Le SIDA en Afrique subsaharienne (serveur d'exploration)

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Concurrency and other sexual partnership patterns reported in a survey of young people in rural Northern Tanzania

Identifieur interne : 000283 ( Pmc/Checkpoint ); précédent : 000282; suivant : 000284

Concurrency and other sexual partnership patterns reported in a survey of young people in rural Northern Tanzania

Auteurs : Aoife M. Doyle [Royaume-Uni] ; Mary L. Plummer [Tanzanie] ; Helen A. Weiss [Royaume-Uni] ; John Changalucha [Tanzanie] ; Deborah Watson-Jones [Royaume-Uni] ; Richard J. Hayes [Royaume-Uni] ; David A. Ross [Suisse]

Source :

RBID : PMC:5570426

Abstract

African adolescents and young adults remain at substantial risk of infection with HIV and other sexually transmitted infections (STIs), and AIDS is the leading cause of death among African adolescents (10–19 years). Sexual partnership patterns influence transmission risk of sexually transmitted infections. We describe patterns reported by youth (15-30y) in a community-based survey in Tanzania. Among participants reporting multiple partners, we investigated factors associated with reported concurrency. Female (N = 6513) and male (N = 7301) participants had median ages of 21 and 22 years, respectively. Most participants (92%) reported having previously been sexually active, of whom 15% of males and <1% of females reported ≥4 partners in the past year. The point prevalence of concurrency was 2.3% (95%CI 1.9–2.9) for females and 10.6% (95%CI 9.3–12.1) for males. High levels of multiple and concurrent partnerships were reported by those previously married. Females were more likely than males to report having spousal/regular partners and longer partnership lengths. Compared to males, the partnerships reported by females were less likely to be new partnerships, and more likely to be defined by the respondent as still ‘ongoing’. Females reporting younger sexual debut were more likely to report concurrent sexual partners. Far fewer young women reported multiple and concurrent partnerships, but we cannot definitively conclude that concurrency was uncommon for women, because stigma towards women’s multiple sexual partnerships might contribute to substantial under-reporting, as was found in extensive qualitative research in the study population. This study provides one of the most comprehensive quantitative descriptions of partnership patterns of young people in an African setting. Interventions addressing sexual risk among youth should involve male partners, empower women to protect themselves within different types of partnerships, and encourage a greater openness about young people’s sexual relationships.


Url:
DOI: 10.1371/journal.pone.0182567
PubMed: 28837686
PubMed Central: 5570426


Affiliations:


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PMC:5570426

Le document en format XML

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<contrib-group>
<contrib contrib-type="author">
<contrib-id authenticated="true" contrib-id-type="orcid">http://orcid.org/0000-0002-3305-7738</contrib-id>
<name>
<surname>Doyle</surname>
<given-names>Aoife M.</given-names>
</name>
<role content-type="http://credit.casrai.org/">Conceptualization</role>
<role content-type="http://credit.casrai.org/">Formal analysis</role>
<role content-type="http://credit.casrai.org/">Methodology</role>
<role content-type="http://credit.casrai.org/">Writing – original draft</role>
<xref ref-type="aff" rid="aff001">
<sup>1</sup>
</xref>
<xref ref-type="corresp" rid="cor001">*</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Plummer</surname>
<given-names>Mary L.</given-names>
</name>
<role content-type="http://credit.casrai.org/">Conceptualization</role>
<role content-type="http://credit.casrai.org/">Investigation</role>
<role content-type="http://credit.casrai.org/">Writing – review & editing</role>
<xref ref-type="aff" rid="aff002">
<sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Weiss</surname>
<given-names>Helen A.</given-names>
</name>
<role content-type="http://credit.casrai.org/">Conceptualization</role>
<role content-type="http://credit.casrai.org/">Formal analysis</role>
<role content-type="http://credit.casrai.org/">Writing – review & editing</role>
<xref ref-type="aff" rid="aff001">
<sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Changalucha</surname>
<given-names>John</given-names>
</name>
<role content-type="http://credit.casrai.org/">Funding acquisition</role>
<role content-type="http://credit.casrai.org/">Supervision</role>
<role content-type="http://credit.casrai.org/">Writing – review & editing</role>
<xref ref-type="aff" rid="aff003">
<sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Watson-Jones</surname>
<given-names>Deborah</given-names>
</name>
<role content-type="http://credit.casrai.org/">Conceptualization</role>
<role content-type="http://credit.casrai.org/">Funding acquisition</role>
<role content-type="http://credit.casrai.org/">Writing – review & editing</role>
<xref ref-type="aff" rid="aff004">
<sup>4</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Hayes</surname>
<given-names>Richard J.</given-names>
</name>
<role content-type="http://credit.casrai.org/">Conceptualization</role>
<role content-type="http://credit.casrai.org/">Funding acquisition</role>
<role content-type="http://credit.casrai.org/">Supervision</role>
<role content-type="http://credit.casrai.org/">Writing – review & editing</role>
<xref ref-type="aff" rid="aff001">
<sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Ross</surname>
<given-names>David A.</given-names>
</name>
<role content-type="http://credit.casrai.org/">Conceptualization</role>
<role content-type="http://credit.casrai.org/">Funding acquisition</role>
<role content-type="http://credit.casrai.org/">Supervision</role>
<role content-type="http://credit.casrai.org/">Writing – review & editing</role>
<xref ref-type="aff" rid="aff005">
<sup>5</sup>
</xref>
</contrib>
</contrib-group>
<aff id="aff001">
<label>1</label>
<addr-line>MRC Tropical Epidemiology Group, London School of Hygiene & Tropical Medicine, London, United Kingdom</addr-line>
</aff>
<aff id="aff002">
<label>2</label>
<addr-line>Independent consultant, Dar es Salaam, Tanzania</addr-line>
</aff>
<aff id="aff003">
<label>3</label>
<addr-line>National Institute for Medical Research, Mwanza, Tanzania</addr-line>
</aff>
<aff id="aff004">
<label>4</label>
<addr-line>Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, United Kingdom</addr-line>
</aff>
<aff id="aff005">
<label>5</label>
<addr-line>World Health Organization, Geneva, Switzerland</addr-line>
</aff>
<contrib-group>
<contrib contrib-type="editor">
<name>
<surname>Harezlak</surname>
<given-names>Jaroslaw</given-names>
</name>
<role>Editor</role>
<xref ref-type="aff" rid="edit1"></xref>
</contrib>
</contrib-group>
<aff id="edit1">
<addr-line>Indiana University, UNITED STATES</addr-line>
</aff>
<author-notes>
<fn fn-type="COI-statement" id="coi001">
<p>
<bold>Competing Interests: </bold>
The authors have declared that no competing interests exist.</p>
</fn>
<corresp id="cor001">* E-mail:
<email>aoife.doyle@lshtm.ac.uk</email>
</corresp>
</author-notes>
<pub-date pub-type="epub">
<day>24</day>
<month>8</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="collection">
<year>2017</year>
</pub-date>
<volume>12</volume>
<issue>8</issue>
<elocation-id>e0182567</elocation-id>
<history>
<date date-type="received">
<day>23</day>
<month>3</month>
<year>2017</year>
</date>
<date date-type="accepted">
<day>20</day>
<month>7</month>
<year>2017</year>
</date>
</history>
<permissions>
<copyright-statement>© 2017 Doyle et al</copyright-statement>
<copyright-year>2017</copyright-year>
<copyright-holder>Doyle et al</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/">
<license-p>This is an open access article distributed under the terms of the
<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">Creative Commons Attribution License</ext-link>
, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</license-p>
</license>
</permissions>
<self-uri content-type="pdf" xlink:href="pone.0182567.pdf"></self-uri>
<abstract>
<p>African adolescents and young adults remain at substantial risk of infection with HIV and other sexually transmitted infections (STIs), and AIDS is the leading cause of death among African adolescents (10–19 years). Sexual partnership patterns influence transmission risk of sexually transmitted infections. We describe patterns reported by youth (15-30y) in a community-based survey in Tanzania. Among participants reporting multiple partners, we investigated factors associated with reported concurrency. Female (N = 6513) and male (N = 7301) participants had median ages of 21 and 22 years, respectively. Most participants (92%) reported having previously been sexually active, of whom 15% of males and <1% of females reported ≥4 partners in the past year. The point prevalence of concurrency was 2.3% (95%CI 1.9–2.9) for females and 10.6% (95%CI 9.3–12.1) for males. High levels of multiple and concurrent partnerships were reported by those previously married. Females were more likely than males to report having spousal/regular partners and longer partnership lengths. Compared to males, the partnerships reported by females were less likely to be new partnerships, and more likely to be defined by the respondent as still ‘ongoing’. Females reporting younger sexual debut were more likely to report concurrent sexual partners. Far fewer young women reported multiple and concurrent partnerships, but we cannot definitively conclude that concurrency was uncommon for women, because stigma towards women’s multiple sexual partnerships might contribute to substantial under-reporting, as was found in extensive qualitative research in the study population. This study provides one of the most comprehensive quantitative descriptions of partnership patterns of young people in an African setting. Interventions addressing sexual risk among youth should involve male partners, empower women to protect themselves within different types of partnerships, and encourage a greater openness about young people’s sexual relationships.</p>
</abstract>
<funding-group>
<award-group id="award001">
<funding-source>
<institution-wrap>
<institution-id institution-id-type="funder-id">http://dx.doi.org/10.13039/501100000265</institution-id>
<institution>Medical Research Council</institution>
</institution-wrap>
</funding-source>
<award-id>G0902121</award-id>
<principal-award-recipient>
<contrib-id authenticated="true" contrib-id-type="orcid">http://orcid.org/0000-0002-3305-7738</contrib-id>
<name>
<surname>Doyle</surname>
<given-names>Aoife M.</given-names>
</name>
</principal-award-recipient>
</award-group>
<award-group id="award002">
<funding-source>
<institution-wrap>
<institution-id institution-id-type="funder-id">http://dx.doi.org/10.13039/501100002992</institution-id>
<institution>Department for International Development, UK Government</institution>
</institution-wrap>
</funding-source>
<principal-award-recipient>
<name>
<surname>Ross</surname>
<given-names>David A.</given-names>
</name>
</principal-award-recipient>
</award-group>
<award-group id="award003">
<funding-source>
<institution-wrap>
<institution-id institution-id-type="funder-id">http://dx.doi.org/10.13039/100009099</institution-id>
<institution>Irish Aid</institution>
</institution-wrap>
</funding-source>
<principal-award-recipient>
<name>
<surname>Ross</surname>
<given-names>David A.</given-names>
</name>
</principal-award-recipient>
</award-group>
<funding-statement>The MEMA kwa Vijana Trial was a collaboration between the London School of Hygiene & Tropical Medicine (LSHTM), the Tanzanian National Institute for Medical Research (NIMR), the African Medical and Research Foundation (AMREF), and the Ministries of Health and Social Welfare and of Education and Vocational Training of the Government of Tanzania. It was supported by grants from the European Commission, the UK Department for International Development, and Irish Aid, with additional funding support from the Medical Research Council of Great Britain and The United Nations Joint Programme on HIV/AIDS (UNAIDS). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. AMD was funded by the UK Medical Research Council (G0902121).</funding-statement>
</funding-group>
<counts>
<fig-count count="1"></fig-count>
<table-count count="5"></table-count>
<page-count count="19"></page-count>
</counts>
<custom-meta-group>
<custom-meta id="data-availability">
<meta-name>Data Availability</meta-name>
<meta-value>Due to ethical restrictions related to participant confidentiality imposed by the Mwanza Intervention Trials Unit Institutional Data Access/Ethics Committee, the data underlying this study are available to qualified researchers upon request. In order to apply for access to these data, interested researchers may submit a formal request in writing specifying their research question(s), their methodology, and the proposed outputs of their work to MITU Director, Dr. Saidi Kapiga (
<email>saidi.kapiga@lshtm.ac.uk</email>
). Applicants must must agree to comply with the ethical approval conditions, i.e. maintaining the confidentiality of the respondents.</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
<notes>
<title>Data Availability</title>
<p>Due to ethical restrictions related to participant confidentiality imposed by the Mwanza Intervention Trials Unit Institutional Data Access/Ethics Committee, the data underlying this study are available to qualified researchers upon request. In order to apply for access to these data, interested researchers may submit a formal request in writing specifying their research question(s), their methodology, and the proposed outputs of their work to MITU Director, Dr. Saidi Kapiga (
<email>saidi.kapiga@lshtm.ac.uk</email>
). Applicants must must agree to comply with the ethical approval conditions, i.e. maintaining the confidentiality of the respondents.</p>
</notes>
</front>
</pmc>
<affiliations>
<list>
<country>
<li>Royaume-Uni</li>
<li>Suisse</li>
<li>Tanzanie</li>
</country>
<region>
<li>Angleterre</li>
<li>Grand Londres</li>
</region>
<settlement>
<li>Londres</li>
</settlement>
</list>
<tree>
<country name="Royaume-Uni">
<region name="Angleterre">
<name sortKey="Doyle, Aoife M" sort="Doyle, Aoife M" uniqKey="Doyle A" first="Aoife M." last="Doyle">Aoife M. Doyle</name>
</region>
<name sortKey="Hayes, Richard J" sort="Hayes, Richard J" uniqKey="Hayes R" first="Richard J." last="Hayes">Richard J. Hayes</name>
<name sortKey="Watson Jones, Deborah" sort="Watson Jones, Deborah" uniqKey="Watson Jones D" first="Deborah" last="Watson-Jones">Deborah Watson-Jones</name>
<name sortKey="Weiss, Helen A" sort="Weiss, Helen A" uniqKey="Weiss H" first="Helen A." last="Weiss">Helen A. Weiss</name>
</country>
<country name="Tanzanie">
<noRegion>
<name sortKey="Plummer, Mary L" sort="Plummer, Mary L" uniqKey="Plummer M" first="Mary L." last="Plummer">Mary L. Plummer</name>
</noRegion>
<name sortKey="Changalucha, John" sort="Changalucha, John" uniqKey="Changalucha J" first="John" last="Changalucha">John Changalucha</name>
</country>
<country name="Suisse">
<noRegion>
<name sortKey="Ross, David A" sort="Ross, David A" uniqKey="Ross D" first="David A." last="Ross">David A. Ross</name>
</noRegion>
</country>
</tree>
</affiliations>
</record>

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