Condom, modern contraceptive, and dual method use are associated with HIV status and relationship concurrency in a context of high mobility: A cross-sectional study of women of reproductive age in rural Kenya and Uganda, 2016

Lee, Joi K.; Gutin, Sarah A.; Getahun, Monica; Okiring, Jaffer; Neilands, Torsten B.; Akullian, Adam; Ssali, Sarah; Cohen, Craig R.; Maeri, Irene; Eyul, Patrick; Kamya, Moses R.; Bukusi, Elizabeth A.; Charlebois, Edwin D.; Camlin, Carol S.

doi:10.1016/j.contraception.2022.09.001

Cited by 3 publications

(3 citation statements)

References 29 publications

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“…El historial reproductivo de la pareja y la evaluación de su estado de salud sexual es un aspecto relevante al momento de decidir si mantener relaciones sexuales o no, la preocupación por el posible contagio previo de una ITS puede motivar el uso simultáneo de dos anticonceptivos, de barrera y hormonal. En concordancia con ello, diversos estudios (10,18,28) encontraron que es más probable que una mujer use la doble protección cuando la pareja ha presentado una ITS previamente; esta evidencia no se alinea a los hallazgos presentes, en los que el diagnóstico previo de ITS en la pareja no fue un factor determinante para usar esta anticoncepción.…”

Section: Discussionunclassified

“…El uso de la protección dual es variable en cada contexto, estudios previos realizados en mujeres universitarias demostraron que entre el 10 % y 40 %, aproximadamente, eran usuarias de este tipo de anticoncepción (8)(9)(10). Pese a su importancia preventiva, su uso puede ser facilitado u obstaculizado por condiciones propias de las personas y de su entorno, como aspectos culturales, demográficos, conocimientos previos vinculados al cuidado de su salud, antecedentes sexuales y reproductivos (11)(12)(13).…”

Section: Introductionunclassified

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Doble protección anticonceptiva en estudiantes de obstetricia: Un estudio de factores asociados

Rodriguez-Clemente,

Guillén-Calle,

Barja-Ore

2024

RSOGV

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Objective: To determine which factors are associated with the use of dual protection in obstetrics students from a public university in Lima, Peru. Methods: Analytical cross-sectional study, done in 217 obstetrics students from the Universidad Nacional Mayor de San Marcos.The chi-squared test was applied, in addition to the raw and adjusted prevalence ratio (PR) Results: The prevalence of the use of dual protection was 41.5%. In the bivariate analysis, the factors associated with it included: age from 25 to 29 years old (raw prevalence ratio: 1.57), Lima as a place of origin (raw prevalence ratio: 2.07), previous pregnancy (raw prevalence ratio: 1.91), previous abortion (raw prevalence ratio: 1.92), antecedent of STI in the couple (raw prevalence ratio: 1.81), knowledge about dual protection (raw prevalence ratio: 3,16), and orientation in family planning (raw prevalence ratio: 1.76). In the multivariate analysis, knowledge about contraceptive protection maintained its significant association (adjusted prevalence ratio: 2.44). Conclusions: Knowledge about contraceptive protection is the only reproductive factor that was associated with a higher probability of using this method. Keywords: Contraceptives, Risk Factors, Contraceptive Hormonal, Condoms.

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Section: Discussionunclassified

Section: Introductionunclassified

Doble protección anticonceptiva en estudiantes de obstetricia: Un estudio de factores asociados

Rodriguez-Clemente,

Guillén-Calle,

Barja-Ore

2024

RSOGV

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“…SEARCH was a cluster-randomized trial conducted between 2013 and 2017 in Kenya and Uganda designed to test the effect of universal ART ("test and treat") on HIV incidence and other health outcomes [12]. In 2016, the "Mobility in SEARCH" study enrolled a cohort from 6 control and 6 intervention SEARCH communities via stratified random sampling (defined by gender, HIV status, and prior mobility) to examine the impact of mobility on sexual risk behavior, HIV and sexually transmitted infection incidence, and HIV care engagement [10,11,[13][14][15][16][17]. At enrollment, participants answered detailed questionnaires regarding demographics, lifetime migration histories, and overnight travel in the past 6 months.…”

Section: Study Design and Samplementioning

confidence: 99%

Geographic Mobility and HIV Care Engagement among People Living with HIV in Rural Kenya and Uganda

Ayieko,

Thorp,

Getahun

et al. 2023

TropicalMed

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Introduction: Human mobility is a critical aspect of existence and survival, but may compromise care engagement among people living with HIV (PLHIV). We examined the association between various forms of human mobility with retention in HIV care and antiretroviral treatment (ART) interruptions. Methods: In a cohort of adult PLHIV in Kenya and Uganda, we collected surveys in 2016 about past 6-month travel and lifetime migration histories, including reasons and locations, and engagement in HIV care defined as (1) discontinuation of care, and (2) history of a treatment interruption among those who remained in care. We estimated associations between mobility and these care engagement outcomes via logistic regression, adjusted for sex, prior mobility, age, region, marital status, household wealth, and education. Results: Among 1081 participants, 56 (5%) reported having discontinued care; among those in care, 104 (10%) reported treatment interruption. Past-year migration was associated with a higher risk of discontinuation of care (adjusted odds ratio [aOR] 1.98, 95% CI 1.08–3.63). In sex-stratified models, the association was somewhat attenuated in women, but remained robust among men. Past-year migration was associated with reduced odds of having a treatment interruption among men (aOR 0.51, 95% CI 0.34–0.77) but not among women (aOR 2.67, 95% CI 0.78, 9.16). Travel in the past 6 months was not associated with discontinuation of care or treatment interruptions. Conclusions: We observed both negative and protective effects of recent migration on care engagement and ART use that were most pronounced among men in this cohort. Migration can break ties to ongoing care, but for men, who have more agency in the decision to migrate, may foster new care and treatment strategies. Strategies that enable health facilities to support individuals throughout the process of transferring care could alleviate the risk of care disengagement.

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Stigma of infidelity associated with condom use explains low rates of condom uptake: qualitative data from Uganda and Tanzania

et al. 2023

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Despite widespread messaging supporting male (external) condom use to prevent HIV in endemic settings, utilization of condoms is low across sub-Saharan Africa. A thorough understanding of barriers to condom use as a form of HIV prevention is necessary to reduce HIV transmission. Here, we present qualitative data from rural eastern Africa to explain low utilization of condoms among heterosexual adults. Focus groups and interviews were conducted in Tanzania and Uganda between 2016 and 2019. A content analysis approach was used to identify attitudes about condoms and factors related to use/non-use. We found that strategies such as abstinence and being faithful to one’s partner are perceived as ideal but rarely achievable methods of HIV prevention. Condoms are used in the setting of “failure” to abstain or be faithful and are therefore stigmatized as markers of infidelity. As such, use within cohabiting and long-term relationships is low. Our data suggest that negative perceptions of condoms may stem from persistent effects of the formerly applied “ABC” HIV prevention approach, a public health messaging strategy that described A—abstinence, B—be faithful, and C—use a condom as tiered prevention tools. Condom uptake could increase if HIV prevention messaging acknowledges existing stigma and reframes condom use for proactive health prevention. These studies were approved by Weill Cornell Medicine (Protocols 1803019105 and 1604017171), Mbarara University of Science and Technology (Protocol 16/0117), Uganda National Council of Science and Technology (Protocol SS-4338), and the Tanzania National Institute for Medical Research (Protocol NIMR/HQ/R.8c/Vol.I/1330).

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Condom, modern contraceptive, and dual method use are associated with HIV status and relationship concurrency in a context of high mobility: A cross-sectional study of women of reproductive age in rural Kenya and Uganda, 2016

Cited by 3 publications

References 29 publications

Doble protección anticonceptiva en estudiantes de obstetricia: Un estudio de factores asociados

Doble protección anticonceptiva en estudiantes de obstetricia: Un estudio de factores asociados

Geographic Mobility and HIV Care Engagement among People Living with HIV in Rural Kenya and Uganda

Stigma of infidelity associated with condom use explains low rates of condom uptake: qualitative data from Uganda and Tanzania

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