sexual behavior

The objective of this study was to examine the prevalence and individual-, household- and community-level factors associated with HIV infection among women of reproductive age in Mozambique. We used nationally representative cross-sectional data from the 2015 Survey of Indicators on Immunization, Malaria and HIV or AIDS in Mozambique. A sample of 4726 women of reproductive age was included in this study. The seroprevalence of HIV among women in Mozambique was 10.3% (95% CI 9.2%, 11.6%). Furthermore, women who had two, three and four or more total lifetime number of sex partners were 2.73, 5.61 and 3.95 times as likely to have HIV infection when compared with women with only one lifetime sex partners, respectively. In addition, women of Islam religion had 60% reduction in HIV infection when compared with Christian women (adjusted odds ratio, AOR = 0.40; 95% CI 0.16, 0.99). Female headship and wealth quintiles were associated with HIV infection at household level. Community illiteracy, intimate partner violence, poverty and geographical region were associated with HIV infection at community level.

Poor socio-economic conditions fuel seasonal migration of adult males from Northwestern Ethiopia, but behavioral and other migration-related changes increase their vulnerability to HIV. This study examined risky sexual behaviors and associated factors that may lead to increased HIV infection vulnerability among migrant laborers in Metema District, Ethiopia. A community-based cross-sectional study was conducted from July 8–18, 2013 at farms with migrant laborers. We enrolled 756 participants through multistage random sampling. Of the participants, 582 (77%) migrant workers had had sexual intercourse in their lifetimes and 68% (397/582) reported non-marital sexual intercourse in the preceding six months. Of these, 74% reported sexual intercourse with commercial sex workers (CSWs), 49% reported having transactional sex, 49% reported unprotected sexual intercourse with CSWs, and 69% reported multiple sexual partners in the preceding six months (mean = 2.9 ± 0.7). Being aged between 20 and 29 years, aged 30 years or older, having received of HIV prevention information in the preceding six months, and staying longer on the farm were factors significantly associated with condom use at last non-marital sexual intercourse. Teenaged respondents aged , those who had not received HIV information in the preceding six months, or those who had stayed on the farm for ≤2 months were less likely to have used condoms at their last non-marital sexual intercourse. Moreover, having daily income above US$5, paying for most recent sexual intercourse, and drinking alcohol before last sexual intercourse were significantly associated with having multiple (≥2) sexual partners during the preceding six months. We concluded that seasonal laborers commonly exhibit risky sexual behaviors likely to increase their vulnerability to HIV infection. Unprotected and multiple sex partners in these populations pose transmission risks to seasonal laborers, their wives, and future sexual partners. The findings support the need for targeted HIV prevention campaigns designed for seasonal workers and their sexual partners.

A major strategy for preventing transmission of HIV and other STIs is the consistent use of condoms during sexual intercourse. Condom use among youths is particularly important to reduce the number of new cases and the national prevalence. Although a number of studies have established an association between condom use at one’s sexual debut and future condom use, few studies have explored this association over time, and whether the results are generalizable across multiple locations. This multi time point, multi district study assesses the relationship between sexual debut and condom use and consistent use of condoms thereafter. Uganda has used Lot Quality Assurance Sampling surveys since 2003 to monitor district level HIV programs and improve access to HIV health services. This study includes 4518 sexually active youths interviewed at five time points (2003–2010) in up to 23 districts located across Uganda. Using logistic regression, we measured the association of condom use at first sexual intercourse on recent condom usage, controlling for several factors including: age, sex, education, marital status, age at first intercourse, geographical location, and survey year. The odds of condom use at last intercourse, using a condom at last intercourse with a non-regular partner, and consistently using a condom are, respectively, 9.63 (95%WaldCI = 8.03–11.56), 3.48 (95%WaldCI = 2.27–5.33), and 11.12 (95%WaldCI = 8.95–13.81) times more likely for those individuals using condoms during their sexual debut. The results suggest that HIV prevention programs should encourage condom use among youth during sexual debut. Success with this outcome may have a lasting influence on preventing HIV and other STIs later in life.

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