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HIV incidence and predictors of inconsistent condom use among adult men enrolled into an HIV vaccine preparedness study, Rustenburg, South Africa.

ABSTRACT: INTRODUCTION:Understanding HIV incidence and risk behaviour among populations being considered for HIV vaccine studies is necessary for the appropriate design of trials. METHODS:Between May 2012 and June 2015, we recruited men aged 18-49 years from urban and peri-urban areas of Rustenburg, a mining town in the North West Province, South Africa. Men who reported HIV-risk behaviour were followed for nine to 12 months to determine HIV incidence and factors associated with condom use. RESULTS:A total of 400 HIV uninfected men were enrolled; 366 (91.5%) had at least one follow-up visit and were included in the analysis; 47.6% were under 25 years of age. HIV incidence was 1.9 per 100 person-years (95% CI: 0.79-4.56). Among heterosexual men (N = 339), 80.8% reported having vaginal intercourse with multiple partners in the past three months, among whom 74.1% reported inconsistent condom use. Sixty-eight percent reported vaginal intercourse with new female partners, of whom 40.6% reported inconsistent condom use. Over half (55.6%) of men who had sex with men (N = 27) reported anal intercourse with multiple male partners in the past three months, of whom 68.2% reported using condoms inconsistently. Men who had more than two female partners in the last three months (n = 121) were more likely to use condoms inconsistently (aOR 4.31, 95% CI: 1.34-13.8); in contrast, those with more than one new female sex partner (aOR 0.13, 94% CI 0.04-0.44), and whose sexual debut was after 19 years of age (aOR 0.39, 95% CI: 0.15-1.01) were less likely to use condoms inconsistently. CONCLUSION:HIV incidence was low and similar to other studies of heterosexual men in South Africa. To identify men at high risk for HIV for enrolment in prevention trials, future researchers may need to focus on those who report early sexual debut and who report having multiple sexual partners. Men in newer relationships appear to use condoms more frequently.

SUBMITTER: Maenetje P

PROVIDER: S-EPMC6447216 | biostudies-other | 2019

REPOSITORIES: biostudies-other

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HIV incidence and predictors of inconsistent condom use among adult men enrolled into an HIV vaccine preparedness study, Rustenburg, South Africa.

Maenetje Pholo P Lindan Christina C Makkan Heeran H Chetty-Makkan Candice M CM Latka Mary H MH Charalambous Salome S Mlotshwa Mandla M Malefo Matshidiso M Brumskine William W Hills Nancy K NK Price Matthew A MA Edward Vinodh V

PloS one 20190403 4

<h4>Introduction</h4>Understanding HIV incidence and risk behaviour among populations being considered for HIV vaccine studies is necessary for the appropriate design of trials.<h4>Methods</h4>Between May 2012 and June 2015, we recruited men aged 18-49 years from urban and peri-urban areas of Rustenburg, a mining town in the North West Province, South Africa. Men who reported HIV-risk behaviour were followed for nine to 12 months to determine HIV incidence and factors associated with condom use. ...[more]

PMID: 30943254

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Project description:Compared to the general population, men who have sex with men (MSM) are at greater risk for HIV and less understood due to their more hidden and stigmatized nature. Moreover, the discrepancy in findings in the literature merits further investigations in MSM populations from different cultures and settings. We therefore conducted this study to explore factors associated with inconsistent condom use among high-risk MSM in Cambodia.This cross-sectional study was conducted in 2014 among 367 MSM randomly selected from Battembang and Siem Reap using a two-stage cluster sampling method. A structured questionnaire was used for face-to-face interviews to collect information on characteristics of respondents, HIV testing history, self-perception of HIV risk, substance use, sexual behaviors, mental disorders, and HIV knowledge. Multivariable logistic regression analysis was performed to identify factors independently associated with inconsistent condom use.On average, 62.3% of respondents reported that they always used condoms over the past three months. The rates varied with types of sexual partners; the proportion of respondents who reported always using condoms was 55.1%, 64.2%, 75.9%, 73.0%, 78.1%, and 70.3%, for sexual partners who were girlfriends, boyfriends, female sex workers, male sex workers, female clients, or male clients, respectively. After adjustment, inconsistent condom use was significantly associated with age of ≥25 (AOR = 1.77, 95% CI = 1.09-2.86), self-rated quality of life as good or very good (AOR = 4.37, 95% CI = 1.79-5.67), self-perception of higher HIV risk compared to the general population (AOR = 2.37, 95% CI = 1.35-4.17), illicit drug use in the past three months (AOR = 5.76, 95% CI = 1.65-10.09), and reported consistent lubricant use when selling anal sex to men in the past three months (AOR = 2.85, 95% CI = 1.07-8.12).We found risky sexual behaviors to be considerably high among MSM in this study, especially among those who used illicit drugs or were older than 25. HIV education and social marketing should be expanded and specifically designed for MSM to better educate on the increased risk of HIV with unprotected anal sex and illicit drug use as risk factors, and the importance of the use of both condoms and lubricant during anal intercourse.

Project description:BACKGROUND:As high stigmatization of HIV and relatively low knowledge of HIV transmission and prevention measures persist in Sub-Saharan Africa, the improvement of HIV-related knowledge, and the evaluation of which types of interventions are most effective in this regard, is an important aspect of further prevention efforts. In addition, it is of interest to assess whether improvements in HIV-related knowledge may actually lead to increased engagement in preventive behaviours and ultimately lower HIV transmission. This study therefore aims to systematically review and meta-analyse the evidence for the effect of HIV-related knowledge interventions on 1) the improvement of HIV-related knowledge, 2) subsequent risk reduction behaviour (condom use), 3) lower incidence of HIV infection. METHODS:A literature search was conducted using the Embase and Medline databases, returning 746 after duplicate removal. Following abstract and full-text screening, 36 studies were ultimately included in the final review. Meta-analyses were conducted in R, using random-effects models, for the HIV-related knowledge, condom use, and HIV incidence outcomes, where sufficient data were available. RESULTS:Interventions assessed in the reviewed studies varied, including computer-based interventions, mass media campaigns, and peer education interventions. The interventions were generally found to be effective at improving HIV-related knowledge in the target population, with 10 studies reporting improved knowledge of risk reduction through condom use in the intervention group (out of 11 studies reporting data for this outcome), with 6 reporting these differences as significant (p?<?0.05). Regarding knowledge of transmission routes, studies assessing peer education interventions often reported significant improvements in the intervention group. Meta-analysis results showed significantly higher odds among the intervention groups of correct knowledge of: risk reduction through condom use (OR: 3.09, 95%CI: 1.83-5.22, p?<?0.0001), sexual transmission of HIV (OR: 5.86, 95%CI: 2.65-12.97, p <?0.001) and transmission through sharps (OR: 4.35, 95%CI?=?3.21-5.90, p?<?0.001), but non-significantly lower odds of HIV infection (OR: 0.97, 95%CI: 0.66-1.41, p?=?0.854). CONCLUSION:Peer-education-based interventions appear to be particularly effective in facilitating the uptake of HIV-related knowledge, particularly pertaining to transmission routes. There is some evidence that improved knowledge of HIV transmission and prevention facilitates increased subsequent engagement in preventive measures, although this requires further exploration. TRIAL REGISTRATION:PROSPERO Number: CRD42018090600.

Dataset Information

HIV incidence and predictors of inconsistent condom use among adult men enrolled into an HIV vaccine preparedness study, Rustenburg, South Africa.

Publications

HIV incidence and predictors of inconsistent condom use among adult men enrolled into an HIV vaccine preparedness study, Rustenburg, South Africa.

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