Browsing by Author "Weiser, S.D."
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Weiser, S.D.; Leiter, K.; Bangsberg, D.R.; Butler, L.M.; Percy-de Korte, F.; Hlanze, Z.; Phaladze, N.; Iacopino, V.; Heisler, M. (Plos Medicine. www.plosmedicine.org, NaN, 2007)[more][less]
Abstract: Background: Both food insufficiency and HIV infection are major public health problems in sub-Saharan Africa, yet the impact of food insufficiency on HIV risk behavior has not been systematically investigated. We tested the hypothesis that food insufficiency is associated with HIV transmission behavior. Methods and Findings: We studied the association between food insufficiency (not having enough food to eat over the previous 12 months) and inconsistent condom use, sex exchange, and other measures of risky sex in a cross-sectional population-based study of 1,255 adults in Botswana and 796 adults in Swaziland using a stratified two-stage probability design. Associations were examined using multivariable logistic regression analyses, clustered by country and stratified by gender. Food insufficiency was reported by 32% of women and 22% of men over the previous 12 months. Among 1,050 women in both countries, after controlling for respondent characteristics including income and education, HIV knowledge, and alcohol use, food insufficiency was associated with inconsistent condom use with a nonprimary partner (adjusted odds ratio [AOR] 1.73, 95% confidence interval [CI] 1.27–2.36), sex exchange (AOR 1.84, 95% CI 1.74–1.93), intergenerational sexual relationships (AOR 1.46, 95% CI 1.03–2.08), and lack of control in sexual relationships (AOR 1.68, 95% CI 1.24–2.28). Associations between food insufficiency and risky sex were much attenuated among men. Conclusions: Food insufficiency is an important risk factor for increased sexual risk-taking among women in Botswana and Swaziland. Targeted food assistance and income generation programs in conjunction with efforts to enhance women’s leg URI: http://hdl.handle.net/10311/556 Files in this item: 1
Food insufficiency.pdf (2.245Mb) -
Weiser, S.D.; Heisler, M.; Leiter, K.; Percy-de Korte, F.; Tlou, S.; DeMonner, S.; Phaladze, N.; Bangsberg, D.R.; Iacopino, V. (PLoS Medicine. www.plosmedicine.org, NaN, 2006)[more][less]
Abstract: Background The Botswana government recently implemented a policy of routine or "opt-out" HIV testing in response to the high prevalence of HIV infection, estimated at 37% of adults. Methods and Findings We conducted a cross-sectional, population-based study of 1,268 adults from five districts in Botswana to assess knowledge of and attitudes toward routine testing, correlates of HIV testing, and barriers and facilitators to testing, 11 months after the introduction of this policy. Most participants (81%) reported being extremely or very much in favor of routine testing. The majority believed that this policy would decrease barriers to testing (89%), HIV-related stigma (60%), and violence toward women (55%), and would increase access to antiretroviral treatment (93%). At the same time, 43% of participants believed that routine testing would lead people to avoid going to the doctor for fear of testing, and 14% believed that this policy could increase gender-based violence related to testing. The prevalence of self-reported HIV testing was 48%. Adjusted correlates of testing included female gender (AOR ¼ 1.5, 95% CI ¼ 1.1–1.9), higher education (AOR¼2.0, 95% CI¼1.5–2.7), more frequent healthcare visits (AOR¼ 1.9, 95% CI ¼ 1.3–2.7), perceived access to HIV testing (AOR ¼ 1.6, 95% CI ¼ 1.1–2.5), and inconsistent condom use (AOR ¼ 1.6, 95% CI ¼ 1.2–2.1). Individuals with stigmatizing attitudes toward people living with HIV and AIDS were less likely to have been tested for HIV/AIDS (AOR ¼ 0.7, 95% CI ¼ 0.5–0.9) or to have heard of routine testing (AOR ¼ 0.59, 95% CI ¼ 0.45–0.76). While experiences with voluntary and routine testing overall were positive, 68% felt that they could not refuse the HIV test. Key barriers to testing included fear of learning one’s status (49%), lack of perceived HIV risk (43%), and fear of having to change sexual practices with a positive HIV test (33%). Conclusions Routine testing appears to be widely supported and may reduce barriers to testing in Botswana. As routine testing is adopted elsewhere, measures should be implemented to assure true informed consent and human rights safeguards, including protection from HIV-related discrimination and protection of women against partner violence related to testing. URI: http://hdl.handle.net/10311/554 Files in this item: 1
Routine HIV testing.pdf (1.339Mb)
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