HIV testing is associated with increased knowledge and reductions in sexual risk behaviours among men in Cape Town, South Africa

Scott-Sheldon, Lori A. J.; Carey, Michael P.; Carey, Kate B.; Cain, Demetria; Simbayi, Leickness C.; Mehlomakhulu, Vuyelwa; Kalichman, Seth C.

doi:10.2989/16085906.2013.863219

Cited by 41 publications

(35 citation statements)

References 20 publications

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“…The observed association between HIV/STI testing and HIV knowledge score in our study was consistent with two other cross-sectional studies, namely Scott-Sheldon LA et al, [18] and Haile BJ et al, 2007 [19]. The cross-sectional study design prevents strong inferences regarding the directionality of this association.…”

Section: Discussionsupporting

confidence: 91%

What are the factors associated with human immunodeficiency virus/sexually transmitted infection screening behaviour among heterosexual men patronising entertainment establishments who engaged in casual or paid sex? – Results from a cross-sectional survey in an Asian urban setting

et al. 2016

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BackgroundLate presentation of human immunodeficiency virus (HIV) is associated with heterosexual transmission, particularly among heterosexual men in Asia. Although data on HIV/sexually transmitted infection (STI) testing behaviour is increasing, information is still lacking among heterosexual men who receive far lesser attention and are generally invisible in HIV/ STI prevention, particularly in the Asian urban setting. The aim of this study was to assess the prevalence of HIV/STI testing among heterosexual men patronising entertainment establishments (EEs) who engaged in casual or paid sex in Singapore, and the factors associated with this behaviour.MethodsThis was a cross-sectional survey involving 604 participants using time location sampling between March and May 2015. For multivariable analysis, we used a mixed effects Poisson regression model with backward stepwise approach to account for clustering by venue and to obtain the adjusted prevalence ratio (aPR) for the association of various factors with HIV/STI testing.ResultsAmong 604 at-risk participants, only 163 (27.0%) had gone for HIV or STI testing in the past 6 months. Of this, 83.4% of them specifically underwent HIV testing. In multivariable analysis, HIV/STI testing increased with being non-Chinese (aPR 1.50; 95% CI: 1.08–2.06), having engaged in anal sex with casual or paid partner in the past 6 months (aPR 1.80; 95% CI: 1.27–2.57), number of partners in the past 6 months (aPR 1.03; 95% CI: 1.01–1.05) and HIV knowledge score (aPR 1.11; 95% CI: 1.05–1.16). Among those who reported non-consistent condom use with casual or paid partner, almost half of them (47.9%) perceived that they were at low risk for HIV/STI. Sigmatisation and discrimination was another common barrier for non-testing.ConclusionsDespite being at risk of HIV/STI, the low prevalence of testing coupled with a high prevalence of risky sexual behaviour among this group of heterosexual men in Singapore calls for a need for HIV/STI prevention interventions in the EE setting. Other than promoting testing and safer sex, the interventions should address the discordance between perceived risk and actual sexual behaviour, in addition to the stigma and discrimination associated with testing for this group.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-016-2088-8) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 91%

What are the factors associated with human immunodeficiency virus/sexually transmitted infection screening behaviour among heterosexual men patronising entertainment establishments who engaged in casual or paid sex? – Results from a cross-sectional survey in an Asian urban setting

et al. 2016

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“…Earlier work by Kalichman and Simbayi (2004) resulted in an 11-item AIDS-related knowledge scale for use in South Africa. A variety of studies in the general population have used the Kalichman and Simbayi (2004) knowledge scale and the Kalichman et al (2005) stigma scale as the bases for their studies (Pitpitan et al, 2012;Scott-Sheldon et al, 2013). Bowen et al (2014) have employed variations of these scales in application to workers in the construction industry.…”

Section: Introductionmentioning

confidence: 99%

Measurement scales for AIDS-related knowledge and stigma in South Africa: An evaluation using item response theory

Rajen¹,

Bowen²,

Peter³

2016

J. AIDS HIV Res.

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AIDS-related knowledge and stigma are key issues in combatting the HIV/AIDS pandemic, primarily because of their relationship with HIV/AIDS testing behavior. Previous studies exploring these issues in southern Africa have employed the 11-item AIDS-related knowledge scale and the 9-item stigma scale, but there has been limited psychometric testing of these scales. Using Item Response Theory (IRT), the two scales were investigated within the context of construction workers in South Africa. The IRT evaluation of these scales offers advantages over classical test theory (CTT) tests as they permit more nuanced understanding of the performance of individual items. Survey data from 512 construction workers in the Western Cape, South Africa, were used for the evaluation. Based on the tests, a revised 9-item AIDSrelated knowledge scale and revised 8-item AIDS-related stigma scale were developed. The slope estimates and threshold parameters for the knowledge scale indicated a robust scale which is most reliable for respondents with low to moderate levels of AIDS knowledge, and less so for those with high knowledge levels. Similar estimates for the stigma scale indicated good reliability at moderate to high levels of AIDS-related stigma, declining when stigma was at low levels. The analysis indicates that the scale items are most precise/reliable when used in populations with (1) lower levels of education, (2) who are more likely to adhere to more traditional or non-scientific beliefs about the origin and causes of HIV and AIDS, and (3) and as a consequence of the first two, who are more likely to exhibit high levels of stigma towards those with HIV/AIDS. The results have various policy and programmatic implications for epidemiological efforts at addressing the pandemic, particularly interventions intended to boost serostatus testing behaviour, such as voluntary counselling and testing (VCT). Greater measurement integrity for applied scales improves the overall rigour of such interventions, thereby ensuring better targeting of high risk populations and more focused allocation and utilization of health financial, technical and human resources, two critically important factors in addressing the pandemic in resource-poor contexts.

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“…Studies relating condom use to factors such as knowledge of how to use a condom and knowledge of STI transmission (Eggers et al, 2014), and to HIV-related knowledge (Villar-Loubet et al, 2013), suggest that HIV knowledge may be an important predictor of sexually risky behaviour in the South African context (Scott-Sheldon et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Determinants of condom use at last sex by South African construction workers

Bowen¹,

Govender²,

Edwards³

2017

J. AIDS HIV Res.

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Due to its fragmented nature, the typically remote location of project sites and considerable reliance upon migrant workers, the construction industry in South Africa is adversely affected by the HIV/AIDS pandemic. The correct and consistent use of condoms is critical to combatting the spread of infection and reinfection. The demographic, behavioural and AIDS-related knowledge determinants of condom use at last sexual encounter were investigated in a survey of 512 site-based construction workers in the Western Cape Province. Half of all survey participants reported not having used a condom at last sexual encounter. Respondents most likely to have not used a condom were predominantly 'Black' African, single, in the 27 to 36 and 37 to 49 years old age groups, and those engaging in risky sexual behavior. Gender, education, employment position, alcohol consumption and cannabis ('dagga') use were not found to be significantly related to condom use, nor was the extent of workers' AIDS-related knowledge. Workplace interventions by employers (in response to requests by the South African government for greater private sector involvement), whilst focusing on all employees, should concentrate their efforts on identifying and targeting those demographic sub-populations that are at greatest risk for lack of condom use. Particular attention should be given to construction workers who are migratory (rural to urban work-seekers), working on sites in remote areas, or working in environments where the appeal and likelihood of risky sexual behavior are anticipated to be greatest.

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HIV testing is associated with increased knowledge and reductions in sexual risk behaviours among men in Cape Town, South Africa

Cited by 41 publications

References 20 publications

What are the factors associated with human immunodeficiency virus/sexually transmitted infection screening behaviour among heterosexual men patronising entertainment establishments who engaged in casual or paid sex? – Results from a cross-sectional survey in an Asian urban setting

What are the factors associated with human immunodeficiency virus/sexually transmitted infection screening behaviour among heterosexual men patronising entertainment establishments who engaged in casual or paid sex? – Results from a cross-sectional survey in an Asian urban setting

Measurement scales for AIDS-related knowledge and stigma in South Africa: An evaluation using item response theory

Determinants of condom use at last sex by South African construction workers

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