Cognitive and behavioural determinants of multiple sexual partnerships and condom use in South Africa: Results of a national survey.

Patience G Manjengwa,Alfred Musekiwa,Kerry Mangold,Lazarus R Kuonza

doi:10.4102/sajhivmed.v20i1.868

Abstract

BackgroundHuman immunodeficiency virus (HIV) risky behaviours including multiple sexual partnership (MSP) and non-condom use (nCU) are known to be drivers of the spread of HIV; cognitive factors including perceived susceptibility of HIV, self-efficacy and attitudes play a significant role in influencing risky sexual behaviours.ObjectivesWe sought to investigate personal beliefs, perceptions, thoughts and actions that are associated with MSP and nCU in South Africa.MethodsWe analysed nationally representative data from the 2012 National HIV Communication Survey (NCS) that included about 10 000 participants aged 16–55 years. Five constructs were created to measure psychosocial and cognitive determinants. Cronbach’s alpha coefficient for internal consistency reliability was calculated. Multivariable logistic regression was used to determine factors associated with MSP and nCU.ResultsOf the 6061 sexually active respondents, 13% (95% CI: 11.47–13.12) reported MSP and 52.7% (n = 3158 of 6039) (95% CI: 51.0–53.55) nCU at last sex. Factors associated with MSP included perceived benefits, adjusted odds ratio (aOR) = 2.16 (95% CI: 1.80–2.58), perceived susceptibility to HIV, aOR = 2.22 (95% CI: 1.83–2.69) and engaging in intergenerational sex, aOR = 2.14 (95% CI: 1.78–2.56). Predictors of nCU were perceived benefits, aOR = 1.25 (95% CI: 1.09–1.43); perceived susceptibility to HIV, aOR = 1.6 (95% CI: 1.39–1.83); and personal beliefs, aOR = 1.35 (95% CI: 1.13–1.62).ConclusionCognitive and behavioural factors were found to be predictors of risky sexual behaviours for HIV. This highlights the importance of considering personal perception and reasoning when attempting to understand and influence an individual’s sexual behaviour. This could be done through enhancing awareness of HIV risk in the general population and by influencing cognitive behaviour change through community mobilisation, advocacy and creating activities to improve self-esteem.

Highlights

Human immunodeficiency virus (HIV) poses a major public health concern, causing high rates of mortality and morbidity.[1]
Similar associations were found in a study conducted in Cameroon in 2012, which revealed the association of multiple sexual partnership (MSP) and low-risk perception of human immunodeficiency virus (HIV) infection.[16]
HIV prevention efforts could be performed through encouraging avoidance of extramarital http://www.sajhivmed.org.za sex and the importance of condom use in all types of relationships, especially where high-risk sexual behaviour takes place such as MSP

Summary

Introduction

Human immunodeficiency virus (HIV) poses a major public health concern, causing high rates of mortality and morbidity.[1]. Cultural and personal intrinsic factors have been identified as important social and structural drivers of the HIV epidemic in SA, including high population mobility and inequalities in wealth and gender.[3] Other contributing drivers of HIV include attitudes and behaviours of men, intergenerational sex, gender and sexual violence, stigma and untreated viral sexually transmitted infections (STIs).[3,4,5,6,7]. SA is continuing to address social and structural factors that influence HIV and prevent new HIV infections.[2,6] One of the goals of the South African National Strategic Plan on HIV, STIs and http://www.sajhivmed.org.za. Human immunodeficiency virus (HIV) risky behaviours including multiple sexual partnership (MSP) and non-condom use (nCU) are known to be drivers of the spread of HIV; cognitive factors including perceived susceptibility of HIV, self-efficacy and attitudes play a significant role in influencing risky sexual behaviours

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