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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

Observed and fitted distributions of the number of sex acts in the last two weeks.Panels A, C and E represent the numbers of sex acts (total, unprotected and protected) reported by men and B, D and F represent the same for women. A normal approximation of ln(sex acts+1) is used for A–D, and a negative binomial approximation of the untransformed data is used for E and F.
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pone-0088378-g002: Observed and fitted distributions of the number of sex acts in the last two weeks.Panels A, C and E represent the numbers of sex acts (total, unprotected and protected) reported by men and B, D and F represent the same for women. A normal approximation of ln(sex acts+1) is used for A–D, and a negative binomial approximation of the untransformed data is used for E and F.

Mentions: Different distributions were fitted to the data for each of the main sexual behaviour indicators examined (Table S2 in File S1). For total and unprotected sex acts, the normal approximation of ln(sex acts+1) was found to best represent the data; for protected sex acts, the best fit was given by the negative binomial distribution applied to the untransformed data. The fitted distributions are shown in Figure 2. As in Figure 1, the distributions for the numbers of total and unprotected sex acts in the previous two weeks are similar within and between the sexes, with the differences occurring at the low numbers.


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)

Observed and fitted distributions of the number of sex acts in the last two weeks.Panels A, C and E represent the numbers of sex acts (total, unprotected and protected) reported by men and B, D and F represent the same for women. A normal approximation of ln(sex acts+1) is used for A–D, and a negative binomial approximation of the untransformed data is used for E and F.
© Copyright Policy
Related In: Results  -  Collection

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

pone-0088378-g002: Observed and fitted distributions of the number of sex acts in the last two weeks.Panels A, C and E represent the numbers of sex acts (total, unprotected and protected) reported by men and B, D and F represent the same for women. A normal approximation of ln(sex acts+1) is used for A–D, and a negative binomial approximation of the untransformed data is used for E and F.
Mentions: Different distributions were fitted to the data for each of the main sexual behaviour indicators examined (Table S2 in File S1). For total and unprotected sex acts, the normal approximation of ln(sex acts+1) was found to best represent the data; for protected sex acts, the best fit was given by the negative binomial distribution applied to the untransformed data. The fitted distributions are shown in Figure 2. As in Figure 1, the distributions for the numbers of total and unprotected sex acts in the previous two weeks are similar within and between the sexes, with the differences occurring at the low numbers.

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