AIDS and Behavior

, Volume 5, Issue 4, pp 343–352 | Cite as

Sexual Risk Behavior in Urban Populations of Northeastern Africa

  • Mohamed M. Ali
  • John G. Cleland
  • Michel Carael
Article

Abstract

Three representative 2-stage cluster sample surveys on sexual risk behavior and its correlates were conducted in Djibouti City and selected urban sites in Ethiopia and Sudan during 1994–95. The analysis in this paper is based on data collected from adults aged 15–49 on topics concerning marriage and regular partnerships (i.e., lasting 12+ months), nonregular sexual partnerships in the preceding 12 months, condom use, and related topics. In Djibouti City and urban sites in Ethiopia, about 10% of males reported 1 or more nonregular partnerships in the last 12 months, compared with 3% in Sudan. Between 20 and 30% of most recent nonregular contacts involved payment of money. Men with no schooling are less likely to report nonregular partnerships than other men in all 3 populations. Less than 5% of females in all 3 populations reported a nonregular partner in the preceding 12 months, but in all settings, the level is higher in divorced, separated, and widowed women. Condom use during the most recent sex act with nonregular partner ranges from 70% in Djibouti to 50% in Ethiopia and 20% in Sudan. In Sudan, the survey results suggest that the risks of rapid spread of HIV/STDs in the general population are low in Khartoum and the town of El Fashir but much higher in El Gadaif, where there is a large refugee population. In Djibouti and urban Ethiopia, risks are more generalized. Because of the lengthening interval between sexual debut and marriage, single males emerge as a priority group and further efforts are badly needed to promote condom use among the less educated.

sexual behavior condoms Djibouti Ethiopia Sudan Africa 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

REFERENCES

  1. Abdool Karim, Q., Abdool Karim, S., Singh, B., Short, R., and Ngxongo, S. (1992). Seroprevalence of HIV infection in rural South Africa. AIDS, 6, 1335–1539.Google Scholar
  2. Anderson, R. M., May, R. M., Boily, M. C., Garnett, G. P., and Rowley, J. T. (1991). The spread of HIV-1 in Africa: Sexual contact patterns and the demographic impact ofAIDS. Nature, 352, 581–589.Google Scholar
  3. Asiime-Okiror, G., Opio, A. A., Musinguzi, J., Madraa, E., Temboo, G., and Carael, M. (1997). Change in sexual behaviour and decline in HIV infection among pregnant women in urban Uganda. AIDS, 11, 1757–1763.Google Scholar
  4. Avins, A. L., Woods, W. J., Lindan, C. P., Hudes, E. S., Clark, W., and Hulley, S. B. (1994). HIV infection and risk behaviors among heterosexuals in alcohol treatment programs. Journal of the American Medical Association, 271, 515–518.Google Scholar
  5. Carael, M. (1995). Sexual Behavior. In J. Cleland and B. Ferry (Eds.), Sexual behaviour and AIDS in the developing world (pp. 75-123). London: Taylor & Francis.Google Scholar
  6. Carael, M., Cleland, J., Deheneffe, J. C., Ferry, B., and Ingham, R. (1995). Sexual behavior in developing countries: Implications for HIV control. AIDS, 9, 1171–1175.Google Scholar
  7. Cleland, J. G., Ali, M. M., and Capo-Chichi, V. (1999). Post-partum sexual abstinence in West Africa: Implications for AIDScontrol and family planning programmes. AIDS, 13, 125–131.Google Scholar
  8. Ethiopian Ministry of Health. (1993). National AIDS Program Review Report. Addis Ababa: Author.Google Scholar
  9. Ezeh, A. C., Seroussi, M., and Raggers, H. (1996). Men's Fertility, Contraceptive Use and Reproductive Preferences (DHS Comparative Studies, No. 19). Calverton: Macro International, Inc.Google Scholar
  10. Ferry, B. (1995). Risk factors related to HIV transmission: Sexually transmitted diseases, alcohol consumption and medicallyrelated injections. In J. Cleland and B. Ferry (Eds.), Sexual behaviour and AIDS in the developing world (pp. 193-207). London: Taylor & Francis.Google Scholar
  11. Ferry, B., Carael, M., Buve, B., Auvert, B., Laourou, M., Kanhonou, L., de Loenzien, M., Akam, E., Chege, J., and Kaona, F., for the Study Group on Heterogeneity of HIV Epidemics in African Cities. (2001). Comparison of key parameters of sexual behaviour in four African urban populations with different levels of HIV infections. AIDS, 15, S40-S50.Google Scholar
  12. Fontanet, A. L., Messele, T., Dejene, A., Enquselassie, F., Abebe, A., Cutts, F.T., Rinke de Wit, T., Sahlu, T., Bindels, P., Yeneneh, H., Coutinho, R. A., and Nokes, D. J. (1998). Age and sexspecific HIV-1 prevalence in the urban community setting of Addis Ababa, Ethiopia. AIDS, 12, 315–322.Google Scholar
  13. Ford, K., and Norris, A. E. (1998). Alcohol use, perception of the effects of alcohol use and condom use in urban minority youth. Journal of Acquired Immune Deficiency Syndromes, 17, 269–274.Google Scholar
  14. Hajnal, J. (1953). Age at marriage and proportions marrying. Population Studies, 7, 115–136.Google Scholar
  15. Jochelson, K., Mothibeli, M., and Leger, J. P. (1991). Human immunodeficiency virus and migrant labor in South Africa. International Journal of Health Science, 21, 157–173.Google Scholar
  16. Johnson, A. M., Wadsworth, J., Wellings, K., and Field, J. (1994). Sexual attitudes and lifestyles. Oxford: Blackwell.Google Scholar
  17. Lauman, E. O., Gagnon, J. H., Michael, R. T., and Michaels, S. (1994). The social organization of sexuality. Chicago: Chicago University Press.Google Scholar
  18. Meda, N., Nadoye, I., M'Boup, S., Wade, A., Ndiaye, S., Niang, C., Sarr, F., Diop, I., and Carael, M. (1999). Low stable HIV infection rates in Senegal: Natural course of the epidemic or evidence for success of prevention? AIDS, 13, 1397–1405.Google Scholar
  19. Mehret, M., Mertens, T., Carael, M., Negassa, H., Feleke, W., Yitbarek, N., and Burton, T. (1996). Baseline for evaluation of an AIDS Programme using prevention indicators:Acase in Ethiopia. WHO Bulletin, 74, 509–516.Google Scholar
  20. Mehryar, A. (1995). Condoms: Awareness, attitudes and use. In J. Cleland and B. Ferry (Eds.), Sexual behaviour and AIDS in the developing world (pp. 124-156). London: Taylor & Francis.Google Scholar
  21. Mertens, T., and Carael, M. (1997). Evaluation of HIV/STD interventions: An update. AIDS Education and Prevention, 9, 133–145.Google Scholar
  22. Mertens, T., Carael, M., Sato, P., Cleland, J., Ward, H., and Davey-Smith, G. (1994). Prevention indicators for evaluating the progress of national AIDS programmes, AIDS, 8, 1359–1369.Google Scholar
  23. Ministere de la Santé Publique et des Affaires Sociales. (1995a). Enquete sur les indicateurs de prevention de l'infection a HIV.Djibouti: Author.Google Scholar
  24. Ministere de la Santé Publique et des Affaires Sociales. (1995b). Rapport sur la Surveillance du VIH. Djibouti: Author.Google Scholar
  25. Nunn, A. J., Wanger, H. U., Kamali, A., Kengeya-kayonda, J. F., and Mulder, D. W. (1995). Migration and HIV-1 seroprevalence in a rural Uganda population, AIDS, 9, 503–506.Google Scholar
  26. Paul, J., Crosby, G. M., Midanik, L., and Stall, R. (1991). A new method for measuring the association between alcohol /drug use and high risk sex (Abstract MD 4044). Paper presented at the VIIth International Conference on AIDS, Florence, Italy.Google Scholar
  27. Pisani, E., Brownm, T., Saidel, T., Rehle, T., and Carael, M. (1998). Meeting the behavioural data collection needs of national HIV/AIDS and STD programmes. Geneva: UNAIDS and Family Health International.Google Scholar
  28. Pison, G., Le Guenno, B., Lagarde, E., Enel, C., and Seck, C. (1993). easonal migration: A risk factor for HIV in rural Senegal. Journal of Acquired Immune Deficiency Syndromes, 6, 196–200.Google Scholar
  29. Rodier, G. R., Couzineau, B., Gray, G. C., Omer, C. S., Fox, E., Bouloumie, J., and Watt, D. (1993a). Trends in human immunodeficiency virus type-1 infection in female prostitute and male diagnosed with a sexually transimtted disease Djibouti, East Africa. American Journal of Tropical Medicine and Hygiene, 48, 682–686.Google Scholar
  30. Rodier, G. R., Morand, J. J., Olson, J. S., Watts, D. M., and Salah, S. (1993b). HIV infection among secondary school students in Djibouti, horn of Africa: Knowledge, exposure and prevalence. East Africa Medical Journal, 70, 414–417.Google Scholar
  31. Seage III, G. R., Mayer, K. H., Wold. C., Lenderking, W. R., Goldstein, R., Cai, B., Gross, M., Heeren, T., and Hingson, R. (1998). The social context of drinking, drug use, and unsafe sex in the Boston young men study. Journal of Acquired Immune Deficiency Syndromes, 17, 368–375.Google Scholar
  32. Sudan Ministry of Health, NationalAIDSControl Program. (1995). Data on HIV Serosurveillance. Khartoum: Author.Google Scholar
  33. UNAIDS. (2000a). http://www.who.int/emc-hiv/fact sheets/pdfs/ djibouti.pdfGoogle Scholar
  34. UNAIDS. (2000b). http://www.who.int/emc-hiv/fact sheets/pdfs/ ethiopia.pdfGoogle Scholar
  35. UNAIDS. (2000c). http://www.who.int/emc-hiv/fact sheets/pdfs/ sudan.pdfGoogle Scholar
  36. Weissleder, W. (1974). Amhara marriage: The stability of divorce. Review Canadian Society and Anthropology, 11, 67–85.Google Scholar
  37. Wilson, D., Sibanda, B., Mboyi, L., Msimanga, S., and Dube, G. (1990). A pilot study for an HIV prevention programme among commercial sex workers in Bulawayo, Zimbabwe. Social Science and Medicine, 31, 609–618.Google Scholar
  38. World Health Organization/Global Program on AIDS Evaluation of National AIDS Programmes. (1994). A methods package: Prevention ofHIVinfection (WHO/GPA/TCO/SEF/94.1). Geneva: Author.Google Scholar

Copyright information

© Plenum Publishing Corporation 2001

Authors and Affiliations

  • Mohamed M. Ali
    • 1
  • John G. Cleland
    • 1
  • Michel Carael
    • 2
  1. 1.Center for Population StudiesLondon School of Hygiene & Tropical MedicineLondonUK
  2. 2.UNAIDSGenevaSwitzerland

Personalised recommendations