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Prevalence and social drivers of HIV among married and cohabitating heterosexual adults in south-eastern Tanzania = analysis of adult health community cohort data
JournalArticle (Originalarbeit in einer wissenschaftlichen Zeitschrift)
ID 3246145
Author(s) Geubbels, Eveline
Author(s) at UniBasel Pfeiffer, Constanze Dorothee
Merten, Sonja
Tanner, Marcel
Year 2015
Title Prevalence and social drivers of HIV among married and cohabitating heterosexual adults in south-eastern Tanzania = analysis of adult health community cohort data
Journal Global health action
Volume 8
Pages / Article-Number 28941
Keywords HIV, couples, social drivers, community surveillance data, Tanzania
Abstract In sub-Saharan Africa, the prevalence of HIV among married and cohabiting couples is substantial. Information about the underlying social drivers of HIV transmission in couples is critical for the development of structural approaches to HIV prevention, but not readily available. We explored the association between social drivers, practices, and HIV status among stable couples in Ifakara, Tanzania.; Using a cross-sectional design, we analyzed data from a sample of 3,988 married or cohabiting individuals, aged 15 years and older from the MZIMA adult health community cohort study of 2013. Sociodemographic factors (sex, income, age, and education), gender norms (perceived acceptability for a wife to ask her partner to use a condom when she knows he is HIV positive), marriage characteristics (being in a monogamous or a polygamous marriage, being remarried), sexual behavior practices (lifetime number of sexual partners and concurrent sexual partners), health system factors (ever used voluntary HIV counseling and testing), and lifestyle patterns (alcohol use) were used to explore the odds of being HIV positive, with 95% confidence intervals.; Prevalence of HIV/AIDS was 6.7% (5.9% males and 7.1% females). Gender norms, that is, perception that a woman is not justified to ask her husband to use a condom even when she knows he has a disease (adjusted odds ratio AOR=1.51, 95% CI 1.06-2.17), marital characteristics, that is, being remarried (AOR=1.49, 95% CI 1.08-2.04), and sexual behavior characteristics, that is, lifetime number of sexual partners (2-4: AOR=1.47, 95% CI 1.02-2.11; 5+: AOR=1.61, 95% CI 1.05-2.47) were the main independent predictors of HIV prevalence.; Among married or cohabiting individuals, the key social drivers/practices that appeared to make people more vulnerable for HIV are gender norms, marriage characteristics (being remarried), and sexual behavior practices (lifetime number of sexual partners). Married and cohabiting couples are an important target group for HIV prevention efforts in Tanzania. In addition to individual interventions, structural interventions are needed to address the gender norms, remarriage, and sexual practices that shape differential vulnerability to HIV in stable couples.
Publisher Co-Action Publishing]
ISSN/ISBN 1654-9880
Full Text on edoc No
Digital Object Identifier DOI 10.3402/gha.v8.28941
PubMed ID
ISI-Number WOS:000362103200001
Document type (ISI) Journal Article

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