Individual and community-level determinates of risky sexual behaviors among sexually active unmarried men: A multilevel analysis of 2016 Ethiopian Demographic and Health Survey.

BACKGROUND: In Ethiopia, HIV/AIDS continues to be a major public health problem mostly due to the high prevalence of risky sexual behaviors. However, research on risky sexual behavior and its determinants among unmarried men (never married, widowed, and divorced) who are highly vulnerable to risky sexual behavior was limited. Therefore, this study aimed to assess the magnitude of risky sexual behavior and its determinants among non-married men using a nationally representative sample. METHODS: The analysis was done on 5680 sexually active unmarried men aged 15-59 years using data from the 2016 Ethiopia Demographic Health Survey (EDHS). The main outcome variable was risky sexual behavior which defined as having at least one of the following: multiple sexual partners; initiation of sex before the age of 18 years; inconsistent condom use in the last 12 months; alcohol consumption at last sex. Multivariable generalized linear mixed-effects regression was employed to identify variables associated with risky sexual behavior. RESULT: The overall magnitude of risky sexual behavior was 26.9% (95% CI; 25.7, 28.0). Currently employed (AOR = 2.49, 95% CI = 1.64-3.77), history of HIV testing (AOR = 2.51, 95% C = 1.95-3.23), drinking alcohol almost every day (AOR = 5.49, 95 CI = 2.73-11.02), and using Internet daily (AOR = 1.99, 95% CI = 1.06-3.74) increase the odds of risky sexual behavior. Whereas, primary education (AOR = 0.44, 95% CI = 0.32-0.61), secondary education level (AOR = 0.46, 95% CI = 0.29-0.72) and a high proportion of community-level media exposure (AOR = 0.42, 95% CI = 0.12-0.75) decrease the odds of risky sexual behavior. CONCLUSION: In general, a significant proportion of sexually active unmarried men in Ethiopia have practiced risky sexual behavior. An intervention should be designed which are against the factors found to increase the odds of risky sexual behavior to reduce the incidence of HIV and other sexually transmitted infections.

Exclusive breastfeeding lowers the odds of childhood diarrhea and other medical conditions: evidence from the 2016 Ethiopian demographic and health survey.

BACKGROUND: Lack of exclusive breastfeeding during the first 6 months of infant life contributes to childhood morbidity and mortality. This study aimed to investigate the association of exclusive breastfeeding and childhood illnesses in Ethiopia. METHODS: A secondary data analysis was conducted using data from the 2016 Ethiopian Demographic and Health Survey (EDHS). Descriptive and multivariable logistic regression analyses were carried out. RESULTS: A total of 1034 mother-infant pairs were included in the analysis. The overall magnitude of exclusive breastfeeding among infants aged under 6 months was 87.6% (95% CI: 84.3-90.3%). Compared to infants who were non-exclusively breastfed, the odds of having an illness with fever in the last 2 weeks among infants who were exclusively breastfed decreased by 66% (AOR: 0.34; 95% CI: 0.16, 0.75). Similarly, exclusively breastfed infants had lower odds of having an illness with a cough (AOR: 0.38; CI: 0.20, 0.72) and having diarrhea (AOR: 0.33; CI: 0.13, 0.83) compared to non-exclusively breastfed infants. CONCLUSION: Exclusive breastfeeding lowers the odds of an illness with fever, illness with cough and diarrhea. The findings of this study implicate the need for promotion of exclusive breastfeeding in the country.

Chronic Energy Deficiency and Its Determinant Factors among Adults Aged 18-59 Years in Ethiopia: A Cross-Sectional Study.

BACKGROUND: The prevalence of undernutrition in low- and middle-income countries is still remarkably high. Undernutrition during adulthood is a greater risk factor for low productivity, poor health, and mortality. There is limited information on the prevalence and determinants of chronic energy deficiency in Ethiopia. OBJECTIVE: To assess the prevalence and determinants of chronic energy deficiency among adults aged 18-59 years in Ethiopia. METHOD: A secondary data analysis was conducted using the data obtained from the 2016 Ethiopia Demographic and Health Survey. Data were collected using a multistage stratified cluster sampling technique, and the analytic sample consisted of 9,280 adults aged 18-59 years. The chi-square test and multivariable logistic regression analyses were used, and p value <0.05 was taken as statistically significant. RESULT: A total of 9280 adults aged 18-59 years were included in the study and 2911 (28.7%) (95% CI: 27.0%-30.4%) of whom were chronic energy deficient. Adults who have no work (AOR = 1.41, 95% CI: 1.16, 1.72), male adults from Tigray region (AOR = 2.23, 95% CI: 1.61, 3.09), Afar region (AOR = 2.98, 95% CI: 2.04, 4.36), Somali region (AOR = 3.14, 95% CI: 2.19, 4.52), Gambella region (AOR = 1.89, 95% CI: 1.29, 2.76), Harari region (AOR = 1.54, 95% CI: 1.09, 2.19), Amhara region (AOR = 1.53, 95% CI: 1.09, 2.13), Oromia region (AOR = 1.53, 95% CI: 1.07, 2.19), Dire Dawa (AOR = 1.45, 95% CI: 1.03, 2.05), adults live lonely (AOR = 1.44, 95% CI: 1.21, 1.71), and adults residing in poor wealth index households (AOR = 1.26 : 95% CI: 1.07, 1.49) were significantly associated with chronic energy deficiency. Conclusion and recommendation. Chronic energy deficiency among male adults in Ethiopia was a high public health problem. Marital status, wealth index, occupation, and region were significant predictors of chronic energy deficiency. The Ministry of Health with other partners should strictly monitor and evaluate interventions that are being applied and should give focus to adult men to prevent malnutrition.

Factors associated with discriminatory attitudes towards people living with HIV among adult population in Ethiopia: analysis on Ethiopian demographic and health survey.

Extensive discriminatory attitudes in a population can affect people's willingness to be tested for Human Immunodeficiency Virus (HIV), their initiation of antiretroviral therapy, social support as well as the quality of life of people infected with HIV. This study aimed to assess factors associated with discriminatory attitudes towards people living with HIV/AIDS (PLWHA). Secondary data analysis was conducted using data from the 2016 Ethiopia Demographic Health Survey. A total of 26,623 adult populations were included. Multivariable logistic regression analysis was conducted to identify factors associated with discriminatory attitudes. The proportion of participants having discriminatory attitudes towards PLWHA was 93.8% among men and 64.5% among women. This study revealed that rural residence, no formal education, lack of media access, not previously tested for HIV and lack of comprehensive HIV knowledge increase the odds of having discriminatory attitudes. In conclusion, there is a high-level discriminatory attitude towards PLWHA. Improvement in HIV-related knowledge and dealing with wrong perceptions and myths are extremely vital to reduce discriminatory attitudes towards HIV-infected people. Information, education and communication programmes need to intensify its educational campaigns to dispel these misconceptions.

Change in Viral Load Count and Its Predictors Among Unsuppressed Viral Load Patients Receiving an Enhanced Adherence Counseling Intervention at Three Hospitals in Northern Ethiopia: An Exploratory Retrospective Follow-Up Study.

BACKGROUND: Enhanced adherence counseling (EAC) is an interventional program that provides targeted adherence counseling for unsuppressed viral load people living with HIV who are receiving antiretroviral therapy before diagnosing treatment failure. However, there is a lack of evidence on change in viral load count among patients receiving EAC intervention. Therefore, this study aimed to assess change in viral load count and its predictors among people living with HIV (PLHIV) in northeast Ethiopia. METHODS: A hospital-based retrospective follow-up study was conducted on 235 randomly selected patients with unsuppressed viral load who started EAC sessions between 2016 and 2019 at three governmental hospitals in the northern part of Ethiopia. Viral load count and patient individual factors were assessed at EAC program enrollment and viral load counts repeated at the end of EAC session. The main outcome variable was a change in viral load count during the EAC session period. A paired sample t-test was used to determine the mean difference in viral load count before and after EAC intervention. Linear mixed-effects models were used to assess the effect of selected factors on viral load count change. RESULTS: Based on the paired sample t-test, there was a significant mean difference in viral load count before and after EAC intervention (mean difference=16,904, (95% CI: 9986-23,821; p-value<0.001). The multivariable linear mixed-effects regression analysis showed that young age (ß= 0.03; 95% CI: 0.01, 0.14), urban residence (ß= -0.55; 95% CI: -0.63, -0.34), CD4 count of 201-500 cells/mm3 (ß= -0.67; 95% CI: -0.87, -0.43) and long duration on ART (ß= -0.01; 95% CI: -0.01, -0.02) were associated with the decline in viral load count. CONCLUSION: We detected a substantial decline in viral load count among patients receiving an EAC intervention. Young age, urban residence, CD4 count of 201-500 cells/mm3 and long duration on ART were the positive predictors of viral load suppression.

Barriers and Facilitators for HIV Testing Practice Among Ethiopian Women Aged 15-24 years: Analysis of the 2016 Ethiopian Demographic and Health Survey.

BACKGROUND: In developing countries, youth women are most at risk of HIV infection. Center for Disease Control recommends that people who participate in high-risk behaviors get tested for HIV at least annually. In 2016, the Ethiopian Ministry of Health set goals to identify 90% of the people living with HIV by 2030. But undiagnosed HIV infections are still high in the country. To alleviate the problem, it is vital to identify the factors that hinder HIV testing practice. Therefore, this study aimed to identify the facilitators and barriers of HIV testing practice among Ethiopian youth women. METHODS: The analysis was done on 6401 women aged 15-24 years using data from the 2016 Ethiopia Demographic Health Survey (EDHS). The main outcome variable was self-reported HIV testing practice. Multivariable logistic regression was used to identify the facilitators and barriers of HIV testing practice. RESULTS: In this study, 37.7% [95% CI: (33.6, 39.1)] of youth women were tested for HIV in their life. Being married (AOR=4.7; 95% CI: (3.67, 6.01)), divorced [AOR=6.2; 95% CI: (3.98-9.54)], having primary level of education [AOR=2.4;95% CI: (1.79-3.13)], and secondary level of education [AOR=4.0; 95% CI: (2.87-5.63)], being rich [AOR=2.3;95% CI: (1.39-3.91)] and being in the highest wealth index catagory [AOR=2.6;95% CI: (1.30-5.16)] increase the odds of HIV testing. However, lack of media acccess [AOR = 0.7; 95 CI %: (0.54-0.87)], lack of comprehensive HIV knowledge [AOR = 0.68; 65% CI: (0.53-0.86)] and having discriminatory attitude towards PLHIV[AOR=0.79;95% CI: (0.64-0.97)] decrease the odds of HIV testing. CONCLUSION: The practice of HIV testing among youth populations was low as compared to national recommendations. Lack of media access, lack of comprehensive knowledge about HIV, and having discriminatory attitudes were the barriers to HIV testing practice. Marriage, secondary or higher education attainment, and high wealth index category were the facilitators for HIV testing. Improving HIV-related knowledge, improving media access, and minimizing discriminatory attitudes are strongly recommended to promote HIV testing practice.

Sociodemographic Factors Associated with Bottle Feeding Practices in Infants Under Two Years of Age: A hospital-based study in Woldia, Ethiopia.

Introduction: Bottle feeding should be avoided when possible in infants under the age of two to improve health outcomes. The magnitude of bottle feeding practice is currently increasing in Ethiopia, however factors associated with bottle feeding usage are rarely addressed in research. We aimed to fill this gap and assess the magnitude of bottle feeding and its association with sociodemographic factors among infants in Woldia, Ethiopia in 2019. Methods: A hospital-based cross-sectional study was conducted in Woldia General Hospital at the Immunization Clinic. A total of 255 mothers who had infants were selected by systematic random sampling method. Data was collected through face-to-face interview using a structured standardized questionnaire. The data was entered to EpiData version 3.1 and analyzed using SPSS version 20. Binary logistic regression analysis models were used to assess the association between dependent and independent variables. Variables with p-value < 0.2 in bivariable logistic regression analysis were entered to multivariable logistic regression analysis. Finally, variables with p-value < 0.05 with 95% CI in multivariable logistic regression were taken as independent predictors. COR and AOR were used to show the strength of association between the dependent and independent variables. Results: The rate of bottle feeding practice in this study was 42.7% (95%CI: 35.8, 48.2). Being an infant age 0-5 months old [AOR=0.16; 95%CI: 0.06, 0.4], being a mother age 35-50 years old [AOR=0.43; 95%CI: 0.22, 0.85], having 2-5 children [AOR=6.37; 95%CI: 1.33, 30.44], and being a farmer as reported mother's occupation [AOR=2.72; 95%CI: 1.30, 5.67] showed significant association with bottle feeding practice. Conclusions: The magnitude of bottle feeding practice was significantly higher in the current study as compared to national prevalence. Several sociodemographic factors showed significant association with bottle feeding practice which need to be explored further in the future research.