
- Department of Community Health and Behavioural Sciences, Makerere University School of Public Health, Kampala, Uganda
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