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The distribution of sex acts and condom use within partnerships in a rural sub-Saharan African population.

Smith J, Nyamukapa C, Gregson S, Lewis J, Magutshwa S, Schumacher C, Mushati P, Hallett T, Garnett G - PLoS ONE (2014)

Bottom Line: 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)).These variables were also associated with more consistent condom use.This will enable a better understanding of the spread of HIV and other STDs in this rural sub-Saharan population.

View Article: PubMed Central - PubMed

Affiliation: Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom.

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.

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Related in: MedlinePlus

Overlaid histograms showing the distributions of the numbers of sex acts (total, unprotected and protected) with a specified partner within the last two weeks for (A) men and (B) women.Note that the line for total sex acts is lower than that for either unprotected or protected sex acts at zero because individuals reporting either zero unprotected or protected sex acts did not often report zero sex acts in total (due to the observed bimodal pattern of condom use described later).
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pone-0088378-g001: Overlaid histograms showing the distributions of the numbers of sex acts (total, unprotected and protected) with a specified partner within the last two weeks for (A) men and (B) women.Note that the line for total sex acts is lower than that for either unprotected or protected sex acts at zero because individuals reporting either zero unprotected or protected sex acts did not often report zero sex acts in total (due to the observed bimodal pattern of condom use described later).

Mentions: Significant differences (p<0.001, Mann-Whitney U test) between men and women were found in the numbers of total, unprotected and protected sex acts in the past two weeks (Figures 1A and 1B). Among both men and women, no sex acts took place within the last two weeks for a substantial proportion of partnerships (13.4% and 14.6%, respectively). This suggests that the last sex act in these partnerships was 2–4 weeks previously. Few people report very high numbers of sex acts, yet there are still a large proportion reporting more than ten per week (12.1% and 13.6% for men and women, respectively). For both sexes, there is data heaping at 10, 14 and 28 sex acts, which represent 10 per fortnight and one or two per day, respectively.


The distribution of sex acts and condom use within partnerships in a rural sub-Saharan African population.

Smith J, Nyamukapa C, Gregson S, Lewis J, Magutshwa S, Schumacher C, Mushati P, Hallett T, Garnett G - PLoS ONE (2014)

Overlaid histograms showing the distributions of the numbers of sex acts (total, unprotected and protected) with a specified partner within the last two weeks for (A) men and (B) women.Note that the line for total sex acts is lower than that for either unprotected or protected sex acts at zero because individuals reporting either zero unprotected or protected sex acts did not often report zero sex acts in total (due to the observed bimodal pattern of condom use described later).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3928170&req=5

pone-0088378-g001: Overlaid histograms showing the distributions of the numbers of sex acts (total, unprotected and protected) with a specified partner within the last two weeks for (A) men and (B) women.Note that the line for total sex acts is lower than that for either unprotected or protected sex acts at zero because individuals reporting either zero unprotected or protected sex acts did not often report zero sex acts in total (due to the observed bimodal pattern of condom use described later).
Mentions: Significant differences (p<0.001, Mann-Whitney U test) between men and women were found in the numbers of total, unprotected and protected sex acts in the past two weeks (Figures 1A and 1B). Among both men and women, no sex acts took place within the last two weeks for a substantial proportion of partnerships (13.4% and 14.6%, respectively). This suggests that the last sex act in these partnerships was 2–4 weeks previously. Few people report very high numbers of sex acts, yet there are still a large proportion reporting more than ten per week (12.1% and 13.6% for men and women, respectively). For both sexes, there is data heaping at 10, 14 and 28 sex acts, which represent 10 per fortnight and one or two per day, respectively.

Bottom Line: 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)).These variables were also associated with more consistent condom use.This will enable a better understanding of the spread of HIV and other STDs in this rural sub-Saharan population.

View Article: PubMed Central - PubMed

Affiliation: Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom.

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.

Show MeSH
Related in: MedlinePlus