COMPARATIVE ANALYSIS OF HIGHER-RISK SEXUAL BEHAVIOR IN TEN SUB-SAHARAN AFRICA COUNTRIES BASED ON THEIR THREE MOST CURRENT DEMOGRAPHIC AND HEALTH SURVEYS

ABSTRACT

Background

Higher-Risk Sexual Behavior (H-RSB) is an act whereby people engage in sexual activities with multiple partners and do not consistently use condom. This practice is very common in sub-Saharan Africa (SSA). Though the prevalence of HIV is decreasing in sub-Saharan Africa H-RSB keep increasing in the region.

Objective

This study investigated and compared the trends and determinants of Higher-Risk Sexual Behavior among ten countries in SSA.

Method

Data for this study was obtained from the Demographic and Health Surveys (DHS) of the ten SSA countries. Out of a total sample of 568,779 participants, 391,132 representing 69% of respondents who have ever had sexual encounters in their lifetime was used. All study variables were extracted from both the women's and men’s data sets. Weighted unadjusted and adjusted Cox regression with constant time was used to investigate whether there were disparities of H-RSB among the ten SSA countries. Also, the association between socio-demographic, socio-economic, knowledge, mass media, and H-RSB were investigated.

Results

The study found out that although Zimbabwe recorded an increasing trend in H-RSB across all periods (4.33%, 5.21%, and 6.24%), Lesotho recorded a decreasing trend in H-RSB across all periods (8.92%, 8.04% and 6.42%) and there existed a significant variation in Zimbabwe’s increasing trend and Lesotho’s decreasing trend between the periods. The study further revealed that individuals whose first sex was before 18 years contributed significantly to the practice of H-RSB. Also across all countries, men engaged in H-RSB

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more than women. Workers in Lesotho, Namibia and Zimbabwe engaged in H-RSB more than worker in the other five countries in the study. Moreover, being exposed to all forms of mass media encouraged H-RSB in all the countries.

Conclusion

H-RSB continues to be the utmost factor that contributes significantly to the risk of new HIV infections in SSA. In order for the world to end the HIV epidemic by 2030, H-RSB should be taken a critical look at. Also, the younger generation should either be taught abstinence before marriage or condom use should be encouraged and promoted by stakeholders. Moreover, people should be encouraged to check and know their HIV status in order to deter them from spreading the disease. Finally sensitization should be encouraged at all levels to caution people to take the necessary measures to prevent them from being infected with the virus and to an extent, manage situations where people get infected.