Sexual Behaviour and Attitudes towards Safe Sex of Youth Receiving Antiretroviral Care at Public Health Facilities in Palapye District, Botswana

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Abstract

Background: Sexual behaviour of HIV-infected youths is very important in determining the direction of the HIV epidemic, as these youths are reservoirs of HIV and can propagate its transmission if they engage in risky sexual behaviours. However, support structures for secondary prevention are weak even in healthcare settings. There is a need to understand the sexual behaviour of these youths and, in turn, tailor appropriate secondary prevention strategies, hence the current study was designed to assess sexual behaviour and attitudes towards safe sex of youth receiving antiretroviral care at public health facilities in Palapye district, Botswana. Method: This quantitative, descriptive cross-sectional survey was used to describe the sexual behaviour and attitudes towards safe sex and identify factors associated with risky sexual behaviours among HIV-infected youths aged between 15 and 19 years receiving antiretroviral therapy (ART) care from public healthcare facilities in Palapye District, Botswana. Results: A total of 188 youths participated in this study, 56% being females while 44% were males. We reported that 15.4% had ever had sex. At their last sexual encounter, more than half of the youths (51.7%) had not used condoms. More than a third of the participants were under the influence of alcohol during their last sexual experience. Generally, the youths had good attitudes towards safe sex, as most youths said they would prioritise protecting their sexual partners and themselves from HIV and STIs. Alcohol use, substance use and not considering religion as important were strongly associated with having ever had sex. Conclusions: A significant proportion of HIV-infected youths are sexually active, whereas their preventive practices such as condom use are poor despite good attitudes towards safe sex. Alcohol use, substance use and not perceiving religion as important were associated with risky sexual behaviours.

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Adherence to antiretroviral therapy in adolescents living with HIV: systematic review and meta-analysis

Sung-Hee Kim, Sarah Gerver, Sarah Fidler … (2014)

Objective: Adolescent and young adult (AYA) populations (12–24 years) represent over 40% of new HIV infections globally. Adolescence is sometimes characterized by high-risk sexual behaviour and a lack of engagement with healthcare services that can affect adherence to antiretroviral therapy (ART). Despite adherence to ART being critical in controlling viral replication, maintaining health and reducing onward viral transmission, there are limited data on ART adherence amongst AYA globally. We undertook a systematic review and meta-analysis of published studies reporting adherence to ART for AYA living with HIV. Design and methods: Searches included Embase, Medline and PsychINFO databases up to 14 August 2013. Eligible studies defined adequate adherence as at least 85% on self-report or undetectable blood plasma virus levels. A random effects meta-analysis was performed and heterogeneity examined using meta-regression. Results: We identified 50 eligible articles reporting data from 53 countries and 10 725 patients. Using a pooled analysis of all eligible studies, 62.3% [95% confidence interval (CI) 57.1–67.6; I 2 : 97.2%] of the AYA population were adherent to therapy. The lowest average ART adherence was in North America [53% (95% CI 46–59; I 2 : 91%)], Europe [62% (95% CI 51–73; I 2 : 97%)] and South America [63% (95% CI 47–77; I 2 : 85%] and, with higher levels in Africa [84% (95% CI 79–89; I 2 : 93%)] and Asia [84% (95% CI 77–91; I 2 : 0%]. Conclusion: Review of published literature from Africa and Asia indicate more than 70% of HIV-positive AYA populations receiving ART are adherent to therapy and lower rates of adherence were shown in Europe and North America at 50–60%. The global discrepancy is probably multifactorial reflecting differences between focused and generalised epidemics, access to healthcare and funding.

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Epidemiology of HIV and AIDS among adolescents: current status, inequities, and data gaps.

Priscilla Idele, Amaya Gillespie, Tyler Porth … (2014)

To examine levels and patterns of HIV prevalence, knowledge, sexual behavior, and coverage of selected HIV services among adolescents aged 10-19 years and highlight data gaps and challenges.

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The sexual behaviour of adolescents in sub-Saharan Africa: patterns and trends from national surveys.

Aoife M Doyle, Sue Mavedzenge, Mary L. Plummer … (2012)

To describe the sexual and reproductive behaviour of adolescents in sub-Saharan Africa, particularly 15- to 19-year-olds. Using DHS/AIS data (2000-2010), nine indicators of adolescent behaviour and one of adult attitudes towards condom education for adolescents were described for 24 countries. Indicators were disaggregated by gender, urban/rural residency and educational status, and time trends were described. Up to 25% of 15- to 19-year-olds reported sex before age 15; this proportion shrank over time in many countries. In most countries, ≥5% of females reported marriage before age 15, and >20% had commenced childbearing. Early sexual debut and childbearing were more common among the least educated and/or rural females. Reporting of multiple sexual partnerships was more common among males than among females, but decreases over time were more common among males. Urban males and females, and females with higher education, were more likely to report multiple partnerships. Urban youth and those with higher education also reported more condom use. Adult support for condom education for 12- to 14-year-olds has increased over time to 60-65%. Many 15- to 19-year-olds are at risk of HIV/STIs and unplanned pregnancies because of multiple partnerships and insufficient condom and other contraceptive use. In many countries, trends are moving in a favourable direction. To better inform prevention programmes in this important area, we recommend routine collection of sexual and reproductive behaviour data for adolescents aged <15 years, expanding the data collected for 15- to 19-year-olds to include detailed information on sexual behaviour within partnerships, and disaggregating data according to sociodemographic variables. © 2012 Blackwell Publishing Ltd.

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Author and article information

Contributors

Mathildah M. Mokgatle: (View ORCID Profile)

Oluwafemi O. Oguntibeju: (View ORCID Profile)

Journal

Journal ID (publisher-id): IJERGQ

Title: International Journal of Environmental Research and Public Health

Abbreviated Title: IJERPH

Publisher: MDPI AG

ISSN (Electronic): 1660-4601

Publication date Created: March 2023

Publication date (Electronic): February 21 2023

Volume: 20

Issue: 5

Page: 3790

Article

DOI: 10.3390/ijerph20053790

SO-VID: 4841fec2-9dd3-4366-8afa-4e4ba9af57f3

License:

https://creativecommons.org/licenses/by/4.0/

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