The Distribution of Sex Acts and Condom Use Within Partnerships in a Rural Sub-Saharan African Population

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2014 Feb 22

PMID 24558387

Citations 9

Authors

Jennifer Smith

Constance Nyamukapa

Simon Gregson

James Lewis

Sitholubuhle Magutshwa

Christina Schumacher

Phyllis Mushati

Tim Hallett

Geoff Garnett

Affiliations

Soon will be listed here.

Abstract

Introduction: In an HIV/AIDS epidemic driven primarily by heterosexual transmission, it is important to have an understanding of the human sexual behaviour patterns that influence transmission. We analysed the distribution and predictors of within-partnership sexual behaviour and condom use in rural Zimbabwe and generated parameters for use in future modelling analyses.

Methods: A population-based cohort was recruited from a household census in 12 communities. A baseline survey was carried out in 1998-2000 with follow-up surveys after 3 and 5 years. Statistical distributions were fitted to reported within-partnership numbers of total, unprotected and protected sex acts in the past two weeks. Multilevel linear and logistic regression models were constructed to assess predictors of the frequency of unprotected sex and consistent condom use.

Results: A normal distribution of ln(sex acts+1) provided the best fit for total and unprotected sex acts for men and women. A negative binomial distribution applied to the untransformed data provided the best fit for protected sex acts. Condom use within partnerships was predominantly bimodal with at least 88% reporting zero or 100% use. Both men and women reported fewer unprotected sex acts with non-regular compared to regular partners (men: 0.26 fewer every two weeks (95% confidence interval 0.18-0.34); women: 0.16 (0.07-0.23)). Never and previously married individuals reported fewer unprotected sex acts than currently married individuals (never married men: 0.64 (0.60-0.67); previously married men: 0.59 (0.50-0.67); never married women: 0.51 (0.45-0.57); previously married women: 0.42 (0.37-0.47)). These variables were also associated with more consistent condom use.

Discussion: We generated parameters that will be useful for defining transmission models of HIV and other STIs, which rely on a valid representation of the underlying sexual network that determines spread of an infection. This will enable a better understanding of the spread of HIV and other STDs in this rural sub-Saharan population.

Citing Articles

Relationships between changes in HIV risk perception and condom use in East Zimbabwe 2003-2013: population-based longitudinal analyses.

Schaefer R, Thomas R, Maswera R, Kadzura N, Nyamukapa C, Gregson S BMC Public Health. 2020; 20(1):756.

PMID: 32448365 PMC: 7245904. DOI: 10.1186/s12889-020-08815-1.

Economy, migrant labour and sex work: interplay of HIV epidemic drivers in Zimbabwe over three decades.

Steen R, Hontelez J, Mugurungi O, Mpofu A, Matthijsse S, de Vlas S AIDS. 2018; 33(1):123-131.

PMID: 30475261 PMC: 6415983. DOI: 10.1097/QAD.0000000000002066.

Projected effectiveness and added value of HIV vaccination campaigns in South Africa: A modeling study.

de Montigny S, Adamson B, Masse B, Garrison Jr L, Kublin J, B Gilbert P Sci Rep. 2018; 8(1):6066.

PMID: 29666455 PMC: 5904131. DOI: 10.1038/s41598-018-24268-4.

Partner age differences and associated sexual risk behaviours among adolescent girls and young women in a cash transfer programme for schooling in Malawi.

Beauclair R, Dushoff J, Delva W BMC Public Health. 2018; 18(1):403.

PMID: 29587710 PMC: 5872581. DOI: 10.1186/s12889-018-5327-7.

Documenting and explaining the HIV decline in east Zimbabwe: the Manicaland General Population Cohort.

Gregson S, Mugurungi O, Eaton J, Takaruza A, Rhead R, Maswera R BMJ Open. 2017; 7(10):e015898.

PMID: 28988165 PMC: 5639985. DOI: 10.1136/bmjopen-2017-015898.

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