Determinants of high-risk sexual behaviour and condom use among adults in the Arusha region, Tanzania

Abstract

Determinants of multiple sexual partners and condom use among adults were assessed through a population-based survey in one urban, one semi-urban and one rural community in the Arusha region, northern Tanzania. The study samples were obtained by randomly selecting clusters of 10 households from the 3 communities. Informed verbal consent was sought from each respondent for participation in the study. High-risk sexual behaviours and condom use were assessed using a structured questionnaire. It was observed that significantly more men than women reported having multiple sexual partners (49% vs 25.2%; OR = 1.69; 95% CI = 1.51-1.90) and urban men were significantly more likely to report having multiple sexual partners than men in rural areas. In both men and women, early sexual debut was associated with having multiple sexual partners while travel, alcohol use, and sex under the influence of alcohol were significantly associated with multiple sexual partners in men only. AIDS-related discussion was significantly associated with having fewer sexual partners in both men and women. Of the 1551 respondents, 320 (20.6%) reported having ever used a condom and of the 320 respondents who had ever used a condom, 34 (10.6%) reported having used it at the last sexual intercourse. Significantly more men than women reported having ever used a condom (34.1% vs 14.1%; OR = 1.77; 95% CI = 1.56-2.01). In both men and women, early sexual debut and being young, unmarried, travelling out of the Arusha region and having multiple sexual partners were associated with increased condom use. For both men and women, frequent discussion of AIDS with family members or friends was associated with increased condom use. These data suggest that interventions targeting adolescents and young adults may be effective for control of HIV transmission in Tanzania. In particular, creation of opportunities for people to come together and discuss AIDS might be an important strategy.

Predictors of Condom Use Among Young Adults in South Africa: The Reproductive Health and HIV Research Unit National Youth Survey

“…In our study, participants who were married or had been involved in a relationship with their most recent sexual partner for 6 months or longer were less likely to have used a condom during their most recent sexual intercourse. It is well established that trust and commitment are associated with decreased condom use, 22,25 and in mutually monogamous relationships between uninfected partners, this is reasonable and expected. However, in long-standing relationships that are not mutually monogamous, in which the partners are serodiscordant (when one is infected with HIV and the other is not), or in which either partner is unaware of his or her HIV status, decreased condom use may be risky.…”

“…Factors such as communication between partners, however, have been found to increase likelihood of condom use. 22 Finally, gender and sexual power dynamics, 23,24 and coercion associated with sexual power dynamics, 25,26 are also inextricably linked to condom nonuse.…”

Education, substance use, and HIV risk among orphaned adolescents in Eastern Zimbabwe

“…Strong associations between substance use and sexual risk behaviours have been reported previously and include smoking, drinking, and drug use being associated with sexual risk behaviours in general (Duncan, Strycker, & Duncan, 1999; Jackson, Sweeting, & Haw, 2012; Tu, Lou, Gao, Li, & Zabin, 2012), early sexual debut (Lowry et al, 1994), and number of sexual partners (Lowry et al, 1994; Shrier, Emans, Woods, & DuRant, 1997). Binge drinking has been associated with a higher number of partners (Guo et al, 2002), while more generally alcohol consumption has been associated with sexual debut, multiple sexual partners, and unprotected sex, all of which lead to an increased risk of HIV infection (Ayisi et al, 2000; Bassett et al, 1996; Clift et al, 2003; Lewis et al, 2005; Mnyika, Klepp, Kvale, & Ole-King’Ori, 1997; Myer, Mathews, & Little, 2002; Somsé, Chapko, & Hawkins, 1993; Zachariah et al, 2003). The increased risk of HIV infection may be attributable to the social consequences of substance use, which facilitates unprotected sex.…”

Factors Influencing Condom Use Among Sexually Transmitted Infection Clinic Patients in Montego Bay, Jamaica

“…The findings of studies on condom use in relation to number of sexual partners appear to be inconsistent. Some studies suggest that there is greater condom use among individuals with multiple partners [20][21][22] while others report decreased condom use particularly among women [18] and adolescents [23] with multiple partners. It is also important to note that some investigators have shown that individuals report greater condom use with non-regular sexual partners as compared to regular partners [14].…”