Population Sexual Behavior and HIV Prevalence in Sub-Saharan Africa: Missing links?
OBJECTIVES:
Patterns
of sexual partnering should shape HIV transmission in human populations. Our
objective was to assess empirical associations between population casual-sex
behavior and HIV prevalence, and between different measures of casual-sex
behavior.
METHODS:
An
ecologic study design was applied to nationally-representative data, that of
the Demographic and Health Surveys, in 25 countries in sub-Saharan Africa.
Spearman rank correlation was used to assess different correlations for males
and females and their statistical significance.
RESULTS:
Correlations
between HIV prevalence and means and variances of the number of casual-sex
partners were positive, but small and statistically insignificant. The majority
of correlations across means and variances of the number of casual-sex partners
were positive, large, and statistically significant. However, all correlations
between the means, as well as variances, and the variance of unmarried females
were weak and statistically insignificant.
CONCLUSIONS:
Population
sexual behavior was not predictive of HIV prevalence across these countries.
Nevertheless, the strong correlations across means and variances of sexual
behavior suggest that self-reported sexual data are self-consistent and convey
valid information content. Unmarried female behavior seemed puzzling, but could
be playing an influential role in HIV transmission patterns.
- 1Division of Bioinformatics, Research Center for Zoonosis Control, Hokkaido University, Sapporo, Hokkaido, 001-0020, Japan; Infectious Disease Epidemiology Group, Weill Cornell Medicine - Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar; Department of Healthcare Policy and Research, Weill Cornell Medicine, Cornell University, New York, New York, USA; JST, PRESTO, 4-1-8 Honcho, Kawaguchi, Saitama, 332-0012, Japan. Electronic address: omori@czc.hokudai.ac.jp.
- 2Infectious Disease Epidemiology Group, Weill Cornell Medicine - Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar; Department of Healthcare Policy and Research, Weill Cornell Medicine, Cornell University, New York, New York, USA; College of Public Health, Hamad bin Khalifa University, Doha, Qatar. Electronic address: lja2002@qatar-med.cornell.edu.
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