Background
Methods
Measures
Individual background characteristics
Social/community norms
Community types
Statistical analysis
Results
Community and gender differences in HIV infection, past year STI symptoms, IPV experiences and HIV/STI risk behaviors: descriptive findings
Fishing | Trading | Agrarian | P value | |
---|---|---|---|---|
Age
| ||||
15 to 24 years | 27.06 (1049) | 36.72 (1989) | 37.40 (2484) | < 0.001 |
25 to 34 years | 45.30 (1756) | 36.28 (1965) | 34.25 (2275) | |
35 years and above | 27.63 (1071) | 26.99 (1462) | 28.35 (1883) | |
Gender
| ||||
Males | 51.7 (1959) | 41.7 (2013) | 43.7 (2559) | < 0.001 |
Females | 48.3 (1827) | 58.3 (2814) | 56.3 (3292) | |
Education
| ||||
No education | 9.75 (378) | 3.31 (179) | 4.02 (267) | < 0.001 |
Primary education | 72.39 (2806) | 56.42 (3055) | 63.15 (4193) | |
Secondary education | 15.94 (618) | 29.60 (1603) | 27.38 (1818) | |
High school and above | 0.77 (30) | 3.29 (178) | 1.05 (70) | |
Vocational/Professional | 1.14 (44) | 7.39 (400) | 4.40 (292) | |
HIV Status
| ||||
Positive | 42.3 (1599) | 16.7 (806) | 15.6 (911) | < 0.001 |
Negative | 57.7 (2184) | 83.3 (4012) | 84.4 (4930) | |
STI
| 34.3 (996) | 15.9 (613) | 16.3 (769) | < 0.001 |
Household Wealth
| ||||
High | 25.49 (962) | 70.96 (3839) | 50.37 (3343) | < 0.001 |
Middle | 9.49 (358) | 18.52 (1002) | 37.22 (2470) | |
Low | 65.02 (2454) | 10.52 (569) | 12.42 (824) | |
Any Physical or Sexual IPV (Past year)
| 25.1 (894) | 14.3 (624) | 13.7 (731) | < 0.001 |
Condom use in past year
| ||||
Never used condom | 39.0 (772) | 40.6 (694) | 41.5 (881) | < 0.001 |
Sometimes used condom | 36.5 (722) | 30.3 (518) | 30.4 (646) | |
Always used condom | 24.5 (485) | 29.1 (498) | 28.1 (598) | |
Multiple sexual partners: Past 12 months
| 44.1 (1570) | 21.1 (910) | 21.6 (1138) | < 0.001 |
Recent partner was a casual partner
| 5.87 (222) | 2.48 (113) | 2.52 (139) | < 0.001 |
Partner’s multiple sexual relationships: Past year
| 57.1 (765) | 52.9 (861) | 46.5 (940) | < 0.001 |
Alcohol use before sex
| 39.7 (1502) | 23.7 (1078) | 26.8 (1479) | < 0.001 |
Partner’s alcohol use before sex
| 40.6 (1537) | 28.8 (1313) | 32.6 (1796) | < 0.001 |
Perceived likelihood of partner being exposed to HIV
| ||||
-Very likely or somewhat likely | 82.1 (3075) | 74.1 (3366) | 74.3 (4088) | < 0.001 |
Number of partners outside the community: Past 12 months
| ||||
One partner | 24.5 (867) | 26.2 (1129) | 22.5 (1182) | < 0.001 |
Two or more partners | 10.7 (379) | 5.34 (230) | 5.17 (272) |
Fishing | Trading | Agrarian | ||||
---|---|---|---|---|---|---|
Men* | Women* | Men* | Women* | Men* | Women* | |
HIV | 35.4 (692) | 49.7 (907) | 12.9 (260) | 19.4 (546) | 12.5 (320) | 17.9 (591) |
STI | 27.7 (467) | 43.5 (529) | 10.0 (183) | 21.4 (430) | 11.1 (259) | 21.2 (510) |
Physical or Sexual IPV in the past year | 17.5 (326) | 33.4 (568) | 9.16 (168) | 17.9 (456) | 9.40 (221) | 17.1 (510) |
Perpetration (men) | ||||||
Victimization (women) | ||||||
Condom use in past year
| ||||||
Never used condom | 36.0 (465) | 44.6 (307) | 33.1 (301) | 49.1 (393) | 35.7 (445) | 49.6 (436) |
Sometimes used condom | 36.6 (472) | 36.3 (250) | 30.5 (277) | 30.1 (241) | 31.7 (395) | 28.5 (251) |
Always used condom | 27.4 (354) | 19.0 (131) | 36.4 (331) | 20.8 (167) | 32.6 (406) | 21.8 (192) |
Multiple sexual partners Past Year (Two or more)
| 64.8 (1202) | 21.6 (368) | 38.9 (708) | 8.07 (202) | 40.7 (950) | 6.41 (188) |
Two or more sex partners outside the community
Past Year
| 17.8 (327) | 3.06 (52) | 9.61 (174) | 2.24 (56) | 9.80 (228) | 1.50 (44) |
Partner’s multiple sexual relationships
Past Year | 30.7 (135) | 70.1 (630) | 9.95 (38) | 66.2 (823) | 11.1 (60) | 59.4 (880) |
Recent casual relationship
| 10.7 (209) | 0.71 (13) | 4.69 (90) | 0.87 (23) | 4.69 (115) | 0.78 (24) |
Alcohol use before sex
| 47.5 (930) | 31.3 (572) | 33.8 (649) | 16.3 (429) | 38.5 (943) | 17.5 (536) |
Partner’s alcohol use before sex
| 33.4 (654) | 48.4 (883) | 17.1 (329) | 37.4 (984) | 18.8 (462) | 43.5 (1334) |
Force was used when had sex for the first time
| 0 | 26.83 (470) | 0 | 14.51 (251) | 1 (100) | 13.38 (250) |
Factors associated with HIV infection, past year STI symptoms and IPV experiences, by community type and gender: multivariate findings
HIV Outcome
Males | Females | |||||
---|---|---|---|---|---|---|
Fishing | Trading | Agrarian | Fishing | Trading | Agrarian | |
Individual characteristics | ||||||
Age | ||||||
15 to 24 years (Ref) | – | – | – | – | ||
25 to 34 years |
1.91 (1.19–3.05)
|
2.29 (1.47–3.57)
|
1.60 (1.09–2.34)
|
1.47 (1.19–1.82
| 0.79 (0.52–1.21) |
1.49 (1.01–2.19)
|
35 years and above |
1.86 (1.08–3.22)
|
4.26 (2.72–6.65)
|
2.37 (1.61–3.48)
|
1.58 (1.24–2.00)
| 1.07 (0.67–1.73) | 1.25 (0.82–1.89) |
Marital Status | ||||||
Never married (Ref) | – | – | – | – | – | – |
Married with multiple partners | 1.09 (0.64–1.84) | 2.88 (1.53–5.42) |
2.06 (1.11–3.81)
| 1.26 (0.75–2.12) | 2.97 (0.91–9.69) | 2.28 (0.56–9.32) |
Married- monogamous | 1.10 (0.57–2.11) |
3.50 (2.02–6.06)
|
2.44 (1.42–4.18)
| 1.40 (0.84–2.33) |
3.57 (1.16–11.05)
| 2.85 (0.66–12.30) |
Previously married | 1.44 (0.92–2.27) |
3.81 (2.15–6.75)
|
2.76 (1.49–5.10)
| 1.46 (0.87–2.44) |
3.28 (1.63–6.63)
|
4.23 (1.07–16.6)
|
Religion | ||||||
Catholic | – | – | – | – | – | – |
Protestant | 1.29 (0.94–1.77) |
0.66 (0.44–0.98)
| 0.96 (0.72–1.27) | |||
Muslim | 0.82 (0.53–1.25) |
0.52 (0.35–0.78)
|
0.61 (0.40–0.94)
| |||
Other or None | 0.79 (0.42–1.46) | 0.56 (0.27–1.25) | 1.27 (0.78–2.07) | |||
Education (Years) | 0.92 (0.83–1.00) | – | – | 0.98 (0.84–1.15) | – | |
Type of Occupation | ||||||
Fishing | Ref | – | – | – | – | – |
Housework | – | – | – | Ref | Ref | Ref |
Agriculture | 0.18 (0.02–1.30) | 1.19 (0.84–1.68) | Ref | 0.73 (0.51–1.04) | 0.83 (0.47–1.45) | 2.20 (0.75–6.48) |
Business/Trading | 0.63 (0.39–1.01) | Ref | 1.34 (0.92–1.96) | 0.96 (0.78–1.18) | 0.75 (0.38–1.51) | 2.39 (0.91–6.29) |
Bar/Restaurant | – | – | – | 0.88 (0.71–1.08) | 1.21 (0.61–2.42) |
2.92 (1.15–7.43)
|
Other |
0.62 (0.43–0.91)
| 0.96 (0.67–1.36_ | 1.12 (0.92–1.36) | 0.87 (0.71–1.08) | 0.55 (0.27–1.11) | 1.79 (0.70–4.56) |
Age of first sexual intercourse | – | |||||
18 and older (Ref) | – | – | – | – | – | |
Childhood (12 years and under) | 1.30 (0.92–1.84) | 0.86 (0.62–1.20) | 1.85 (0.75–4.57) | |||
Adolescence (13–17 years) | 1.11 (0.91–1.34) | 1.37 (0.68–2.74) | 1.50 (0.92–2.46) | |||
Forced first sex | – | – | – | 1.05 (0.91–1.22) | 0.49 (0.06–3.56) | 1.14 (0.79–1.65) |
Relationship charactersitics | ||||||
Any Physical or Sexual IPV | 1.00 (0.71–1.41) | 0.86 (0.53–1.38) | 1.38 (0.92–2.10) | 1.07 (0.93–1.22) | 1.27 (0.76–2.11) | 0.91 (0.62–1.32) |
Age Gap Between Partners | ||||||
1–5 years’ gap (Ref) | – | – | – | – | ||
6–10 years’ gap (2) | 1.23 (0.92–1.64) | 0.96 0.76–1.21) | 0.95 (0.70–1.31) | – | 0.86 (0.62–1.21) | – |
11 or more years (3) | 1.26 (0.83–1.90) | 0.63 (0.39–1.02) | 0.86 (0.59–1.25) | 1.37 (0.68–2.74) | ||
Condom use in past year | ||||||
Never used condom (Ref) | ||||||
Sometimes used condom | – | – | – | 1.20 (0.94–1.54) | – | |
Always used condom | 1.32 (0.69–2.50) | |||||
Multiple sexual partners: Past 12 months | 1.18 (0.84–1.66) | 1.37 (0.95–1.97) |
1.38 (1.15–1.65)
| 1.05 (0.89–1.23) | 1.16 (0.75–1.80) |
1.44 (1.03–2.02)
|
Partner’s multiple sexual relationships | – | – | – | 1.15 (0.96–1.37) | 1.38 (0.62–3.07) | 1.26 (0.81–1.96) |
Alcohol use before sex | 0.99 (0.74–1.32) | 1.04 (0.77–1.41) | 1.05 (0.81–1.35) |
1.17 (1.01–1.36)
| 1.33 (0.92–1.93) | 0.83 (0.58–1.19) |
Partner’s alcohol use before sex | 1.25 (0.95–1.64) | 0.93 (0.65–1.31) | 1.18 (0.93–1.51) | 1.15 (0.98–1.33) | 0.65 (0.39–1.08) |
1.87 (1.37–2.54)
|
Perceived likelihood of partner being exposed to HIV | ||||||
-Very likely or somewhat likely | 1.17 (0.58–2.34) |
2.18 (1.47–3.23)
|
2.37 (1.83–3.06)
|
1.79 (1.30–2.46)
| 1.41 (0.71–2.81) |
2.39 (1.51–3.79)
|
Number of partners outside the community: Past 12 months | - | - | - | |||
One partner | 0.86 (0.60–1.23) | 1.22 (0.98–1.52) | ||||
Two or more partners | 0.97 (0.65–1.44) | 0.92 (0.64–1.32) | ||||
Partner’s movement | – | – | ||||
Regular resident of the community | 0.95 (0.64–1.42) | – | ||||
Not a regular | ||||||
Household characteristics | ||||||
Household wealth | – | – | ||||
High | – | – | – | – | ||
Middle | 1.45 (0.87–2.44) | 0.95 (0.78–1.17) | 1.07 (0.81–1.41) | 1.09 0.80–1.48) | ||
Low | 1.28 (0.87–1.88) | 1.18 (0.89–1.57) |
1.24 (1.04–1.47)
| 0.91 (0.61–1.37) | ||
Family size |
1.07 (1.01–1.14)
|
0.86 (0.81–0.92)
|
0.91 (0.85–0.98)
|
0.94 (0.90–0.97)
| 0.95 (0.85–1.07) |
0.89 (0.82–0.96)
|
STI Outcome
Males | Females | |||||
---|---|---|---|---|---|---|
Fishing | Trading | Agrarian | Fishing | Trading | Agrarian | |
Individual characteristics | ||||||
Age | ||||||
15 to 24 years (Ref) | – | – | ||||
25 to 34 years (2) | 1.02 (0.74–1.42) | 1.02 (0.56–1.83) | – | – | 0.90 (0.75–1.08) | 1.16 (0.86–1.57) |
35 years and above (3) | 0.82 (0.53–1.27) | 0.77 (0.40–1.46) |
0.69 (0.52–0.92)
| 0.62 (0.32–1.22) | ||
Marital Status | ||||||
Never married (Ref) | – | – | – | – | – | – |
Married with multiple partners (1) | 1.19 (0.80–1.78) | 1.00 (0.61–1.65) |
1.94 (1.33–2.83)
| 0.92 (0.55–1.55) | ||
Married- monogamous (2) | 1.15 (0.67–1.98) | 1.02 (0.62–1.69) |
1.72 (1.15–2.57)
| 1.57 (0.97–2.54) | ||
Previously married (3) | 1.24 (0.86–1.79) | 1.15 (0.69–1.91) |
1.74 (1.13–2.67)
| 1.34 (0.84–2.13) | ||
Religion | ||||||
Catholic | – | – | – | – | – | – |
Protestant | 0.89 (0.59–1.34) | |||||
Muslim | 0.83 (0.55–1.26) | |||||
Other or None |
1.71 (1.14–2.54)
| |||||
Education (Years) | – |
0.94 (0.89–0.99)
| – | – | ||
Type of Occupation | ||||||
Fishing | Ref | – | – | – | ||
Housework | – | – | Ref | – | ||
Agriculture | 0.62 (0.22–1.70) | Ref | – | 1.04 (0.76–1.43) | ||
Business/Trading | 1.32 (0.96–1.82) | 1.09 (0.62–1.91) |
1.38 (1.04–1.83)
| |||
Bar/Restaurant Worker/Waitress/Waiter | – | – | 1.08 (0.80–1.46) | |||
Other | 0.73 (0.51–1.03) | 1.01 (0.68–1.51) | 0.93 (0.71–1.22) | |||
Age of first sexual intercourse | ||||||
18 and older (Ref) | – | – | – | – | – | – |
Childhood (12 years and under) | 0.79 (0.36–1.74) | 0.80 (0.40–1.60) | ||||
Adolescence (13–17 years) | 1.11 (0.87–1.40) | 0.99 (0.73–1.33) | ||||
Forced first sex | – | – | – | 1.10 (0.91–1.34) | – | 1.27 (0.73–2.19) |
Relationship charactersitics | ||||||
Any Physical or Sexual IPV | 1.31 (0.98–1.76) | 1.53 (0.93–2.50) | 1.29 (0.79–2.11) |
1.31 (1.08–1.58)
|
1.59 (1.37–1.84)
| 1.15 (0.88–1.52) |
Age Gap Between Partners | ||||||
1–5 years’ gap (Ref) | – | – | – | – | – | – |
6–10 years’ gap (2) | 1.00 (0.78–1.29) | |||||
11 or more years (3) | 1.40 (0.84–2.33) | |||||
Condom use in past year | ||||||
Never used condom (Ref) | – | |||||
Sometimes used condom | 0.80 (0.62–1.03) | 0.80 (0.62–1.04) | 0.95 (0.65–1.39) | – | – | |
Always used condom |
0.38 (0.24–0.63)
|
0.41 (0.23–0.69)
| 0.61 (0.33–1.13) | |||
Multiple Sexual Partners (Two or more sexual partners: Past 12 months) | 1.33 (0.89–1.99) |
2.09 (1.21–3.62)
| 1.74 (0.93–3.24) | 1.14 (0.91–1.42) |
1.50 (1.06–2.10)
| 1.36 (0.77–2.41) |
Partner’s multiple sexual relationships | – | – | – | 1.25 (0.96–1.63) | – |
1.44 (1.05–2.00)
|
Alcohol use before sex | 1.12 (0.82–1.52) | 1.45 (0.96–2.19) | 1.22 (0.76–1.94) | 1.10 (0.89–1.35) | 1.02 (0.74–1.39) | 1.19 (0.86–1.65) |
Partner’s alcohol-use before sex | 1.22 (0.93–1.61) | – | 0.95 (0.65–1.39) | 1.20 (0.98–1.48) | 1.16 (0.94–1.44) | 0.98 (0.67–1.44) |
Perceived likelihood of partner being exposed to HIV | 1.09 (0.74–1.60) | |||||
-Very likely or somewhat likely | 1.31 (0.79–2.17) | 1.78 (0.88–3.59) | 1.45 (0.80–2.64) | 1.22 (0.85–1.76) | 1.35 (0.99–1.83) | |
Number of partners outside the community: Past 12 months | - | - | - | - | - | |
One partner | 0.88 (0.62–1.24) | 1.75 (0.87–3.52) | 1.10 (0.88–1.37) | 0.95 (0.73–1.23) | ||
Two or more partners | 1.31 (0.94–1.81) | 1.65 (0.55–4.90) | 1.25 (0.74–2.14) | 1.15 (0.70–1.89) | ||
Partner’s movement | ||||||
Regular resident of the community (Ref) | – | – | – | – | – | – |
Not a regular | 0.56 (0.31–1.02) | 0.72 (0.48–1.07) | ||||
Household characteristics | ||||||
Family size | 0.97 (0.92–1.02) | 0.95 (0.91–1.00) |
0.86 (0.79–0.94)
| 0.97 (0.92–1.02) |
0.91 (0.86–0.95)
|
0.92 (0.85–0.98)
|
IPV Outcome
Males | Females | |||||
---|---|---|---|---|---|---|
Fishing | Trading | Agrarian | Fishing | Trading | Agrarian | |
IPV Perpetration | IPV Victimization | |||||
Individual characteristics | ||||||
Age | ||||||
15 to 24 years (Ref) | – | – | – | |||
25 to 34 years (2) | 0.83 (0.57–1.21) | – | – | 0.82 (0.61–1.09) | ||
35 years and above (3) | 0.67 (0.40–1.12) |
0.65 (0.43–0.98)
| ||||
Marital Status | ||||||
Never married (Ref) | – | – | – | – | – | |
Married with multiple partners (1) | 1.51 (0.87–2.59) | 1.31 (0.82–2.08) | 1.95 (0.97–3.92) | 0.82 (0.46–1.44) | 1.13 (0.49–2.58) | – |
Married- monogamous (2) |
1.73 (1.02–2.93)
| 1.29 (0.68–2.42) |
2.16 (1.16–4.03)
| 0.91 (0.52–1.57) |
2.37 (1.08–5.21)
| |
Previously married (3) | 1.39 (0.82–2.36) | 0.81 (0.29–2.27) | 1.07 (0.40–2.83) | 0.63 (0.35–1.12) | 0.59 (0.22–1.59) | |
Children | ||||||
0–1 child | – | – | – | – | ||
2–3 children | 1.11 (0.82–1.49) | |||||
4–5 children | 1.07 (0.71–1.60) | |||||
6 children and above | 1.11 (0.66–1.89) | |||||
Religion | ||||||
Catholic | – | – | – | – | – | |
Protestant |
0.49 (0.26–0.92)
| 0.78 (0.49–1.22) | ||||
Muslim | 0.95 (0.64–1.40) | 0.54 (0.27–1.09) | ||||
Other or None | 0.73 (0.32–1.67) | 0.78 (0.23–2.58) | ||||
Education (Years) | – | – | – | – | – | |
Type of Occupation | ||||||
Fishing | – | – | – | – | ||
Housework | – | Ref | Ref | |||
Agriculture | 0.87 (0.51–1.48) | 1.03 (0.51–2.07) | – | |||
Business/Trading | 0.81 (0.56–1.16) | 1.34 (0.65–2.75) | ||||
Bar/Restaurant | 1.11 (0.79–1.57) | 1.35 (0.51–3.61) | ||||
Other | 0.91 (0.65–1.29) | 0.68 (0.30–1.51) | ||||
Age of first sexual intercourse | ||||||
18 and older (Ref) | – | – | – | – | – | – |
Childhood (12 years and under) | 1.53 (0.88–2.65) | 1.58 (0.85–2.93) | 1.00 (0.32–3.06) | |||
Adolescence (13–17 years) | 0.97 (0.73–1.30) | 1.15 (0.72–1.84) | 0.52 (0.23–1.19) | |||
Forced first sex | – | – | – | 1.12 (0.87–1.45) | 1.05 (0.63–1.76) | 1.83 (0.67–5.05) |
HIV Status | 1.08 (0.82–1.43) | 1.05 (0.65–1.68) |
1.28 (1.00–1.65)
| 1.26 (0.78–2.03) | – | |
STI Symptoms | 1.24 (0.93–1.65) | 1.72 (0.97–3.03) | 1.23 (0.81–1.87) |
1.37 (1.07–1.76)
|
1.45 (1.01–2.09)
| 2.03 (0.91–4.52) |
Relationship charactersitics | ||||||
Age Gap Between Partners | ||||||
1–5 years’ gap (Ref) | – | |||||
6–10 years’ gap (2) | 0.75 (0.50–1.14) | – | – | – | ||
11 or more years (3) | 1.20 (0.68–2.13) | – | – | |||
Condom use in past year | ||||||
Never used condom (Ref) | – | – | – | – | ||
Sometimes used condom | 0.93 (0.69–1.31) | 0.75 (0.52–1.09) | 1.20 (0.72–1.97) | – | – | |
Always used condom |
0.45 (0.28–0.72)
| 0.42 (0.17–1.04) | 0.71 (0.39–1.27) | |||
Multiple sexual partners: Past 12 months |
2.32 (1.11–4.85)
|
4.57 (1.87–11.1)
| 1.92 (0.83–4.44) |
1.39 (1.05–1.83)
| 1.06 (0.65–1.71) |
5.71 (2.56–12.71)
|
Partner’s multiple sexual relationships | – | – | – | 1.20 (0.89–1.62) |
3.54 (1.94–6.48)
| 1.51 (0.56–4.01) |
Recent casual relationship | ||||||
-A spouse/consensual regular partner (Ref) -Irregular partner | - 1.10 (0.69–1.75) | – | – | – | – | – |
Alcohol use before sex | 1.13 (0.81–1.57) | 1.62 (0.99–2.64) | 1.44 (0.88–2.36) | 0.96 (0.74–1.25) | 1.13 (0.78–1.63) | 0.94 (0.31–2.86) |
Partner’s alcohol use before sex | 0.95 (0.69–1.31) | 1.46 (0.76–2.79) |
1.56 (1.03–2.35)
|
1.42 (1.10–1.83)
|
1.53 (1.01–2.33)
| 2.27 (0.71–7.27) |
Perceived likelihood of partner being exposed to HIV | - | 0.72 (0.24–2.11) | ||||
-Very likely or somewhat likely | 1.33 (0.84–2.11) | 1.24 (0.72–2.13) | ||||
Number of partners outside the community: Past 12 months | - | - | - | - | - | - |
One partner | 1.30 (0.72–2.36) | 0.85 (0.61–1.19) | 1.18 (0.79–1.78) | |||
Two or more partners |
1.94 (1.05–3.60)
| 1.28 (0.81–2.01) |
2.86 (1.09–7.47)
| |||
Household characteristics | ||||||
Household wealth | – | – | – | |||
High | – | – | – |
2.26 (1.00–5.11)
| ||
Middle | 0.94 (0.27–3.18) | |||||
Low | ||||||
Family size | 1.02 (0.96–1.09) | 0.93 (0.83–1.04) | 0.98 (0.91–1.07) | 0.96 (0.89–1.04) | 1.07 (0.99–1.14) | 1.08 (0.99–1.19) |
Social/community norms | ||||||
Any Justification of wife/partner beating |
3.05 (1.99–4.69)
| – | 1.49 (0.86–2.57) | 1.38 (0.98–1.95) | – | 1.69 (0.85–3.38) |