Prevalence and Correlates of HIV Testing among Young People Enrolled in Non-Formal Education Centers in Urban Chiang Mai, Thailand

Background

HIV testing is the gateway to HIV prevention, treatment, and care. Despite the established vulnerability of young Thai people to HIV infection, studies examining the prevalence and correlates of HIV testing among the general population of Thai youth are still very limited. This study investigates socio-demographic, behavioral, and psychosocial factors associated with HIV testing among young Thai people enrolled in Non-formal Education Centers (NFEC) in urban Chiang Mai, Northern Thailand.

Methods

This was a cross-sectional quantitative study conducted among young unmarried Thai youth—between the ages of 15 and 24—who were enrolled in NFEC in urban Chiang Mai. Multiple logistic regressions were used to identify correlates of “ever tested for HIV” among the sexually active participants.

Findings

Of the 295 sexually active participants, 27.3% reported “ever tested for HIV;” 65.4% “did not consistently use condom;” and 61.7% “had at least 2 lifetime partners.” We found that “self-efficacy” (AOR, 4.92; CI, 1.22–19.73); “perception that it is easy to find a location nearby to test for HIV” (AOR, 4.67; CI, 1.21–18.06); “having at least 2 lifetime sexual partners” (AOR, 2.05; CI, 1.09–3.85); and “ever been pregnant or made someone pregnant” (AOR, 4.06; CI, 2.69–9.15); were associated with increased odds of having ever been tested. On the other hand, “fear of HIV test results” (AOR, 0.21; CI, 0.08–0.57) was associated with lower odds of ever having been tested for HIV.

Conclusion

The main finding is that a substantially high proportion of Thai youth is engaged in risky sexual behaviors—yet reports low rates of ever having been tested for HIV. This highlights an urgent need to develop appropriate interventions—based on the identified correlates of HIV testing. There is also an urgent need to enhance HIV testing and to promote safer sexual behaviors among young Thai people—particularly those who are out-of-school.

Full article at:   http://goo.gl/r4869M

By:  

Patou Masika Musumari, Teeranee Techasrivichien, S. Pilar Suguimoto, Masako Ono-Kihara, Masahiro Kihara
Department of Global Health and Socio-epidemiology, Kyoto University School of Public Health, Kyoto, Japan

Arunrat Tangmunkongvorakul, Kriengkrai Srithanaviboonchai, Sawang Yungyuankul, Suwat Chariyalertsak
Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand

Kriengkrai Srithanaviboonchai, Suwat Chariyalertsak
Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand

S. Pilar Suguimoto
Center of Medical Education, Graduate School of Medicine, Kyoto University, Kyoto, Japan

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Your Face is Your Fortune: Does Adolescent Attractiveness Predict Intimate Relationships Later in Life?

OBJECTIVE:

A growing literature documents the importance of physical attractiveness in young and middle adulthood for romantic, marital, and sexual relationships, but little is known about how attractiveness in adolescence matters to intimate relationships in later life. We ask: does attractiveness early in life convey ongoing benefits late in life, or do such benefits erode over time?

METHODS:

We use multivariate regression models and more than 50 years of data from the Wisconsin Longitudinal Study to examine the connections between adolescent physical attractiveness and intimate relationships (i.e., sexual activity and access to potential sexual partners) in later life.

RESULTS:

We find that adolescent attractiveness facilitates sexual activity in later life. This relationship is largely driven by attractiveness increasing the probability of having access to potential sexual partners. However, attractiveness is not related to sexual activity among married couples, even after controlling for marital duration. Men, those in good health, and wealthier individuals are also more likely to engage in several facets of intimate relationships.

DISCUSSION:

These findings highlight the importance of relationship context for later life sexual activity and begin to explicate the pathways through which factors across the life course-particularly attractiveness-influence sexual activity in later life.

Purchase full article at:   http://goo.gl/Ms73g7

By:   Karraker A1, Sicinski K2, Moynihan D3.

• 1Human Development and Family Studies, Iowa State University. karraker@iastate.edu.
• 2Center for Demography of Health and Aging and.
• 3La Follette School of Public Affairs, University of Wisconsin-Madison. 

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Determinants of Late Presentation to HIV/AIDS Care in Southern Tigray Zone, Northern Ethiopia

Background

Late diagnosis and presentation to human immune deficiency virus (HIV)/acquired immune deficiency syndrome care reduce the benefits of antiretroviral therapy and increase the risk of HIV transmission.

Objectives

This study was conducted to identify determinants of late presentation to HIV care among people living with HIV in Southern Tigray, Northern Ethiopia.

Methods

An institution based un-matched case–control (1:2 ratios) supported with qualitative data was conducted in Southern Tigray Zone from March 1 to April 30, 2014. Individuals with HIV enrolled from six randomly selected health facilities were included in the study. Cases were people living with HIV who had cluster of differentiation four count <350 cells/μl or World Health Organization stages 3 or 4. A total of 442 study participants were included by systematic sampling techniques. Bivariable and multivariable binary logistic regression model was used to identify associated factors. Odds ratio with 95 % CI was computed to assess the strength of the associations.

Result

Age categories, 25–29 years and 35–39 years, having two and more lifetime sexual partners, poor social support, second (next to lowest) wealth quintile, fear of stigma, fear of losing job, and reported severe illness were identified to be the risk factors for late presentation.

Conclusion

Low socio-economic status and social support, fear of stigma were potential risk factors for late presentation. Efforts towards promoting early care seeking should target on these factors in the study area and other similar settings.

Table 3

FGD results extracted from HIV positive individuals works on mothers supporting groups concerning barriers to early HIV/AIDS care, Southern Tigray Zone, April 2014

Barriers to HIV/AIDS care	HIV/AIDS positive individuals working on Mother Supporting Group
Fear of stigma	“… I was worried that people will talk about me if they hear I tested positive”… Male-32 “When I became aware of my HIV status my challenge was fear of health professionals and seeing other individuals I know while attending the ART clinic”, Female-27.
Fear of losing income source/former job	“People seem supportive towards HIV positives at first, but the pain is that they gradually change their feeling and treat you as ‘too weak’ to accomplish your duty …HIV positives will be shifted to lower status/position”, Male-55 “Although they are HIV positive, numerous commercial sex workers in the town continue their commercial sex work”, Female-27
Use of non-medical treatment	“…then she ate a dried Wild boar’s meat and Wild boar’s bile”, Female-30 “…he told me a very bitter plant called ‘Oure’ or ‘Eret’ is medicine for HIV and he had been drinking it until he ended up dying”, Female-30 “I went to a local traditional healer called ‘TonqualIi’ or magician and spent around 3000 Ethiopian Birr then he told to my wife wash my body using sheep’s blood and dung added together ….”, Male-38 “There was one HIV-positive neighbor with symptoms of diarrhea, she bought drugs from the pharmacy, was relieved of her symptoms for some time and then went to other pharmacy a few days later….”, Female-30 “My husband and were severely diseased and confined to bed for around 6 months. He had been telling that his illness was due to other diseases like malaria, and he has been getting medicines from drug stores”, Female-34
Low families driving force for initiation care	“We should let peoples think for the next generation…If my children are healthy…..”, Male -32 … “My child is negative”, Female-27, “My wife and children are negative”, Males-32, 55
Inadequacy of social support (spouse, friends and religious leaders)	“… I show him my ART drugs that I am taking and he became persuaded to take his treatment too”, Female-55 “I become angry and decided not to take any treatment for 1 year. Later on my friends were taking HIV treatment and they encouraged me to take treatment.” Male-28 “Males say that we are healthy even though we have the HIV and nothing bad is going on us, but, females become ill and suffer from headache and they come to ART clinics saying I tested positive for HIV …”, Female-27 “….later on my wife went to the health center and tested positive after that she encouraged me to be tested …”, Male-38 “…..I then persuaded my husband to be tested for HIV and avoided taking other drugs from outside the treatment center’’, Female-34 “My brother shouts at me, you should be tested and know the cause for your illness today; I will help every expense that follows …..”, Female-35 “…she was severely ill and her family said that they didn’t want to take care of the dead”, Female-27
Inadequate knowledge	“The HIV testing sites that are conducted in the shade in town are always crowded with people being tested, especially males. But they don’t come to care once they have tested positive [F-55] and they can only be accessed after they become diseased, arriving on a stretcher or by ambulance, or when found during house-to-house tracing by volunteer HIV support groups. …”, Female-34

Full article at:  http://goo.gl/tRVDU0

By:  Yalemzewod Assefa Gelaw

Email author, 

Goitom Halefom Senbete, 

Akelew Awoke Adane and 

Kefyalew Addis Alene

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Prevalence & Correlates of HIV-Risky Sexual Behaviors among Students Attending the Medical & Social Welfare Center of the University of Maroua, Cameroon

Data on sexual behaviors in Cameroonian youths are needed to design and implement effective preventive strategies against HIV/AIDS. This study aimed at assessing sociodemographic and religious factors associated with sexual behaviors among university students in Cameroon.

In 2011, 411 university students were surveyed by a self-administered questionnaire at the Medical and Social Welfare Center of the University of Maroua. Logistic regression analyses were used to determine correlates of sexual behaviors.

80.8 % of students were sexually active. The mean age at sexual debut was 18.1 years. The frequency of premarital sex was 92.8 %. Pornography viewing and an increased age of 1 year were significantly associated with having previously had sex. The likelihood to have a lower (<18) age at sexual debut was increased by male gender, and urban origin. The probability to have a high number (#3) of lifetime sexual partners was increased by age, pornography viewing, an early sexual debut, having had occasional sexual partners, and was decreased by Muslim religious affiliation. Having had casual sexual partners was associated with less inconsistent condom use.

Our findings indicate that there is an alarming level of risky sexual behaviors among the study population. Strong and efficient measures should be undertaken to handle such harmful behaviors, this for the prevention and control of HIV/AIDS and other STIs in this vulnerable population.

Table 3

Adjusted correlates of having previously had sex, low age at sexual debut, high number of lifetime sexual partners and inconsistent condom use

Explanatory variables (referent)	Dependent variables aOR (95 % CI)
	Having previously had sex (n = 411)	Low age at sexual debut (n = 332)	High number of lifetime sexual partners (n = 332)	Inconsistent condom use (n = 332)
Age (increase by 1 year)	1.3 (1.2–1.4)****	1.0 (0.9–1.0)	1.1 (1.0–1.2)***	1.0 (0.9–1.1)
Female (male)	1.3 (0.7–2.5)	0.4 (0.2–0.6)***	1.0 (0.6–1.9)
Collocation accommodation (in family)	1.5 (0.7–3.2)	1.6 (0.8–3.2)
Single accommodation (in family)	1.8 (1.8–3.6)*	1.7 (0.9–3.3)
Unmarried (married)				0.3 (0.2–0.8)*
Urban (rural)		2.9 (1.5–5.7)**		0.5 (0.3–1.0)
Polygamous (monogamous)a
Single parent (monogamous)a
Low educational level of head of household (high)		0.6 (0.3–1.0)
Academic level (undergraduate)
Types of studies (sciences)
Catholic affiliation (Pentecostal)			0.7 (0.2–2.2)
Muslim affiliation (Pentecostal)			0.2 (0.1–0.9)*
Protestant affiliation (Pentecostal)			0.8 (0.2–2.8)
Had sexual education at school (yes)		1.4 (0.9–2.5)		1.1 (0.6–1.9)
Had ever discussed with parent about sexuality (yes)		0.8 (0.5–1.3)		1.5 (0.9–2.6)
Had ever watched pornography (no)	3.4 (1.8–6.4)****		4.3 (1.9–9.5)***	0.7 (0.3–1.3)
Age at sexual debut (high)			2.8 (1.6–5.0)***	0.9 (0.6–1.5)
Previously had casual sexual partners (no)			7.0 (3.7–13.1)****	0.5 (0.3–0.9)*
Number of lifetime sexual partners (low)				0.6 (0.4–1.0)*
Inconsistent condom use (no)			0.7 (0.4–1.3)

The best model selected based on the Akaike Information Criterion is presented for each outcome variable

aOR adjusted odds ratio

a Marital status of parents of household during childhood

* p < 0.05; ** p < 0.01; *** p < 0.001; **** p < 0.0001

Full article at: http://goo.gl/WyC1Se

By: Jean Jacques N. Noubiap, Jobert Richie N. Nansseu, Shalom Tchokfe Ndoula, Binhuan Wang, Ahmadou M. Jingi, Jean Joel R. Bigna, Leopold N. Aminde, Rosette Amélie Youmbi, and Joël Fokom-Domgue

Department of Medicine, Groote Schuur Hospital and University of Cape Town, 7925 Observatory, Cape Town, South Africa

Medical Diagnostic Center, Yaoundé, Cameroon

Intensive Care Unit, Mother and Child Centre, Chantal Biya Foundation, Yaoundé, Cameroon

Guidiguis Health District, Guidiguis, Cameroon

Medical and Social Welfare Center of the University of Maroua, Maroua, Cameroon

Department of Population Health, Division of Biostatistics, New York School of Medicine, New York, USA

Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon

Department of Epidemiology and Public Health, Pasteur Center of Cameroon, PO Box 1274, Yaounde, Cameroon

Clinical Research Education, Networking & Consultancy (CRENC), Douala, Cameroon

Department of Obstetrics and Gynecology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon

Jean Jacques N. Noubiap, Phone: +27 73 803 6352, Email: rf.oohay@jjpaibuon.

   

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Child Maltreatment and Sexual Risk Behavior: Maltreatment Types and Gender Differences

To compare sexual risk behaviors in maltreated male and female sexually active adolescents with a comparison population and examine whether specific maltreatment experiences were associated with sexual risk behaviors and teen pregnancy.

Data came from the fourth assessment (M = 7.2 years after baseline) of an ongoing longitudinal study with case-control design. The sample was restricted to only the sexually active adolescents, leaving a sample of 251 (n = 82 comparison, n = 169 maltreated, mean age = 18.49 years, SD = 1.46). Maltreatment type was coded from case records, and sexual behaviors were assessed via computerized questionnaire.

• Maltreated youth were significantly younger at first consensual intercourse than comparison youth, and males were younger than females. 
• Maltreated males reported significantly higher number of lifetime sexual partners than maltreated females. 
• Neglected, sexually abused, and physically abused youth were more likely to have had a one-night stand than comparison youth. 
• Sexually abused females were at higher risk of having sex under the influence than other maltreated females. 
• Neglected females were more likely to have ever been pregnant than females with other maltreatment types or comparison females. 
• A higher number of maltreatment victimizations predicted a younger age at first pregnancy involvement for both sexes.

Many maltreated youth continue to be at high risk for engaging in behaviors that may initiate a trajectory of problematic sexual behaviors. The findings highlight maltreated males and neglected females as vulnerable groups that should be targeted in prevention efforts to curtail sexual risk behaviors and prevent teenage pregnancy.

Via: http://ht.ly/SxNgv Purchase full article at: http://goo.gl/SnkgaX

By: Negriff S1, Schneiderman JU, Trickett PK.

• 1School of Social Work, University of Southern California, Los Angeles, CA.
• 
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