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  • Title: Predictors of AIDS knowledge, condom use and high-risk sexual behaviour among women in Dar-es-Salaam, Tanzania.
    Author: Kapiga SH, Lwihula GK, Shao JF, Hunter DJ.
    Journal: Int J STD AIDS; 1995; 6(3):175-83. PubMed ID: 7647120.
    Abstract:
    Reducing the number of sex partners and using condoms are the major means for individuals to protect themselves from STDs and AIDS in sub-Saharan Africa. To identify predictors of having only one sex partner in the last year and to assess knowledge and use of condoms among women of reproductive age in Dar-es-Salaam, Tanzania, we interviewed 2285 women at 3 representative family planning clinics between February 1991 and June 1992. After interview, blood and genital specimens were collected for laboratory diagnosis of HIV and other sexually transmitted diseases (STDs). Although knowledge of sexual transmission of AIDS was very high, less than a half of the respondents (42.8%) mentioned use of condoms as an AIDS preventive measure. Younger and more educated women were more likely to mention use of condoms for AIDS prevention, however only 4.6% of women interviewed were regular users of condoms, while 19.8% were occasional users. The majority of women who had never used a condom (57.5%) reported not using condoms because 'men did not like them'. Condom use was positively associated with increasing level of education and increasing number of sexual partners. 14.8% of women reported having more than one sex partner in the last year; this behaviour was more likely among cohabiting women (increased by 210%); HIV-positives (increased by 120%); and among women with STDs (increased by 50%).(ABSTRACT TRUNCATED AT 250 WORDS) The authors interviewed 2285 women at three representative family planning clinics in Dar-es-Salaam, Tanzania, between February 1991 and June 1992 to identify predictors of having only one sex partner in the preceding year and to assess levels of knowledge and use of condoms among women of reproductive age in the study area. Blood and genital specimens were collected for the laboratory diagnosis of HIV and other sexually transmitted diseases (STD). 37.5% of the women had abnormal vaginal discharge on examination and 26.1% had microbiological evidence of STD. 11.5% of the women were HIV-seropositive. 98.3% of the women mentioned sexual contact as a mode of HIV transmission, but only 42.8% cited condom use as a way to prevent HIV/AIDS infection. Younger and more educated women were more likely to mention condom use for the prevention of AIDS. Only 4.6%, however, reported using condoms on a regular basis, and 19.8% on an occasional basis. 57.5% of women who had never used a condom reported not using them because men did not like them. Condom use was positively associated with increasing level of education and increasing number of sex partners. 14.8% of women reported having more than one sex partner in the preceding year. Having sex with multiple partners increased by 210% among cohabiting women, 120% among HIV-seropositive women, and 50% among women with STDs. These findings indicate that AIDS prevention activities have been only partially successful in reaching at-risk women in this population. Even among these high-risk women, only a minority used condoms. Men's negative attitudes about condoms was identified as the major reason for low condom use. Interventions designed to increase condom use should therefore aim to change male attitudes.
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