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Prevalence and social drivers of HIV among married and cohabitating heterosexual adults in south-eastern Tanzania = analysis of adult health community cohort data

Mtenga, Sally M. and Pfeiffer, Constanze and Merten, Sonja and Mamdani, Masuma and Exavery, Amon and Haafkens, Joke and Tanner, Marcel and Geubbels, Eveline. (2015) Prevalence and social drivers of HIV among married and cohabitating heterosexual adults in south-eastern Tanzania = analysis of adult health community cohort data. Global health action, Vol. 8 , 28941.

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Official URL: http://edoc.unibas.ch/dok/A6438861

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Abstract

In sub-Saharan Africa, the prevalence of HIV among married and cohabiting couples is substantial. Information about the underlying social drivers of HIV transmission in couples is critical for the development of structural approaches to HIV prevention, but not readily available. We explored the association between social drivers, practices, and HIV status among stable couples in Ifakara, Tanzania.; Using a cross-sectional design, we analyzed data from a sample of 3,988 married or cohabiting individuals, aged 15 years and older from the MZIMA adult health community cohort study of 2013. Sociodemographic factors (sex, income, age, and education), gender norms (perceived acceptability for a wife to ask her partner to use a condom when she knows he is HIV positive), marriage characteristics (being in a monogamous or a polygamous marriage, being remarried), sexual behavior practices (lifetime number of sexual partners and concurrent sexual partners), health system factors (ever used voluntary HIV counseling and testing), and lifestyle patterns (alcohol use) were used to explore the odds of being HIV positive, with 95% confidence intervals.; Prevalence of HIV/AIDS was 6.7% (5.9% males and 7.1% females). Gender norms, that is, perception that a woman is not justified to ask her husband to use a condom even when she knows he has a disease (adjusted odds ratio AOR=1.51, 95% CI 1.06-2.17), marital characteristics, that is, being remarried (AOR=1.49, 95% CI 1.08-2.04), and sexual behavior characteristics, that is, lifetime number of sexual partners (2-4: AOR=1.47, 95% CI 1.02-2.11; 5+: AOR=1.61, 95% CI 1.05-2.47) were the main independent predictors of HIV prevalence.; Among married or cohabiting individuals, the key social drivers/practices that appeared to make people more vulnerable for HIV are gender norms, marriage characteristics (being remarried), and sexual behavior practices (lifetime number of sexual partners). Married and cohabiting couples are an important target group for HIV prevention efforts in Tanzania. In addition to individual interventions, structural interventions are needed to address the gender norms, remarriage, and sexual practices that shape differential vulnerability to HIV in stable couples.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Epidemiology and Public Health (EPH) > Society, Gender and Health > Medical Anthropology (Obrist)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
03 Faculty of Medicine > Departement Public Health > Sozial- und Präventivmedizin > Malaria Vaccines (Tanner)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Epidemiology and Public Health (EPH) > Health Interventions > Malaria Vaccines (Tanner)
UniBasel Contributors:Pfeiffer, Constanze D. and Merten, Sonja and Tanner, Marcel
Item Type:Article, refereed
Article Subtype:Research Article
Bibsysno:Link to catalogue
Publisher:Co-Action Publishing]
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:06 Nov 2015 10:21
Deposited On:06 Nov 2015 10:21

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