Women's Health Nursing (여성건강간호학회지)

Korean Society of Women Health Nursing (한국여성건강간호학회)
권호 표지
DOI QR코드

DOI QR Code

Vulnerability to human immunodeficiency virus infection and associated factors among married women in northwest Ethiopia: a cross-sectional study

  • Asiya, Hussien (College of Health Sciences, Ambo University) ;
  • Abdissa, Boka (College of Health Sciences, Addis Ababa University) ;
  • Asnake, Fantu (College of Health Sciences, Ethiopian Defense University)
  • Received : 2022.08.19
  • Accepted : 2022.12.02
  • Published : 2022.12.31
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: This study investigated the vulnerability to human immunodeficiency virus (HIV) infection and associated factors among married women in northwest Ethiopia. Methods: A community-based cross-sectional survey (n=657) was conducted from April 1 to 15, 2020, in Metema District, northwest Ethiopia, in four randomly selected kebele administrations (the lowest level of local government). The inclusion criteria were married women aged ≥18 years residing with their husbands. Logistic regression analysis was conducted to identify factors associated with married women's vulnerability to HIV infection. Results: Participants were on average 33.70±9.50 years and nearly one-fourth (n=148, 22.5%) were identified as vulnerable to HIV infection (i.e., experienced sexually transmitted disease symptoms or an extramarital affair of either spouse within the past 12 months). Only 18.9% reported sexual communication with their husband. Respondents who did not discuss the risk of HIV infection with their husbands had fivefold odds of vulnerability (adjusted odds ratio [AOR], 5.02; 95% confidence interval [CI], 1.43-17.5). Those who did not have premarital sex (AOR, 0.20; 95% CI, 0.05-0.77) had no worries about HIV infection (AOR, 0.27; 95% CI, 0.08-0.94), sufficient income (AOR, 0.56; 95% CI, 0.16-0.86), and less than four children (AOR, 0.69; 95% CI, 0.50-0.97) had decreased odds of being vulnerable to HIV than their counterparts. Conclusion: Not discussing risk of HIV infection with husband was a major factor of vulnerability to HIV infection as was premarital sex, worry about HIV, income, and number of children. Measures to strengthen couple's sexual communication and support economical stability is important for decreasing HIV vulnerability.

Keywords

Acknowledgement

The authors acknowledge all data collectors and women who participated in the study.

References

  1. Lewin SR, Deeks SG, Barre-Sinoussi F. Towards a cure for HIV--are we making progress? Lancet. 2014;384(9939):209-211. https://doi.org/10.1016/S0140-6736(14)61181-8 
  2. Patrao AL, McIntyre T. Socio-demographic, marital and psychosocial predictors of safe sex behaviour among Mozambican women at risk for HIV/AIDS. Afr J AIDS Res. 2018;17(4):323-331. https://doi.org/10.2989/16085906.2018.1536672 
  3. UNAIDS. Global HIV & AIDS statistics-fact sheet [Internet]. Geneva: Author; 2021 [cited 2022 Aug 19]. Available from: https://www.unaids.org/en/resources/fact-sheet 
  4. Habiyambere V, Dongmo Nguimfack B, Vojnov L, Ford N, Stover J, Hasek L, et al. Forecasting the global demand for HIV monitoring and diagnostic tests: a 2016-2021 analysis. PLoS One. 2018;13(9):e0201341. https://doi.org/10.1371/journal.pone.0201341 
  5. Coleman R. Setting the scene, setting the targets. The Joint United Nations Programme on HIV/AIDS prevention targets of 2016 and estimating global pre-exposure prophylaxis targets. Sex Health. 2018;15(6):485-488. https://doi.org/10.1071/SH18147 
  6. World Health Organization. HIV/AIDS: disease burden [Internet]. Geneva: Author; 2020 [cited 2021 Nov 28]. Available from: https://www.afro.who.int/health-topics/hivaids 
  7. Zablotska IB, Baeten JM, Phanuphak N, McCormack S, Ong J. Getting pre-exposure prophylaxis (PrEP) to the people: opportunities, challenges and examples of successful health service models of PrEP implementation. Sex Health. 2018;15 (6):481-484. https://doi.org/10.1071/SH18182 
  8. Ferede A, Erulkar A. Adolescent girls in urban Ethiopia: vulnerability and opportunity [Internet]. New York: Population Council; 2009 [cited 2022 Aug 19]. Available from: https://knowledgecommons.popcouncil.org/departments_sbsr-pgy/159/ 
  9. Central Statistical Agency (Ethiopia) and ICF (USA). Ethiopia demographic and health survey 2016 [Internet]. Addis Ababa, Ethiopia and Rockville, MD: Authors; 2016 [cited 2022 Aug 19]. Available from: https://dhsprogram.com/pubs/pdf/FR328/FR328.pdf 
  10. UNAIDS. HIV transmission in intimate partner relationships in Asia. Geneva: Author; 2009 [cited 2022 Aug 19]. Available from: https://www.unaids.org/en/resources/presscentre/featurestories/2009/august/20090811intimatepartners 
  11. Tiruneh K, Wasie B, Gonzalez H. Sexual behavior and vulnerability to HIV infection among seasonal migrant laborers in Metema district, northwest Ethiopia: a cross-sectional study. BMC Public Health. 2015;15:122. https://doi.org/10.1186/s12889-015-1468-0 
  12. Patrao AL, McIntyre TM, Costa EC, Matediane E, Azevedo V. Testing the effectiveness of two psychosocial interventions on socio-cognitive risk factors for HIV/AIDS in mozambican women: a randomized controlled trial. AIDS Educ Prev. 2021;33(3):169-186. https://doi.org/10.1521/aeap.2021.33.3.169 
  13. Dursit A. Vulnerability of married women to HIV infection and factors contributing to vulnerability in Nazareth, Ethiopia. Addis Ababa, Ethiopia: Addis Ababa University; 2000. 
  14. Dunkle KL, Stephenson R, Karita E, Chomba E, Kayitenkore K, Vwalika C, et al. New heterosexually transmitted HIV infections in married or cohabiting couples in urban Zambia and Rwanda: an analysis of survey and clinical data. Lancet. 2008;371(9631):2183-2191. https://doi.org/10.1016/S0140-6736(08)60953-8 
  15. Gelmon L. Kenya HIV prevention response and modes of transmission analysis. Nairobi, Kenya: National AIDS Control Council; 2009. 
  16. Oraby D, Abdel-Tawab NG. Understanding married women's vulnerability to HIV infection in Egypt: an exploratory study [Internet]. New York: Population Council; 2016 [cited 2022 Aug 19]. Available from: https://knowledgecommons.popcouncil.org/departments_sbsr-rh/712/ 
  17. UNAIDS. Empower young women and adolescents girls: Fast-tracking the end of the AIDS epidemic in Africa [Internet]. Geneva: Author; 2015 [cited 2022 Aug 19]. Available from: https://www.unaids.org/en/resources/documents/2015/JC2746 
  18. Khobotlo M, Tshehlo R, Nkonyana J, Ramoseme M, Khobotle M, Chitoshia A, et al. Lesotho: HIV prevention response and modes of transmission analysis. Maseru, Lesotho: World Bank; 2009. 
  19. Fagbamigbe AF, Adebayo SB, Idemudia E. Marital status and HIV prevalence among women in Nigeria: Ingredients for evidence-based programming. Int J Infect Dis. 2016;48:57-63. https://doi.org/10.1016/j.ijid.2016.05.002 
  20. Ramjee G, Daniels B. Women and HIV in Sub-Saharan Africa. AIDS Res Ther. 2013;10(1):30. https://doi.org/10.1186/1742-6405-10-30 
  21. Jones N, Tafere Y, Woldehanna T. Gendered risks, poverty and vulnerability in Ethiopia: to what extent is the Productive Safety Net Programme (PSNP) making a difference? London: Overseas Development Institute; 2010. 
  22. Karanja L. Just die quietly, domestic violence and women's vulnerability to HIV in Uganda. New York: Human Rights Watch; 2003. 
  23. Merso F. Women & girls and HIV/AIDS in Ethiopia. Addis Ababa, Ethiopia: United Nations Population Fund; 2008. 
  24. Ghosh J, Kalipeni E. Women in Chinsapo, Malawi: vulnerability and risk to HIV/AIDS. SAHARA J. 2005;2(3):320-332. https://doi.org/10.1080/17290376.2005.9724857 
  25. Smith KP, Watkins SC. Perceptions of risk and strategies for prevention: responses to HIV/AIDS in rural Malawi. Soc Sci Med. 2005;60(3):649-660. https://doi.org/10.1016/j.socscimed.2004.06.009 
  26. UNAIDS. Global report: UNAIDS report on the global AIDS epidemic 2010. Geneva: UNAIDS; 2010. 
  27. Assefa Y, Gilks CF, Dean J, Tekle B, Lera M, Balcha TT, et al. Towards achieving the fast-track targets and ending the epidemic of HIV/AIDS in Ethiopia: successes and challenges. Int J Infect Dis. 2019;78:57-64. https://doi.org/10.1016/j.ijid.2018.10.022 
  28. Ministry of Finance and Economic Development, Ethiopia. Annual statistical bulletin of Metema (woreda) in 2015/16. 
  29. Halperin DT, Epstein H. Concurrent sexual partnerships help to explain Africa's high HIV prevalence: implications for prevention. Lancet. 2004;364(9428):4-6. https://doi.org/10.1016/S0140-6736(04)16606-3 
  30. Patrao AL, McIntyre TM. Socio-demographic, marital, and psychosocial factors associated with condom use negotiation self-efficacy among mozambican women at risk for HIV infection. Int J Behav Med. 2017;24(6):846-855. https://doi.org/10.1007/s12529-017-9681-0 
  31. Aryal N, Regmi PR, Teijlingen EV, Dhungel D, Ghale G, Bhatta GK, et al. Knowing is not enough: migrant workers' spouses vulnerability to HIV. SAARC J Tuberc Lung Dis. 2016;13(1):9-15. https://doi.org/10.3126/saarctb.v13i1.16923 
  32. Arulogun OS, Obisesan OO, Desmennu A. Perception of risk of contracting HIV from spouses among married women in a peri-urban community of south west Nigeria. IOSR J Humanit Soc Sci. 2013;8(6):60-66. https://doi.org/10.9790/0837-0866066