The distribution of sex acts and condom use within partnerships in a rural sub-Saharan African population.

<h4>Introduction</h4>In an HIV/AIDS epidemic driven primarily by heterosexual transmission, it is important to have an understanding of the human sexual behaviour patterns that influence transmission. We analysed the distribution and predictors of within-partnership sexual behaviour and...

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Main Authors: Jennifer Smith, Constance Nyamukapa, Simon Gregson, James Lewis, Sitholubuhle Magutshwa, Christina Schumacher, Phyllis Mushati, Tim Hallett, Geoff Garnett
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2014-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0088378
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author Jennifer Smith
Constance Nyamukapa
Simon Gregson
James Lewis
Sitholubuhle Magutshwa
Christina Schumacher
Phyllis Mushati
Tim Hallett
Geoff Garnett
author_facet Jennifer Smith
Constance Nyamukapa
Simon Gregson
James Lewis
Sitholubuhle Magutshwa
Christina Schumacher
Phyllis Mushati
Tim Hallett
Geoff Garnett
author_sort Jennifer Smith
collection DOAJ
description <h4>Introduction</h4>In an HIV/AIDS epidemic driven primarily by heterosexual transmission, it is important to have an understanding of the human sexual behaviour patterns that influence transmission. We analysed the distribution and predictors of within-partnership sexual behaviour and condom use in rural Zimbabwe and generated parameters for use in future modelling analyses.<h4>Methods</h4>A population-based cohort was recruited from a household census in 12 communities. A baseline survey was carried out in 1998-2000 with follow-up surveys after 3 and 5 years. Statistical distributions were fitted to reported within-partnership numbers of total, unprotected and protected sex acts in the past two weeks. Multilevel linear and logistic regression models were constructed to assess predictors of the frequency of unprotected sex and consistent condom use.<h4>Results</h4>A normal distribution of ln(sex acts+1) provided the best fit for total and unprotected sex acts for men and women. A negative binomial distribution applied to the untransformed data provided the best fit for protected sex acts. Condom use within partnerships was predominantly bimodal with at least 88% reporting zero or 100% use. Both men and women reported fewer unprotected sex acts with non-regular compared to regular partners (men: 0.26 fewer every two weeks (95% confidence interval 0.18-0.34); women: 0.16 (0.07-0.23)). Never and previously married individuals reported fewer unprotected sex acts than currently married individuals (never married men: 0.64 (0.60-0.67); previously married men: 0.59 (0.50-0.67); never married women: 0.51 (0.45-0.57); previously married women: 0.42 (0.37-0.47)). These variables were also associated with more consistent condom use.<h4>Discussion</h4>We generated parameters that will be useful for defining transmission models of HIV and other STIs, which rely on a valid representation of the underlying sexual network that determines spread of an infection. This will enable a better understanding of the spread of HIV and other STDs in this rural sub-Saharan population.
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spelling doaj-art-7b1792463db7403da992fa08a2a9eeef2025-08-20T02:34:14ZengPublic Library of Science (PLoS)PLoS ONE1932-62032014-01-0192e8837810.1371/journal.pone.0088378The distribution of sex acts and condom use within partnerships in a rural sub-Saharan African population.Jennifer SmithConstance NyamukapaSimon GregsonJames LewisSitholubuhle MagutshwaChristina SchumacherPhyllis MushatiTim HallettGeoff Garnett<h4>Introduction</h4>In an HIV/AIDS epidemic driven primarily by heterosexual transmission, it is important to have an understanding of the human sexual behaviour patterns that influence transmission. We analysed the distribution and predictors of within-partnership sexual behaviour and condom use in rural Zimbabwe and generated parameters for use in future modelling analyses.<h4>Methods</h4>A population-based cohort was recruited from a household census in 12 communities. A baseline survey was carried out in 1998-2000 with follow-up surveys after 3 and 5 years. Statistical distributions were fitted to reported within-partnership numbers of total, unprotected and protected sex acts in the past two weeks. Multilevel linear and logistic regression models were constructed to assess predictors of the frequency of unprotected sex and consistent condom use.<h4>Results</h4>A normal distribution of ln(sex acts+1) provided the best fit for total and unprotected sex acts for men and women. A negative binomial distribution applied to the untransformed data provided the best fit for protected sex acts. Condom use within partnerships was predominantly bimodal with at least 88% reporting zero or 100% use. Both men and women reported fewer unprotected sex acts with non-regular compared to regular partners (men: 0.26 fewer every two weeks (95% confidence interval 0.18-0.34); women: 0.16 (0.07-0.23)). Never and previously married individuals reported fewer unprotected sex acts than currently married individuals (never married men: 0.64 (0.60-0.67); previously married men: 0.59 (0.50-0.67); never married women: 0.51 (0.45-0.57); previously married women: 0.42 (0.37-0.47)). These variables were also associated with more consistent condom use.<h4>Discussion</h4>We generated parameters that will be useful for defining transmission models of HIV and other STIs, which rely on a valid representation of the underlying sexual network that determines spread of an infection. This will enable a better understanding of the spread of HIV and other STDs in this rural sub-Saharan population.https://doi.org/10.1371/journal.pone.0088378
spellingShingle Jennifer Smith
Constance Nyamukapa
Simon Gregson
James Lewis
Sitholubuhle Magutshwa
Christina Schumacher
Phyllis Mushati
Tim Hallett
Geoff Garnett
The distribution of sex acts and condom use within partnerships in a rural sub-Saharan African population.
PLoS ONE
title The distribution of sex acts and condom use within partnerships in a rural sub-Saharan African population.
title_full The distribution of sex acts and condom use within partnerships in a rural sub-Saharan African population.
title_fullStr The distribution of sex acts and condom use within partnerships in a rural sub-Saharan African population.
title_full_unstemmed The distribution of sex acts and condom use within partnerships in a rural sub-Saharan African population.
title_short The distribution of sex acts and condom use within partnerships in a rural sub-Saharan African population.
title_sort distribution of sex acts and condom use within partnerships in a rural sub saharan african population
url https://doi.org/10.1371/journal.pone.0088378
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