A Population-Based Study on Alcohol and High-Risk Sexual Behaviors in Botswana
Identifieur interne : 006E15 ( Main/Exploration ); précédent : 006E14; suivant : 006E16A Population-Based Study on Alcohol and High-Risk Sexual Behaviors in Botswana
Auteurs : Sheri D. Weiser [États-Unis] ; Karen Leiter [États-Unis] ; Michele Heisler [États-Unis] ; Willi Mcfarland [États-Unis] ; Fiona Percy-De Korte [États-Unis] ; Sonya M. Demonner [États-Unis] ; Sheila Tlou [Botswana] ; Nthabiseng Phaladze [Botswana] ; Vincent Iacopino [États-Unis] ; David R. Bangsberg [États-Unis]Source :
- PLoS Medicine [ 1549-1277 ] ; 2006.
Abstract
In Botswana, an estimated 24% of adults ages 15–49 years are infected with HIV. While alcohol use is strongly associated with HIV infection in Africa, few population-based studies have characterized the association of alcohol use with specific high-risk sexual behaviors.
We conducted a cross-sectional, population-based study of 1,268 adults from five districts in Botswana using a stratified two-stage probability sample design. Multivariate logistic regression was used to assess correlates of heavy alcohol consumption (>14 drinks/week for women, and >21 drinks/week for men) as a dependent variable. We also assessed gender-specific associations between alcohol use as a primary independent variable (categorized as none, moderate, problem and heavy drinking) and several risky sex outcomes including: (a) having unprotected sex with a nonmonogamous partner; (b) having multiple sexual partners; and (c) paying for or selling sex in exchange for money or other resources. Criteria for heavy drinking were met by 31% of men and 17% of women. Adjusted correlates of heavy alcohol use included male gender, intergenerational relationships (age gap ≥10 y), higher education, and living with a sexual partner. Among men, heavy alcohol use was associated with higher odds of all risky sex outcomes examined, including unprotected sex (AOR = 3.48; 95% confidence interval [CI], 1.65 to 7.32), multiple partners (AOR = 3.08; 95% CI, 1.95 to 4.87), and paying for sex (AOR = 3.65; 95% CI, 2.58 to 12.37). Similarly, among women, heavy alcohol consumption was associated with higher odds of unprotected sex (AOR = 3.28; 95% CI, 1.71 to 6.28), multiple partners (AOR = 3.05; 95% CI, 1.83 to 5.07), and selling sex (AOR = 8.50; 95% CI, 3.41 to 21.18). A dose-response relationship was seen between alcohol use and risky sexual behaviors, with moderate drinkers at lower risk than both problem and heavy drinkers.
Alcohol use is associated with multiple risks for HIV transmission among both men and women. The findings of this study underscore the need to integrate alcohol abuse and HIV prevention efforts in Botswana and elsewhere.
Url:
DOI: 10.1371/journal.pmed.0030392
PubMed: 17032060
PubMed Central: 1592342
Affiliations:
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Demonner</name><affiliation wicri:level="2"><nlm:aff id="aff1">Physicians for Human Rights, Cambridge, Massachusetts, United States of America</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Physicians for Human Rights, Cambridge, Massachusetts</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Tlou, Sheila" sort="Tlou, Sheila" uniqKey="Tlou S" first="Sheila" last="Tlou">Sheila Tlou</name><affiliation wicri:level="1"><nlm:aff id="aff6">Department of Nursing, University of Botswana, Gaborone, Botswana</nlm:aff><country xml:lang="fr">Botswana</country><wicri:regionArea>Department of Nursing, University of Botswana, Gaborone</wicri:regionArea><wicri:noRegion>Gaborone</wicri:noRegion></affiliation></author><author><name sortKey="Phaladze, Nthabiseng" sort="Phaladze, Nthabiseng" uniqKey="Phaladze N" first="Nthabiseng" last="Phaladze">Nthabiseng Phaladze</name><affiliation wicri:level="1"><nlm:aff id="aff6">Department of Nursing, University of Botswana, Gaborone, Botswana</nlm:aff><country xml:lang="fr">Botswana</country><wicri:regionArea>Department of Nursing, University of Botswana, Gaborone</wicri:regionArea><wicri:noRegion>Gaborone</wicri:noRegion></affiliation></author><author><name sortKey="Iacopino, Vincent" sort="Iacopino, Vincent" uniqKey="Iacopino V" first="Vincent" last="Iacopino">Vincent Iacopino</name><affiliation wicri:level="2"><nlm:aff id="aff1">Physicians for Human Rights, Cambridge, Massachusetts, United States of America</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Physicians for Human Rights, Cambridge, Massachusetts</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation><affiliation wicri:level="2"><nlm:aff id="aff7">Department of Medicine, University of Minnesota, Minneapolis, Minnesota, United States of America</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Medicine, University of Minnesota, Minneapolis, Minnesota</wicri:regionArea><placeName><region type="state">Minnesota</region></placeName></affiliation></author><author><name sortKey="Bangsberg, David R" sort="Bangsberg, David R" uniqKey="Bangsberg D" first="David R" last="Bangsberg">David R. 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Weiser</name><affiliation wicri:level="2"><nlm:aff id="aff1">Physicians for Human Rights, Cambridge, Massachusetts, United States of America</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Physicians for Human Rights, Cambridge, Massachusetts</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation><affiliation wicri:level="2"><nlm:aff id="aff2">Center for AIDS Prevention Studies, University of California San Francisco, San Francisco, California, United States of America</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Center for AIDS Prevention Studies, University of California San Francisco, San Francisco, California</wicri:regionArea><placeName><region type="state">Californie</region></placeName></affiliation><affiliation wicri:level="2"><nlm:aff id="aff3">Epidemiology and Prevention Interventions Center, Division of Infectious Diseases, San Francisco General Hospital, University of California San Francisco, San Francisco, California, United States of America</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Epidemiology and Prevention Interventions Center, Division of Infectious Diseases, San Francisco General Hospital, University of California San Francisco, San Francisco, California</wicri:regionArea><placeName><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Leiter, Karen" sort="Leiter, Karen" uniqKey="Leiter K" first="Karen" last="Leiter">Karen Leiter</name><affiliation wicri:level="2"><nlm:aff id="aff1">Physicians for Human Rights, Cambridge, Massachusetts, United States of America</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Physicians for Human Rights, Cambridge, Massachusetts</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Heisler, Michele" sort="Heisler, Michele" uniqKey="Heisler M" first="Michele" last="Heisler">Michele Heisler</name><affiliation wicri:level="2"><nlm:aff id="aff1">Physicians for Human Rights, Cambridge, Massachusetts, United States of America</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Physicians for Human Rights, Cambridge, Massachusetts</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation><affiliation wicri:level="2"><nlm:aff id="aff4">Veterans Affairs Ann Arbor Health System and Department of Internal Medicine, University of Michigan School of Medicine, Ann Arbor, Michigan, United States of America</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Veterans Affairs Ann Arbor Health System and Department of Internal Medicine, University of Michigan School of Medicine, Ann Arbor, Michigan</wicri:regionArea><placeName><region type="state">Michigan</region></placeName></affiliation></author><author><name sortKey="Mcfarland, Willi" sort="Mcfarland, Willi" uniqKey="Mcfarland W" first="Willi" last="Mcfarland">Willi Mcfarland</name><affiliation wicri:level="2"><nlm:aff id="aff2">Center for AIDS Prevention Studies, University of California San Francisco, San Francisco, California, United States of America</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Center for AIDS Prevention Studies, University of California San Francisco, San Francisco, California</wicri:regionArea><placeName><region type="state">Californie</region></placeName></affiliation><affiliation wicri:level="2"><nlm:aff id="aff5">San Francisco Department of Public Health, San Francisco, California, United States of America</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>San Francisco Department of Public Health, San Francisco, California</wicri:regionArea><placeName><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Korte, Fiona Percy De" sort="Korte, Fiona Percy De" uniqKey="Korte F" first="Fiona Percy-De" last="Korte">Fiona Percy-De Korte</name><affiliation wicri:level="2"><nlm:aff id="aff1">Physicians for Human Rights, Cambridge, Massachusetts, United States of America</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Physicians for Human Rights, Cambridge, Massachusetts</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Demonner, Sonya M" sort="Demonner, Sonya M" uniqKey="Demonner S" first="Sonya M" last="Demonner">Sonya M. Demonner</name><affiliation wicri:level="2"><nlm:aff id="aff1">Physicians for Human Rights, Cambridge, Massachusetts, United States of America</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Physicians for Human Rights, Cambridge, Massachusetts</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Tlou, Sheila" sort="Tlou, Sheila" uniqKey="Tlou S" first="Sheila" last="Tlou">Sheila Tlou</name><affiliation wicri:level="1"><nlm:aff id="aff6">Department of Nursing, University of Botswana, Gaborone, Botswana</nlm:aff><country xml:lang="fr">Botswana</country><wicri:regionArea>Department of Nursing, University of Botswana, Gaborone</wicri:regionArea><wicri:noRegion>Gaborone</wicri:noRegion></affiliation></author><author><name sortKey="Phaladze, Nthabiseng" sort="Phaladze, Nthabiseng" uniqKey="Phaladze N" first="Nthabiseng" last="Phaladze">Nthabiseng Phaladze</name><affiliation wicri:level="1"><nlm:aff id="aff6">Department of Nursing, University of Botswana, Gaborone, Botswana</nlm:aff><country xml:lang="fr">Botswana</country><wicri:regionArea>Department of Nursing, University of Botswana, Gaborone</wicri:regionArea><wicri:noRegion>Gaborone</wicri:noRegion></affiliation></author><author><name sortKey="Iacopino, Vincent" sort="Iacopino, Vincent" uniqKey="Iacopino V" first="Vincent" last="Iacopino">Vincent Iacopino</name><affiliation wicri:level="2"><nlm:aff id="aff1">Physicians for Human Rights, Cambridge, Massachusetts, United States of America</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Physicians for Human Rights, Cambridge, Massachusetts</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation><affiliation wicri:level="2"><nlm:aff id="aff7">Department of Medicine, University of Minnesota, Minneapolis, Minnesota, United States of America</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Medicine, University of Minnesota, Minneapolis, Minnesota</wicri:regionArea><placeName><region type="state">Minnesota</region></placeName></affiliation></author><author><name sortKey="Bangsberg, David R" sort="Bangsberg, David R" uniqKey="Bangsberg D" first="David R" last="Bangsberg">David R. Bangsberg</name><affiliation wicri:level="2"><nlm:aff id="aff3">Epidemiology and Prevention Interventions Center, Division of Infectious Diseases, San Francisco General Hospital, University of California San Francisco, San Francisco, California, United States of America</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Epidemiology and Prevention Interventions Center, Division of Infectious Diseases, San Francisco General Hospital, University of California San Francisco, San Francisco, California</wicri:regionArea><placeName><region type="state">Californie</region></placeName></affiliation><affiliation wicri:level="2"><nlm:aff id="aff8">Positive Health Program, San Francisco General Hospital, University of California San Francisco, San Francisco, California, United States of America</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Positive Health Program, San Francisco General Hospital, University of California San Francisco, San Francisco, California</wicri:regionArea><placeName><region type="state">Californie</region></placeName></affiliation></author></analytic><series><title level="j">PLoS Medicine</title><idno type="ISSN">1549-1277</idno><idno type="eISSN">1549-1676</idno><imprint><date when="2006">2006</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="st1"><title>Background</title><p>In Botswana, an estimated 24% of adults ages 15–49 years are infected with HIV. While alcohol use is strongly associated with HIV infection in Africa, few population-based studies have characterized the association of alcohol use with specific high-risk sexual behaviors.</p></sec><sec id="st2"><title>Methods and Findings</title><p>We conducted a cross-sectional, population-based study of 1,268 adults from five districts in Botswana using a stratified two-stage probability sample design. Multivariate logistic regression was used to assess correlates of heavy alcohol consumption (>14 drinks/week for women, and >21 drinks/week for men) as a dependent variable. We also assessed gender-specific associations between alcohol use as a primary independent variable (categorized as none, moderate, problem and heavy drinking) and several risky sex outcomes including: (a) having unprotected sex with a nonmonogamous partner; (b) having multiple sexual partners; and (c) paying for or selling sex in exchange for money or other resources. Criteria for heavy drinking were met by 31% of men and 17% of women. Adjusted correlates of heavy alcohol use included male gender, intergenerational relationships (age gap ≥10 y), higher education, and living with a sexual partner. Among men, heavy alcohol use was associated with higher odds of all risky sex outcomes examined, including unprotected sex (AOR = 3.48; 95% confidence interval [CI], 1.65 to 7.32), multiple partners (AOR = 3.08; 95% CI, 1.95 to 4.87), and paying for sex (AOR = 3.65; 95% CI, 2.58 to 12.37). Similarly, among women, heavy alcohol consumption was associated with higher odds of unprotected sex (AOR = 3.28; 95% CI, 1.71 to 6.28), multiple partners (AOR = 3.05; 95% CI, 1.83 to 5.07), and selling sex (AOR = 8.50; 95% CI, 3.41 to 21.18). A dose-response relationship was seen between alcohol use and risky sexual behaviors, with moderate drinkers at lower risk than both problem and heavy drinkers.</p></sec><sec id="st3"><title>Conclusions</title><p>Alcohol use is associated with multiple risks for HIV transmission among both men and women. The findings of this study underscore the need to integrate alcohol abuse and HIV prevention efforts in Botswana and elsewhere.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Fritz, Ke" uniqKey="Fritz K">KE Fritz</name></author><author><name sortKey="Woelk, Gb" uniqKey="Woelk G">GB Woelk</name></author><author><name sortKey="Bassett, Mt" uniqKey="Bassett M">MT Bassett</name></author><author><name sortKey="Mcfarland, Wc" uniqKey="Mcfarland W">WC McFarland</name></author><author><name sortKey="Routh, Ja" uniqKey="Routh J">JA Routh</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mnyika, Ks" uniqKey="Mnyika K">KS Mnyika</name></author><author><name sortKey="Klepp, Ki" uniqKey="Klepp K">KI Klepp</name></author><author><name sortKey="Kvale, G" uniqKey="Kvale G">G Kvale</name></author><author><name sortKey="Ole King Ori, N" uniqKey="Ole King Ori N">N Ole-King'ori</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Simbayi, Lc" uniqKey="Simbayi L">LC Simbayi</name></author><author><name sortKey="Kalichman, Sc" uniqKey="Kalichman S">SC Kalichman</name></author><author><name sortKey="Jooste, S" uniqKey="Jooste S">S Jooste</name></author><author><name sortKey="Mathiti, V" uniqKey="Mathiti V">V Mathiti</name></author><author><name sortKey="Cain, D" uniqKey="Cain D">D Cain</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Morrison, Cs" uniqKey="Morrison C">CS Morrison</name></author><author><name sortKey="Sunkutu, Mr" uniqKey="Sunkutu M">MR Sunkutu</name></author><author><name sortKey="Musaba, E" uniqKey="Musaba E">E Musaba</name></author><author><name sortKey="Glover, Lh" uniqKey="Glover L">LH Glover</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kapiga, Sh" uniqKey="Kapiga S">SH Kapiga</name></author><author><name sortKey="Lyamuya, Ef" uniqKey="Lyamuya E">EF Lyamuya</name></author><author><name sortKey="Lwihula, Gk" uniqKey="Lwihula G">GK Lwihula</name></author><author><name sortKey="Hunter, Dj" uniqKey="Hunter D">DJ Hunter</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hargreaves, Jr" uniqKey="Hargreaves J">JR Hargreaves</name></author><author><name sortKey="Morison, La" uniqKey="Morison L">LA Morison</name></author><author><name sortKey="Chege, J" uniqKey="Chege J">J Chege</name></author><author><name sortKey="Rutenburg, N" uniqKey="Rutenburg N">N Rutenburg</name></author><author><name sortKey="Kahindo, M" uniqKey="Kahindo M">M Kahindo</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mbulaiteye, Sm" uniqKey="Mbulaiteye S">SM Mbulaiteye</name></author><author><name sortKey="Ruberantwari, A" uniqKey="Ruberantwari A">A Ruberantwari</name></author><author><name sortKey="Nakiyingi, Js" uniqKey="Nakiyingi J">JS 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sortKey="Mataure, P" uniqKey="Mataure P">P Mataure</name></author><author><name sortKey="Mcfarland, W" uniqKey="Mcfarland W">W McFarland</name></author><author><name sortKey="Fritz, K" uniqKey="Fritz K">K Fritz</name></author><author><name sortKey="Kim, A" uniqKey="Kim A">A Kim</name></author><author><name sortKey="Woelk, G" uniqKey="Woelk G">G Woelk</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Obot, Is" uniqKey="Obot I">IS Obot</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Parry, Cd" uniqKey="Parry C">CD Parry</name></author><author><name sortKey="Bhana, A" uniqKey="Bhana A">A Bhana</name></author><author><name sortKey="Myers, B" uniqKey="Myers B">B Myers</name></author><author><name sortKey="Pluddemann, A" uniqKey="Pluddemann A">A Pluddemann</name></author><author><name sortKey="Flisher, Aj" uniqKey="Flisher A">AJ Flisher</name></author></analytic></biblStruct><biblStruct><analytic><author><name 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Sam</name></author><author><name sortKey="Shao, Jf" uniqKey="Shao J">JF Shao</name></author><author><name sortKey="Renjifo, B" uniqKey="Renjifo B">B Renjifo</name></author><author><name sortKey="Masenga, Ej" uniqKey="Masenga E">EJ Masenga</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Station, C" uniqKey="Station C">C Station</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Parry, Cd" uniqKey="Parry C">CD Parry</name></author><author><name sortKey="Pluddemann, A" uniqKey="Pluddemann A">A Pluddemann</name></author><author><name sortKey="Steyn, K" uniqKey="Steyn K">K Steyn</name></author><author><name sortKey="Bradshaw, D" uniqKey="Bradshaw D">D Bradshaw</name></author><author><name sortKey="Norman, R" uniqKey="Norman R">R Norman</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Suggs, Dn" uniqKey="Suggs D">DN Suggs</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ajuwon, Aj" uniqKey="Ajuwon A">AJ Ajuwon</name></author><author><name sortKey="Mcfarland, W" uniqKey="Mcfarland W">W McFarland</name></author><author><name sortKey="Hudes, Es" uniqKey="Hudes E">ES Hudes</name></author><author><name sortKey="Adepapo, S" uniqKey="Adepapo S">S Adepapo</name></author><author><name sortKey="Okikiolu, T" uniqKey="Okikiolu T">T Okikiolu</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Pettifor, Ae" uniqKey="Pettifor A">AE Pettifor</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Dunkle, Kl" uniqKey="Dunkle K">KL Dunkle</name></author><author><name sortKey="Jewkes, Rk" uniqKey="Jewkes R">RK Jewkes</name></author><author><name sortKey="Brown, Hc" uniqKey="Brown H">HC Brown</name></author><author><name sortKey="Gray, Ge" uniqKey="Gray G">GE Gray</name></author><author><name sortKey="Mcintryre, Ja" uniqKey="Mcintryre J">JA McIntryre</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Strathdee, Sa" uniqKey="Strathdee S">SA Strathdee</name></author><author><name sortKey="Hogg, Rs" uniqKey="Hogg R">RS Hogg</name></author><author><name sortKey="Martindale, Sl" uniqKey="Martindale S">SL Martindale</name></author><author><name sortKey="Cornelisse, Pg" uniqKey="Cornelisse P">PG Cornelisse</name></author><author><name sortKey="Craib, Kj" uniqKey="Craib K">KJ Craib</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Williams, Ct" uniqKey="Williams C">CT Williams</name></author><author><name sortKey="Latkin, Ca" uniqKey="Latkin C">CA Latkin</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Botswana</li><li>États-Unis</li></country><region><li>Californie</li><li>Massachusetts</li><li>Michigan</li><li>Minnesota</li></region></list><tree><country name="États-Unis"><region name="Massachusetts"><name sortKey="Weiser, Sheri D" sort="Weiser, Sheri D" uniqKey="Weiser S" first="Sheri D" last="Weiser">Sheri D. 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Demonner</name><name sortKey="Heisler, Michele" sort="Heisler, Michele" uniqKey="Heisler M" first="Michele" last="Heisler">Michele Heisler</name><name sortKey="Heisler, Michele" sort="Heisler, Michele" uniqKey="Heisler M" first="Michele" last="Heisler">Michele Heisler</name><name sortKey="Iacopino, Vincent" sort="Iacopino, Vincent" uniqKey="Iacopino V" first="Vincent" last="Iacopino">Vincent Iacopino</name><name sortKey="Iacopino, Vincent" sort="Iacopino, Vincent" uniqKey="Iacopino V" first="Vincent" last="Iacopino">Vincent Iacopino</name><name sortKey="Korte, Fiona Percy De" sort="Korte, Fiona Percy De" uniqKey="Korte F" first="Fiona Percy-De" last="Korte">Fiona Percy-De Korte</name><name sortKey="Leiter, Karen" sort="Leiter, Karen" uniqKey="Leiter K" first="Karen" last="Leiter">Karen Leiter</name><name sortKey="Mcfarland, Willi" sort="Mcfarland, Willi" uniqKey="Mcfarland W" first="Willi" last="Mcfarland">Willi Mcfarland</name><name sortKey="Mcfarland, Willi" sort="Mcfarland, Willi" uniqKey="Mcfarland W" first="Willi" last="Mcfarland">Willi Mcfarland</name><name sortKey="Weiser, Sheri D" sort="Weiser, Sheri D" uniqKey="Weiser S" first="Sheri D" last="Weiser">Sheri D. Weiser</name><name sortKey="Weiser, Sheri D" sort="Weiser, Sheri D" uniqKey="Weiser S" first="Sheri D" last="Weiser">Sheri D. Weiser</name></country><country name="Botswana"><noRegion><name sortKey="Tlou, Sheila" sort="Tlou, Sheila" uniqKey="Tlou S" first="Sheila" last="Tlou">Sheila Tlou</name></noRegion><name sortKey="Phaladze, Nthabiseng" sort="Phaladze, Nthabiseng" uniqKey="Phaladze N" first="Nthabiseng" last="Phaladze">Nthabiseng Phaladze</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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