Urban-rural disparity in sociodemographic characteristics and sexual behaviors of HIV-positive adolescent girls and young women and their perspectives on their male sexual partners: A cross-sectional study in Zimbabwe

Abstract

We conducted a cross sectional survey in Zimbabwe to describe urban-rural disparity in socio-demographic characteristics and sexual behaviors of HIV-positive adolescent girls and young women (AGYW) and their male sexual partners. Between September and November 2016, we interviewed 360 sexually active HIV positive AGYW, aged 15-24 years attending ART and PMTCT clinics in urban and rural health facilities in Harare and Mazowe district respectively. HIV positive AGYW in rural areas as compared to those in urban areas were older, less educated, more frequently married or cohabiting, had lower number of male sexual partners in their lifetime and in the last 12 months preceding the survey. They were mostly heterosexually infected, more likely to disclose their status to a family member and to be more adherent to ART (OR = 2.5-95% CI = 1.1-5.5). Most recent male sexual partners of HIV positive AGYW in urban areas as compared to those from rural areas were mainly current or former boyfriends, single, more educated, less likely to have a child with them and to engage in couple voluntary counseling and testing (CVCT). They were more likely to patronize dancing and drinking venues and involved in transactional sex (OR = 2.2-95% CI: 1.2-4). They were also more likely to be circumcised (OR = 2.3-95% CI: 1.3-4.1) and to use condom more consistently in the last 12 months preceding the survey. Our study findings called for the strengthening of HIV prevention interventions in urban areas among HIV positive AGYW who had more than one partner in their lifetime or are patronizing dancing and drinking venues. In Zimbabwe, promotion of CVCT, index testing, male circumcision and condom use should be sustained to engage male sexual partners of both urban and rural HIV positive AGYW in HIV prevention.

Factors Associated with HIV Status Disclosure to Orphans and Vulnerable Children Living with HIV: Results from a Longitudinal Study in Tanzania

“…A study that assessed the prevalence and factors associated with HIV status disclosure among children and adolescents selected from urban and rural clinics across western Kenya reported a higher prevalence of disclosure among children at rural clinics than those at a large referral hospital in the urban area [8]. In contrast, a study done in Zimbabwe revealed that adolescent girls and young women in rural areas learned their HIVpositive status for the first time at an older age (median of 19 years), compared to those in urban areas (median of 16 years) [28]. Interestingly, in contrast to the results for the whole study population that female caregivers were less likely to disclose HIV status of their OVC, female caregivers of multiple OVCLHIV were more likely to disclose HIV status to all OVC living in the same household, compared to their male counterparts.…”

Impact of COVID-19 on Malaria Elimination: Juxtaposing Indoor Residual Spraying and Mobile Phones in Buhera Rural District, Zimbabwe

“…The acquisition of mobile phones in most of Zimbabwe's rural areas is increasing, making mobile phones the most feasible communication gadget for people in resource-constrained areas [17]. Also, many of Zimbabwe population (over 67%) lives in rural areas [58] and heavily depends on mobile phones for communication and making payments using mobile money platforms such as EcoCash, One-Money, MyCash and Tele-Cash because of cash shortages [59]. Owing to this proliferation, mobile phones especially short messaging service (SMS) could be utilized to promote and market IRS programme and campaigns in malaria hotspots area and high-risk population in Buhera rural district.…”

Impact of COVID-19 on Malaria Elimination: Juxtaposing Indoor Residual Spraying and Mobile Phones in Buhera Rural District, Zimbabwe

“…The ownership of mobile phones in most of Zimbabwe's rural areas is at the boom, making it the most feasible communication even in resource-constrained areas [33]. Also, many of Zimbabwe population (over 67%) lives in rural areas [57] and heavily depends on mobile phones for communication and making payments using mobile money platforms such as EcoCash, One-Money, MyCash and Tele-Cash because of cash shortages [58]. Owing to this proliferation, mobile phones especially short messaging service (SMS) could be utilized to promote and market IRS programme and campaigns in malaria hotspots area and high-risk population in Buhera rural district.…”