Who are the male partners of adolescent girls and young women in Swaziland? Analysis of survey data from community venues across 19 DREAMS districts
Adolescent girls and young women (AGYW, ages 15-24) are at high risk of HIV in Swaziland. Understanding more about their male sexual partners can inform HIV prevention efforts for both. Using the PLACE methodology across all 19 DREAMS implementation districts, 843 men ages 20-34 were surveyed betwee...
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| creator | Reynolds, Zahra Gottert, Ann Luben, Erin Mamba, Bheki Shabangu, Patrick Dlamini, Nsindiso Dlamini, Muhle Mathur, Sanyukta Pulerwitz, Julie |
| description | Adolescent girls and young women (AGYW, ages 15-24) are at high risk of HIV in Swaziland. Understanding more about their male sexual partners can inform HIV prevention efforts for both.
Using the PLACE methodology across all 19 DREAMS implementation districts, 843 men ages 20-34 were surveyed between December 2016-February 2017. Surveys were conducted at 182 venues identified by community informants as places where AGYW and men meet/socialize. Descriptive and multivariate analyses examined characteristics and risk behaviors of male partners of AGYW.
Men's average age was 25.7. Sixty-three percent reported female partners ages 15-19, and 70% reported partners ages 20-24 in the last year; of those, 12% and 11% respectively had five or more such partners. Among the 568 male partners of AGYW, 36% reported consistent condom use with their current/last partner. Forty-two percent reported testing for HIV in the last year; 6% were HIV-positive, and of those, 97% were currently on treatment. One-third (37%) reported being circumcised; among uncircumcised, 81% were not considering it. In multivariate analyses, men who reported three or more AGYW partners in the last year were more likely to be HIV-positive (aOR 3.2, 95% CI 1.1,8.8). Men were also less likely to disclose their HIV status to adolescent versus older partners (aOR 0.6, 95% CI 0.4,0.9) and partners more than 5 years younger than themselves (aOR 0.6, 95% CI 0.4,0.9). Results also revealed relatively high unemployment and mobility, substantial financial responsibilities, and periodic homelessness.
Most men identified through community venues reported relationships with AGYW, and these relationships demonstrated substantial HIV risk. Challenging life circumstances suggest structural factors may underlie some risk behaviors. Engaging men in HIV prevention and targeted health services is critical, and informant-identified community venues are promising intervention sites to reach high-risk male partners of AGYW. |
| doi_str_mv | 10.1371/journal.pone.0203208 |
| format | Article |
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Using the PLACE methodology across all 19 DREAMS implementation districts, 843 men ages 20-34 were surveyed between December 2016-February 2017. Surveys were conducted at 182 venues identified by community informants as places where AGYW and men meet/socialize. Descriptive and multivariate analyses examined characteristics and risk behaviors of male partners of AGYW.
Men's average age was 25.7. Sixty-three percent reported female partners ages 15-19, and 70% reported partners ages 20-24 in the last year; of those, 12% and 11% respectively had five or more such partners. Among the 568 male partners of AGYW, 36% reported consistent condom use with their current/last partner. Forty-two percent reported testing for HIV in the last year; 6% were HIV-positive, and of those, 97% were currently on treatment. One-third (37%) reported being circumcised; among uncircumcised, 81% were not considering it. In multivariate analyses, men who reported three or more AGYW partners in the last year were more likely to be HIV-positive (aOR 3.2, 95% CI 1.1,8.8). Men were also less likely to disclose their HIV status to adolescent versus older partners (aOR 0.6, 95% CI 0.4,0.9) and partners more than 5 years younger than themselves (aOR 0.6, 95% CI 0.4,0.9). Results also revealed relatively high unemployment and mobility, substantial financial responsibilities, and periodic homelessness.
Most men identified through community venues reported relationships with AGYW, and these relationships demonstrated substantial HIV risk. Challenging life circumstances suggest structural factors may underlie some risk behaviors. Engaging men in HIV prevention and targeted health services is critical, and informant-identified community venues are promising intervention sites to reach high-risk male partners of AGYW.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0203208</identifier><identifier>PMID: 30216356</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Acquired immune deficiency syndrome ; Age ; AIDS ; Antiretroviral drugs ; Biology and Life Sciences ; Community ; Councils ; Data processing ; Disease prevention ; Employment ; Gender ; Girls ; Health risks ; HIV ; Homeless people ; Homelessness ; Human immunodeficiency virus ; Intergenerational relationships ; Medical tests ; Medicine and Health Sciences ; Men ; People and Places ; Physical Sciences ; Polls & surveys ; Population ; Prevention ; Public health ; Research and Analysis Methods ; Risk ; Risk taking ; Rural areas ; Sexual partners ; Sexually transmitted diseases ; STD ; Teenagers ; Venue ; Young adults</subject><ispartof>PloS one, 2018-09, Vol.13 (9), p.e0203208-e0203208</ispartof><rights>2018 Reynolds et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2018 Reynolds et al 2018 Reynolds et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c526t-beeda4276944046ae1a28f9c4e55838eabd40d5997f1d58d00614fb64e6342c43</citedby><cites>FETCH-LOGICAL-c526t-beeda4276944046ae1a28f9c4e55838eabd40d5997f1d58d00614fb64e6342c43</cites><orcidid>0000-0003-1645-6734</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6157821/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6157821/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30216356$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Laga, Marie</contributor><creatorcontrib>Reynolds, Zahra</creatorcontrib><creatorcontrib>Gottert, Ann</creatorcontrib><creatorcontrib>Luben, Erin</creatorcontrib><creatorcontrib>Mamba, Bheki</creatorcontrib><creatorcontrib>Shabangu, Patrick</creatorcontrib><creatorcontrib>Dlamini, Nsindiso</creatorcontrib><creatorcontrib>Dlamini, Muhle</creatorcontrib><creatorcontrib>Mathur, Sanyukta</creatorcontrib><creatorcontrib>Pulerwitz, Julie</creatorcontrib><title>Who are the male partners of adolescent girls and young women in Swaziland? Analysis of survey data from community venues across 19 DREAMS districts</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Adolescent girls and young women (AGYW, ages 15-24) are at high risk of HIV in Swaziland. Understanding more about their male sexual partners can inform HIV prevention efforts for both.
Using the PLACE methodology across all 19 DREAMS implementation districts, 843 men ages 20-34 were surveyed between December 2016-February 2017. Surveys were conducted at 182 venues identified by community informants as places where AGYW and men meet/socialize. Descriptive and multivariate analyses examined characteristics and risk behaviors of male partners of AGYW.
Men's average age was 25.7. Sixty-three percent reported female partners ages 15-19, and 70% reported partners ages 20-24 in the last year; of those, 12% and 11% respectively had five or more such partners. Among the 568 male partners of AGYW, 36% reported consistent condom use with their current/last partner. Forty-two percent reported testing for HIV in the last year; 6% were HIV-positive, and of those, 97% were currently on treatment. One-third (37%) reported being circumcised; among uncircumcised, 81% were not considering it. In multivariate analyses, men who reported three or more AGYW partners in the last year were more likely to be HIV-positive (aOR 3.2, 95% CI 1.1,8.8). Men were also less likely to disclose their HIV status to adolescent versus older partners (aOR 0.6, 95% CI 0.4,0.9) and partners more than 5 years younger than themselves (aOR 0.6, 95% CI 0.4,0.9). Results also revealed relatively high unemployment and mobility, substantial financial responsibilities, and periodic homelessness.
Most men identified through community venues reported relationships with AGYW, and these relationships demonstrated substantial HIV risk. Challenging life circumstances suggest structural factors may underlie some risk behaviors. Engaging men in HIV prevention and targeted health services is critical, and informant-identified community venues are promising intervention sites to reach high-risk male partners of AGYW.</description><subject>Acquired immune deficiency syndrome</subject><subject>Age</subject><subject>AIDS</subject><subject>Antiretroviral drugs</subject><subject>Biology and Life Sciences</subject><subject>Community</subject><subject>Councils</subject><subject>Data processing</subject><subject>Disease prevention</subject><subject>Employment</subject><subject>Gender</subject><subject>Girls</subject><subject>Health risks</subject><subject>HIV</subject><subject>Homeless people</subject><subject>Homelessness</subject><subject>Human immunodeficiency virus</subject><subject>Intergenerational relationships</subject><subject>Medical tests</subject><subject>Medicine and Health Sciences</subject><subject>Men</subject><subject>People and Places</subject><subject>Physical Sciences</subject><subject>Polls & surveys</subject><subject>Population</subject><subject>Prevention</subject><subject>Public health</subject><subject>Research and Analysis Methods</subject><subject>Risk</subject><subject>Risk taking</subject><subject>Rural areas</subject><subject>Sexual partners</subject><subject>Sexually transmitted diseases</subject><subject>STD</subject><subject>Teenagers</subject><subject>Venue</subject><subject>Young adults</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNptUttuEzEQXSEQvcAfILDECy8J9vqS3RdQVApUKkKiIB6tiT2bONq1U3s3VfodfDDOpVWLePJlzpw5c2aK4hWjY8Yn7P0yDNFDO14Fj2NaUl7S6klxzGpejlR-Pn1wPypOUlpSKnml1PPiiNOSKS7VcfHn9yIQiEj6BZIOWiQriL3HmEhoCNjQYjLoezJ3sU0EvCWbMPg5uQkdeuI8ubqBW9fmwEcyzXo2ye1S0xDXuCEWeiBNDB0xoesG7_oNWaMfMHOZGFIirCaffpxPv10R61IfnenTi-JZA23Cl4fztPj1-fzn2dfR5fcvF2fTy5GRpepHM0QLopyoWggqFCCDsmpqI1DKilcIMyuolXU9aZiVlaVUMdHMlEDFRWkEPy3e7HlXbUj6YGjSJaOC5Qq0yoiLPcIGWOpVdB3EjQ7g9O4jxLnOdjnTopaGs0pSwMqWooEapGUGuAJVGYBaZa4Ph2rDrEO7dTVC-4j0ccS7hZ6HtVZMTqqSZYJ3B4IYrrODve5cHk6bzccw7HTLrHxSb6Fv_4H-vzuxR-0mEbG5F8Oo3i7ZXZbeLpk-LFlOe_2wkfuku63ifwGiddGz</recordid><startdate>20180914</startdate><enddate>20180914</enddate><creator>Reynolds, Zahra</creator><creator>Gottert, Ann</creator><creator>Luben, Erin</creator><creator>Mamba, Bheki</creator><creator>Shabangu, Patrick</creator><creator>Dlamini, Nsindiso</creator><creator>Dlamini, Muhle</creator><creator>Mathur, Sanyukta</creator><creator>Pulerwitz, Julie</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0003-1645-6734</orcidid></search><sort><creationdate>20180914</creationdate><title>Who are the male partners of adolescent girls and young women in Swaziland? Analysis of survey data from community venues across 19 DREAMS districts</title><author>Reynolds, Zahra ; Gottert, Ann ; Luben, Erin ; Mamba, Bheki ; Shabangu, Patrick ; Dlamini, Nsindiso ; Dlamini, Muhle ; Mathur, Sanyukta ; Pulerwitz, Julie</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c526t-beeda4276944046ae1a28f9c4e55838eabd40d5997f1d58d00614fb64e6342c43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Acquired immune deficiency syndrome</topic><topic>Age</topic><topic>AIDS</topic><topic>Antiretroviral drugs</topic><topic>Biology and Life Sciences</topic><topic>Community</topic><topic>Councils</topic><topic>Data processing</topic><topic>Disease prevention</topic><topic>Employment</topic><topic>Gender</topic><topic>Girls</topic><topic>Health risks</topic><topic>HIV</topic><topic>Homeless people</topic><topic>Homelessness</topic><topic>Human immunodeficiency virus</topic><topic>Intergenerational relationships</topic><topic>Medical tests</topic><topic>Medicine and Health Sciences</topic><topic>Men</topic><topic>People and Places</topic><topic>Physical Sciences</topic><topic>Polls & surveys</topic><topic>Population</topic><topic>Prevention</topic><topic>Public health</topic><topic>Research and Analysis Methods</topic><topic>Risk</topic><topic>Risk taking</topic><topic>Rural areas</topic><topic>Sexual partners</topic><topic>Sexually transmitted diseases</topic><topic>STD</topic><topic>Teenagers</topic><topic>Venue</topic><topic>Young adults</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Reynolds, Zahra</creatorcontrib><creatorcontrib>Gottert, Ann</creatorcontrib><creatorcontrib>Luben, Erin</creatorcontrib><creatorcontrib>Mamba, Bheki</creatorcontrib><creatorcontrib>Shabangu, Patrick</creatorcontrib><creatorcontrib>Dlamini, Nsindiso</creatorcontrib><creatorcontrib>Dlamini, Muhle</creatorcontrib><creatorcontrib>Mathur, Sanyukta</creatorcontrib><creatorcontrib>Pulerwitz, Julie</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Reynolds, Zahra</au><au>Gottert, Ann</au><au>Luben, Erin</au><au>Mamba, Bheki</au><au>Shabangu, Patrick</au><au>Dlamini, Nsindiso</au><au>Dlamini, Muhle</au><au>Mathur, Sanyukta</au><au>Pulerwitz, Julie</au><au>Laga, Marie</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Who are the male partners of adolescent girls and young women in Swaziland? Analysis of survey data from community venues across 19 DREAMS districts</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2018-09-14</date><risdate>2018</risdate><volume>13</volume><issue>9</issue><spage>e0203208</spage><epage>e0203208</epage><pages>e0203208-e0203208</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Adolescent girls and young women (AGYW, ages 15-24) are at high risk of HIV in Swaziland. Understanding more about their male sexual partners can inform HIV prevention efforts for both.
Using the PLACE methodology across all 19 DREAMS implementation districts, 843 men ages 20-34 were surveyed between December 2016-February 2017. Surveys were conducted at 182 venues identified by community informants as places where AGYW and men meet/socialize. Descriptive and multivariate analyses examined characteristics and risk behaviors of male partners of AGYW.
Men's average age was 25.7. Sixty-three percent reported female partners ages 15-19, and 70% reported partners ages 20-24 in the last year; of those, 12% and 11% respectively had five or more such partners. Among the 568 male partners of AGYW, 36% reported consistent condom use with their current/last partner. Forty-two percent reported testing for HIV in the last year; 6% were HIV-positive, and of those, 97% were currently on treatment. One-third (37%) reported being circumcised; among uncircumcised, 81% were not considering it. In multivariate analyses, men who reported three or more AGYW partners in the last year were more likely to be HIV-positive (aOR 3.2, 95% CI 1.1,8.8). Men were also less likely to disclose their HIV status to adolescent versus older partners (aOR 0.6, 95% CI 0.4,0.9) and partners more than 5 years younger than themselves (aOR 0.6, 95% CI 0.4,0.9). Results also revealed relatively high unemployment and mobility, substantial financial responsibilities, and periodic homelessness.
Most men identified through community venues reported relationships with AGYW, and these relationships demonstrated substantial HIV risk. Challenging life circumstances suggest structural factors may underlie some risk behaviors. Engaging men in HIV prevention and targeted health services is critical, and informant-identified community venues are promising intervention sites to reach high-risk male partners of AGYW.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>30216356</pmid><doi>10.1371/journal.pone.0203208</doi><orcidid>https://orcid.org/0000-0003-1645-6734</orcidid><oa>free_for_read</oa></addata></record> |
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| issn | 1932-6203 1932-6203 |
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| subjects | Acquired immune deficiency syndrome Age AIDS Antiretroviral drugs Biology and Life Sciences Community Councils Data processing Disease prevention Employment Gender Girls Health risks HIV Homeless people Homelessness Human immunodeficiency virus Intergenerational relationships Medical tests Medicine and Health Sciences Men People and Places Physical Sciences Polls & surveys Population Prevention Public health Research and Analysis Methods Risk Risk taking Rural areas Sexual partners Sexually transmitted diseases STD Teenagers Venue Young adults |
| title | Who are the male partners of adolescent girls and young women in Swaziland? Analysis of survey data from community venues across 19 DREAMS districts |
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