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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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Olamijuwon E, Odimegwu C, Chemhaka G. Involuntary Childlessness and Marital Infidelity Among Women in Sub-Saharan African Countries: An Assessment of the Moderating Role of Women's Education. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:601-614. [PMID: 32621140 DOI: 10.1007/s10508-020-01770-3] [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: 11/11/2018] [Revised: 05/31/2020] [Accepted: 06/10/2020] [Indexed: 06/11/2023]
Abstract
A considerable number of married women in sub-Saharan African countries are childless and may be likely to engage in marital infidelity to avoid social stigma, economic insecurities, and other debilitating experience associated with being involuntarily childless. This study sought to investigate the relationship between involuntary childlessness and marital infidelity and how it may be moderated by women's educational attainment. Data were obtained from 23,847 women in their first union for at least 2 years and participated in the demographic and health surveys of five sub-Saharan African countries comprising Cameroon, Gabon, Lesotho, Liberia, and Sierra Leone. Data were analyzed using multivariate logistic regression, adjusted for socioeconomic, union, and partner characteristics. Involuntarily childless women in Cameroon (AOR: 2.34, 95% CI 1.62-3.39) and Sierra Leone (AOR: 2.22, 95% CI 1.42-3.49) were about two times more likely to engage in marital infidelity compared to non-childless married women. In Gabon, Lesotho, and Liberia, the odds of marital infidelity did not significantly differ between involuntarily childless and non-childless married women. Although involuntarily childless women with secondary or higher education reported higher levels of marital infidelity than non-childless women with a similar level of education, we found no statistical evidence in all the countries that the relationship between involuntary childlessness and marital infidelity was moderated by women's educational attainment. These findings suggest that involuntary childlessness is a critical factor potentially related to marital infidelity and may be an important target for intervention and prevention, particularly in settings with high levels of sexually transmitted infections.
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Affiliation(s)
- Emmanuel Olamijuwon
- Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of the Witwatersrand, 1 Jan Smuts Avenue, Braamfontein, Johannesburg, 2000, South Africa.
- Department of Statistics and Demography, Faculty of Social Sciences, University of Eswatini, Kwaluseni Campus, Kwaluseni, Eswatini.
| | - Clifford Odimegwu
- Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of the Witwatersrand, 1 Jan Smuts Avenue, Braamfontein, Johannesburg, 2000, South Africa
| | - Garikayi Chemhaka
- Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of the Witwatersrand, 1 Jan Smuts Avenue, Braamfontein, Johannesburg, 2000, South Africa
- Department of Statistics and Demography, Faculty of Social Sciences, University of Eswatini, Kwaluseni Campus, Kwaluseni, Eswatini
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Simelane MS, Vermaak K, Zwane E, Masango S. Individual and community-level factors associated with lifetime number of sexual partners among women aged 15-49 in Eswatini. PLoS One 2021; 16:e0246100. [PMID: 33497398 PMCID: PMC7837491 DOI: 10.1371/journal.pone.0246100] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 01/13/2021] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Understanding the risk factors for behavioral patterns in sexual relationships play a significant role in the reduction of the transmission of HIV/AIDS and other sexually transmitted infections. OBJECTIVE To investigate individual and community level factors on the lifetime number of sexual partners of women in Eswatini. MATERIAL AND METHODS The study was a secondary cross-sectional analysis of the 2014 Eswatini Multiple Indicator Cluster Survey (MICS). A total of 2,832 women aged 15-49 years were asked in total, how many different people have you had sexual intercourse in your lifetime. The multilevel negative binomial regression model was used to analyze the data. RESULTS The overall mean number of lifetime sexual partners was 2.78 (95% CI: 2.66, 2.91) in 2014. Compared to women aged 15-19, those aged 20 years and older, formerly married or never married reported more lifetime sexual partners compared to currently married women. Those that were aged 15 years and older at sexual debut reported fewer lifetime sexual partners compared to those that were aged less than 15 years. Compared to women that used a condom at last sexual intercourse, those that did not use a condom at last sexual encounter reported fewer lifetime sexual partners. Relative to women that lived with their sons and daughters, those that did not live with their sons and daughters reported more lifetime sexual partners. Women that lived in the Shiselweni and Lubombo regions reported fewer lifetime sexual partners compared to those residents in the Hhohho region. CONCLUSION Overall, lifetime sexual partners in Eswatini was significantly associated with individual characteristics and is unique across regions. Programs that aim to elucidate the factors associated with incident HIV infections among women in Eswatini should focus on individual and community-level factors that are associated with multiple sexual partnerships, which in turn might increase the risk of HIV exposure.
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Affiliation(s)
- Maswati S. Simelane
- Department of Statistics and Demography, Faculty of Social Sciences, University of Eswatini, Kwaluseni, Eswatini
| | - Kerry Vermaak
- The School of Built Environment and Development Studies, University of KwaZulu-Natal, Durban, South Africa
| | - Eugene Zwane
- Department of Statistics and Demography, Faculty of Social Sciences, University of Eswatini, Kwaluseni, Eswatini
| | - Sdumo Masango
- Department of Statistics and Demography, Faculty of Social Sciences, University of Eswatini, Kwaluseni, Eswatini
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Ahinkorah BO, Hagan JE, Seidu AA, Torgbenu E, Budu E, Schack T. Understanding the linkages between male circumcision and multiple sexual partnership among married Ghanaian men: Analysis of data from the 2014 Ghana demographic and health survey. SSM Popul Health 2020; 11:100622. [PMID: 32642549 PMCID: PMC7334616 DOI: 10.1016/j.ssmph.2020.100622] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 06/22/2020] [Accepted: 06/23/2020] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION This current study sought to investigate the association between male circumcision status and engaging in multiple sexual partnership among men in Ghana. METHODS Data from this study come from the men's file of the 2014 Ghana demographic and health survey. Both descriptive and inferential statistics were conducted among 1, 948 men and the level of statistical significance was pegged at p < 0.05. RESULTS Results revealed that men who have been circumcised were more likely to engage in multiple sexual partnership (AOR = 3.36; CI:1.14-9.89), compared to those who have not been circumcised. With the covariates, men with primary level of education were more likely to have multiple sexual partners (AOR = 2.01; CI:1.10-3.69), compared to those with no education. With wealth status, men with richest (AOR = 2.27; CI:1.04-4.97), richer (AOR = 2.05; CI: 1.03-4.08), and middle wealth status (AOR = 1.83; CI:1.01-3.34) had the highest likelihood of having multiple sexual partners, compared to those with poorest wealth status. Conversely, men who professed the Islamic faith were less likely to engage in multiple sexual partnership (AOR = 0.58; CI: 0.36-0.94), compared to Christians. Similarly, men who resided in the Brong Ahafo (AOR = 0.51; CI: 0.26-0.99), Upper East (AOR = 0.41; CI:0.19-0.89), and Ashanti regions (AOR = 0.39; CI: 0.20-0.78) were less likely to engage in multiple sexual partnership. CONCLUSION Based on the current findings, educational campaigns by stakeholder groups (e.g., Ministry of Health in collaboration with the National Commission on Civic Education, civil society, educational institutions) should sensitize the sexually active population at the community level to consistently use condoms, especially when they have multiple sexual partners, even when a man is circumcised. Campaign messages must clearly emphasize that male circumcision should not substitute precautionary measures such as delay in the onset of sexual relationships, averting penetrative sex, reducing the number of sexual partners as well as correct and consistent use of male or female condoms regardless one's social standing.
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Affiliation(s)
- Bright Opoku Ahinkorah
- The Australian Centre for Public and Population Health Research (ACPPHR), Faculty of Health, University of Technology Sydney, Australia
| | - John Elvis Hagan
- Department of Health, Physical Education, and Recreation, University of Cape Coast, Cape Coast, Ghana
- Neurocognition and Action-Biomechanics-Research Group, Faculty of Psychology and Sport Sciences, Bielefeld University, Bielefeld, Germany
| | - Abdul-Aziz Seidu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - Eric Torgbenu
- Department of Physiotherapy and Rehabilitation Sciences, School of Allied Health Sciences, Ho, Ghana
| | - Eugene Budu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Thomas Schack
- Neurocognition and Action-Biomechanics-Research Group, Faculty of Psychology and Sport Sciences, Bielefeld University, Bielefeld, Germany
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Budambula V, Matoka C, Ouma J, Ahmed AA, Otieno MF, Were T. Socio-demographic and sexual practices associated with HIV infection in Kenyan injection and non-injection drug users. BMC Public Health 2018; 18:193. [PMID: 29378631 PMCID: PMC5789578 DOI: 10.1186/s12889-018-5100-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 01/18/2018] [Indexed: 11/19/2022] Open
Abstract
Background Substance use is increasingly becoming prevalent on the African continent, fueling the spread of HIV infection. Although socio-demographic factors influence substance consumption and risk of HIV infection, the association of these factors with HIV infection is poorly understood among substance users on the African continent. The objective of the study was to assess socio-demographic and sexual practices that are associated with HIV infection among injection drug users (IDUs), non-IDUs, and non-drug users (DUs) at an urban setting of coastal Kenya. Methods A cross-sectional descriptive study was conducted among 451 adults comprising HIV-infected and -uninfected IDUs (n = 157 and 39); non-IDUs (n = 17 and 48); and non-DUs (n = 55 and 135); respectively at coastal, Kenya. Respondent driven sampling, snowball and makeshift methods were used to enroll IDUs and non-IDUs. Convenience and purposive sampling were used to enroll non-DUs from the hospital’s voluntary HIV testing unit. Participant assisted questionnaire was used in collecting socio-demographic data and sexual practices. Results Binary logistic regression analysis indicated that higher likelihood of HIV infection was associated with sex for police protection (OR, 9.526; 95% CI, 1.156-78.528; P = 0.036) and history of sexually transmitted infection (OR, 5.117; 95% CI, 1.924-13.485; P = 0.001) in IDUs; divorced, separated or widowed marital status (OR, 6.315; 95% CI, 1.334-29.898; P = 0.020) in non-IDUs; and unemployment (OR, 2.724; 95% CI, 1.049-7.070; P = 0.040) in non-drug users. However, never married (single) marital status (OR, 0.140; 95% CI, 0.030-0.649; P = 0.012) was associated with lower odds for HIV infection in non-drug users. Conclusion Altogether, these results suggest that socio-demographic and sexual risk factors for HIV transmission differ with drug use status, suggesting targeted preventive measures for drug users.
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Affiliation(s)
- Valentine Budambula
- Department of Environment and Health Sciences, Technical University of Mombasa, P. O. Box 90420-80100, Mombasa, Kenya.
| | - Charles Matoka
- Department of Applied Sciences, Technical University of Mombasa, P. O. Box 90420-80100, Mombasa, Kenya
| | - James Ouma
- Department of Environmental Health, University of Kabianga, P. O. Box 2030-20200, Kericho, Kenya
| | | | - Michael F Otieno
- Department of Medical Laboratory Sciences, Kenyatta University, P. O. Box 43844-00100, Nairobi, Kenya
| | - Tom Were
- Department of Medical Laboratory Sciences, Masinde Muliro University of Science and Technology, P.O. Box 190-50100, Kakamega, Kenya.
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Tchuenche M, Palmer E, Haté V, Thambinayagam A, Loykissoonlal D, Njeuhmeli E, Forsythe S. The Cost of Voluntary Medical Male Circumcision in South Africa. PLoS One 2016; 11:e0160207. [PMID: 27783612 PMCID: PMC5082632 DOI: 10.1371/journal.pone.0160207] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Accepted: 07/17/2016] [Indexed: 11/23/2022] Open
Abstract
Given compelling evidence associating voluntary medical male circumcision (VMMC) with men's reduced HIV acquisition through heterosexual intercourse, South Africa in 2010 began scaling up VMMC. To project the resources needed to complete 4.3 million circumcisions between 2010 and 2016, we (1) estimated the unit cost to provide VMMC; (2) assessed cost drivers and cost variances across eight provinces and VMMC service delivery modes; and (3) evaluated the costs associated with mobilize and motivate men and boys to access VMMC services. Cost data were systematically collected and analyzed using a provider's perspective from 33 Government and PEPFAR-supported (U.S. President's Emergency Plan for AIDS Relief) urban, rural, and peri-urban VMMC facilities. The cost per circumcision performed in 2014 was US$132 (R1,431): higher in public hospitals (US$158 [R1,710]) than in health centers and clinics (US$121 [R1,309]). There was no substantial difference between the cost at fixed circumcision sites and fixed sites that also offer outreach services. Direct labor costs could be reduced by 17% with task shifting from doctors to professional nurses; this could have saved as much as $15 million (R163.20 million) in 2015, when the goal was 1.6 million circumcisions. About $14.2 million (R154 million) was spent on medical male circumcision demand creation in South Africa in 2014-primarily on personnel, including community mobilizers (36%), and on small and mass media promotions (35%). Calculating the unit cost of VMMC demand creation was daunting, because data on the denominator (number of people reached with demand creation messages or number of people seeking VMMC as a result of demand creation) were not available. Because there are no "dose-response" data on demand creation ($X in demand creation will result in an additional Z% increase in VMMC clients), research is needed to determine the appropriate amount and allocation of demand creation resources.
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Affiliation(s)
- Michel Tchuenche
- Health Policy Project, Project SOAR (Supporting Operational AIDS Research), Avenir Health, Washington, District of Columbia, United States of America
| | - Eurica Palmer
- Health Policy Project, Palladium Consultant, Johannesburg, South Africa
| | - Vibhuti Haté
- George Washington University, Washington, District of Columbia, United States of America
| | | | | | | | - Steven Forsythe
- Health Policy Project, Project SOAR (Supporting Operational AIDS Research), Avenir Health, Washington, District of Columbia, United States of America
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Mlambo MG, Peltzer K, Chirinda W. Predictors of multiple concurrent and multiple sexual partnerships among male and female youth aged 18–24 in South Africa. JOURNAL OF PSYCHOLOGY IN AFRICA 2016. [DOI: 10.1080/14330237.2016.1163901] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Motlatso Gladys Mlambo
- Centre for Rural Health, Family Medicine Department, University of the Witwatersrand, South Africa
| | - Karl Peltzer
- HIV/AIDS/STIs and TB (HAST), Human Sciences Research Council, Pretoria, South Africa
- Department of Research and Innovation, University of Limpopo, Turfloop Campus, South Africa
- ASEAN Institute for Health Development, Mahidol University, Salaya, Thailand
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N WC, A S. Associated Risk Factors of STIs and Multiple Sexual Relationships among Youths in Malawi. PLoS One 2015; 10:e0134286. [PMID: 26248328 PMCID: PMC4527764 DOI: 10.1371/journal.pone.0134286] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Accepted: 07/07/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Having unprotected sex with multiple sexual partners (MSP) is the greatest risk factor for human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs) among youths. Young people with MSPs are less likely to use a condom and the greater the risk for STIs. This study examines the associated risk factors of STIs and multiple sexual partnerships among youths aged 15-24 years. DATA AND METHODS The Malawi Demographic Health Survey 2010 data was used. Out of a sample of 2,987 males and 9,559 females aged 15-24 years, 2,026 males and 6,470 females were considered in the study. Chi square test and logistic regression techniques were performed. Analysis was performed using Statistical Package for Social Sciences (SPSS) version 22. FINDINGS The results indicate that 1,399 (69.0%) males and 2,290 (35.4%) females reported multiple sexual partnerships (MSP). Within the rural area, females (n = 1779) were more likely to report MSP than males (n = 1082) and within the urban areas, a higher proportion of females (n = 511) still reported MSP, with males (n = 316). About 78% rural females aged 20-24 years, and about 79% rural males aged 15-19 years reported MSP. The likelihood of MSP was higher among females in the poorest households (OR = 1.31), being married (OR = 5.71) and Catholic males (OR = 1.63), who were married (OR = 1.59). Catholic males (OR = 1.82) in the rural areas, who were married (OR = 1.80) and rural females in the northern region (OR = 1.26) were more likely to have MSP. The odds ratios were higher among urban females in the poorest (OR = 3.45) households who were married (OR = 4.22). CONCLUSIONS Having more than one sexual partner increases the risk of STIs and sexuality education programs should be introduced that emphasize the danger that surrounds MSP.
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Affiliation(s)
- Wilson Chialepeh N
- Department of Statistics and Population Studies, University of the Western Cape, Cape Town, South Africa
| | - Sathiyasusuman A
- Department of Statistics and Population Studies, University of the Western Cape, Cape Town, South Africa
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