New heterosexually transmitted HIV infections in married or cohabiting couples in urban Zambia and Rwanda: an analysis of survey and clinical data

Dunkle, Kristin; Stephenson, Rob; Karita, Etienne; Chomba, Elwyn; Kayitenkore, Kayitesi; Vwalika, Cheswa; Greenberg, Lauren; Allen, Susan

doi:10.1016/s0140-6736(08)60953-8

Cited by 447 publications

(401 citation statements)

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“…Couples counseling in Zambia has also been associated with increased condom use among discordant couples, although consistent condom use was imperfectly maintained (Allen et al 2003). Recent mathematical modeling using data from Zambia and Rwanda indicates that most heterosexual HIV transmission takes place within marriage or cohabiting relationships (Dunkle et al 2008). Encouraging partners to test together is therefore an important strategy for African countries to consider implementing more widely, given the high levels of HIV-discordancy in stable heterosexual relationships (Allen et al 2007;Painter 2001).…”

Section: Discussionmentioning

confidence: 99%

Factors Associated with HIV Testing Among Public Sector Clinic Attendees in Johannesburg, South Africa

et al. 2008

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Uptake of VCT remains low in many sub-Saharan African countries. Men and women aged 15 and older were recruited from a family planning, STI, and VCT clinic in inner-city Johannesburg between 2004 and 2005 to take part in a cross-sectional survey on HIV testing (n = 198). Fourty-eight percent of participants reported previously testing for HIV and, of these, 86.9% reported disclosing their status to their sex partner. In multivariable analyses, individuals whose partners had been tested for HIV were more likely to have tested (AOR 2.92; 95% CI: 1.38-6.20). In addition, those who reported greater blame/ shame attitudes towards people living with HIV/AIDS were less likely to have tested (AOR 0.35; 95% CI: 0.16-0.77) while those reporting more equitable attitudes towards people living with HIV/AIDS were more likely to have tested (AOR 2.87; 95% CI: 1.20-6.86). Promotion of and increased access to couples HIV testing should be made available within the South African context. Abstract Uptake of VCT remains low in many subSaharan African countries. Men and women aged 15 and older were recruited from a family planning, STI, and VCT clinic in inner-city Johannesburg between 2004 and 2005 to take part in a cross-sectional survey on HIV testing (n = 198). Fourty-eight percent of participants reported previously testing for HIV and, of these, 86.9% reported disclosing their status to their sex partner. In multivariable analyses, individuals whose partners had been tested for HIV were more likely to have tested (AOR 2.92; 95% CI: 1.38-6.20). In addition, those who reported greater blame/ shame attitudes towards people living with HIV/AIDS were less likely to have tested (AOR 0.35; 95% CI: 0.16-0.77) while those reporting more equitable attitudes towards people living with HIV/AIDS were more likely to have tested (AOR 2.87; 95% CI: 1.20-6.86). Promotion of and increased access to couples HIV testing should be made available within the South African context.

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Section: Discussionmentioning

confidence: 99%

Factors Associated with HIV Testing Among Public Sector Clinic Attendees in Johannesburg, South Africa

et al. 2008

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“…Like our model, other dynamic models of the HIV/AIDS epidemic in Africa have estimated that the proportion of new HIV infections occurring in non-spousal relationships is substantially greater than the proportion occurring in spousal relationships (van Vliet et al 2001;Auvert et al 2000). However, a recent static model of HIV transmission in Zambia and Rwanda estimated that more than half of all sexual transmission in these countries occurs between spousal partners (Dunkle et al 2008), and another recent dynamic model of HIV transmission in Zambia estimated that almost half of all HIV transmission occurs in spousal unions (Leclerc, Matthews, and Garenne 2009). The relatively high contribution of spousal transmission in these models may be due to the relatively early age at first marriage in Zambia and Rwanda, compared to South Africa (Wellings et al 2006).…”

Section: Discussionmentioning

confidence: 60%

“…The models that have been developed to address this question can be classified as either static or dynamic: static models are designed to estimate the number of new HIV infections in the short-term future based on assumptions about current HIV prevalence levels (Gouws et al 2006;Dunkle et al 2008;Rehle et al 1998), while dynamic models simulate the entire history of the epidemic and are capable of long-term projections of future HIV incidence (Brown and Peerapatanapokin 2004;van Vliet et al 2001;Auvert et al 2000). The advantage of the latter approach is that it provides more detailed output, and the model predictions of past HIV prevalence levels by age and sex provide a useful 'reality check' on the plausibility of the model.…”

Section: Discussionmentioning

confidence: 99%

“…Studies have also shown that prompting individuals with additional questions can lead to enhanced recall of past sexual relationships (Brewer et al 2005). Although a number of mathematical models have been parameterized on the assumption that individuals report their sexual behaviour accurately in FTFIs (Dunkle et al 2008;Merli et al 2006;Oster 2005;Leclerc and Garenne 2007), this assumption is questionable in light of the recent evidence regarding social desirability bias. Other models that are calibrated to sexual behaviour data have allowed for bias, implicitly or explicitly, but have not considered the extent of the uncertainty regarding this bias (Van der Ploeg et al 1998).…”

Section: Introductionmentioning

confidence: 99%

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Sexual behaviour patterns in South Africa and their association with the spread of HIV: insights from a mathematical model

Johnson¹,

Dorrington²,

Bradshaw³

et al. 2009

DemRes

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“…In Zambia 60% of the people newly infected through heterosexual transmission are infected within marriage or cohabitation (Dunkle et al 2008). Whereas in Swaziland the percentage is between 50% and 65% (18); Lesotho between 35% and 62% (Khobotlo et al 2009) and Kenya about 44% (Gelmon, 2009).…”

Section: Resultsmentioning

confidence: 99%

Sexual Webs Model for the Examination of Unsafe Sexual Behaviors and the Spread of Sexually Transmitted Diseases Including HIV/AIDS

Timiun¹

2012

ASS

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Unsafe sex is the second most important risk factor for disability and deaths in the poorest countries and the ninth most important in developed countries. Globally, 30.8 million adults are living with HIV/AIDS and 340 million people are infected annually with sexually transmitted diseases. Unwanted pregnancies and sexually transmitted diseases including HIV/AIDS had been inexorably linked to sex, yet, there is no health behavior model focusing squarely on sexual attributes to provide analytical framework for the examination of unsafe sexual behaviors and the spread of sexual transmitted diseases including HIV/AIDS. This hinders the understanding of the roles of sexual attributes and contextual factors in influencing unsafe sex and the spread of related infections. The 'Sexual Webs model' has been constructed based on the individuals' sexual attributes; levels of entanglement into the "sexual networks" known as "Sexual webs" for the examination of contextual issues influencing unsafe sexual behavior and the spread of sexually transmitted diseases including HIV/AIDS. Published qualitative research articles on sexual behaviors, and health behavior models were selected from the internet using Google and Google Scholar search. The research findings were synthesized using meta-ethnographic analysis. Research endeavors using the postulates of this model would provide better insight on the contextual issues influencing unsafe sexual behavior for policy formulation and program interventions to promote safe sexual practices.

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New heterosexually transmitted HIV infections in married or cohabiting couples in urban Zambia and Rwanda: an analysis of survey and clinical data

Cited by 447 publications

References 28 publications

Factors Associated with HIV Testing Among Public Sector Clinic Attendees in Johannesburg, South Africa

Factors Associated with HIV Testing Among Public Sector Clinic Attendees in Johannesburg, South Africa

Sexual behaviour patterns in South Africa and their association with the spread of HIV: insights from a mathematical model

Sexual Webs Model for the Examination of Unsafe Sexual Behaviors and the Spread of Sexually Transmitted Diseases Including HIV/AIDS

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