Partner faithfulness and sexual reproductive health practices in Botswana: does perception of partner infidelity influence sexual risk behaviours of people aged 10-34 years?

The main aim of this study was to test whether perception of partner infidelity prompts people to adopt behaviour that is meant to compensate for the increased risk of infection posed by their partner's infidelity; or whether it prompts people to engage in behaviour that magnifies the risk associated with partner infidelity. Data used were derived from the fourth and latest Botswana AIDS Impact Survey (BAIS IV) conducted in 2013. The sample consisted of 6985 people aged 10-34 years. Logistic regression analysis was used to identify factors associated with perception of partner infidelity and sexual risk behaviours. Perception of partner infidelity with the current and most recent partner was 39.6% while perception of partner infidelity with other previous sexual partners was 79.9%. The main socio-demographic factors associated with perception of partner infidelity were being a man, being single and having secondary education, while sexual risk behaviours associated with perception of partner infidelity were having multiple sexual partners and being involved in multiple concurrent sexual partnerships. These relationships were statistically significant at the 5% level. Botswana's HIV prevention strategies should seek to improve partner communication within relationships in order to enhance people's confidence and skills so as to minimize perceptions of infidelity.

Socioeconomic inequalities in non-communicable disease risk factors in Botswana: a cross-sectional study.

BACKGROUND: The debate on socioeconomic inequalities in health dominates the research and policy agenda of many countries. The prevalence of non-communicable diseases (NCDs) is on the rise in recent years in Botswana. As a prevention and policy effort, the study provided an empirical evidence on socioeconomic inequalities in NCD risk factors in Botswana. METHODS: Data used in this study was derived from a cross sectional survey on chronic non communicable diseases in Botswana conducted in 2016. The survey adopted a multistage sampling design and a sample of 1178 participants (males and females) aged 15 years and above was selected in both urban and rural areas of Botswana. The inequality analysis was conducted employing decomposition analysis using ADePT software version 6. Logistic regression models were used to show the association between NCD risk factors and socioeconomic status using SPSS version 25. RESULTS: Concentration indices showed that poor physical activity (CI = 0.0546), alcohol consumption (CI = 0.1859) and overweight/obesity (CI = 0.038) were more concentrated among the non-poor while daily smoking (CI = - 0.0308) and poor fruit/vegetable consumption (CI = - 0.1909) were more concentrated among the poor. Wealth status was observed to be the leading contributor to socioeconomic inequality for daily smoking, poor fruit/vegetable consumption, overweight/obesity and poor physical activity. Education was the leading contributor to socioeconomic inequality for alcohol consumption. CONCLUSIONS: Findings in this study indicate the need for concerted differential efforts to address the needs of the poor and non-poor in order to reduce NCD risk factor inequalities.

Patterns and determinants of modern contraceptive use and intention to usecontraceptives among Malawian women of reproductive ages (15-49 years).

BACKGROUND: Malawi is one of the countries in SSA with the highest TFR. This study aimed to explore factors associated with modern contraceptive use and intention to use contraceptives among women of reproductive ages (15-49 years) in Malawi. METHODS: The study used secondary data from 2015 to 16 Malawi Demographic and Health Survey (MDHS) dataset. Logistic regression models were used to derive adjusted odd ratios as the measures of association between need, predisposing and enabling factors, and contraceptive use and the intention to use contraceptives among women. The sample constituted 24,562 women who were successfully interviewed during the MDHS. All comparisons are considered statistically significant at 5% level. RESULTS: Overall 54.8% of women were currently using contraceptives, while 69.1% had the intention to use contraceptives. The odds of contraceptive use were significantly low among, women aged 15-19 years, 20-24 years, 25-29 years, 30-34 years, 35-39 years and 40-44 years compared to women aged 45-49 years; women of Tonga ethnic group (OR = O.60, CI = 0.43 0.84) compared to women of Nyanga ethnic group; women from poor households (OR = 0.78, CI = 0.68-0.90) and middle income households (OR = 0.84, CI = 0.74-0.95) compared to women from rich household. Nonetheless, women with no past experience of terminated pregnancy (OR = 1.50, CI = 1.34-1.68) were more likely to use contraceptives compared to women with past experience of terminated pregnancy. Similarly, Women with primary education (OR = 1.56, CI = 1.16-2.09) and secondary education (OR = 1.39, CI = 1.04-1.85) were more likely to use contraceptives compared to women with higher education. While the odds of intending to use contraceptives were significantly high with age only thus among women aged 15-19 years, (OR = 15.18, CI = 5.94-38.77); 20-24 years (OR = 16.77, CI = 7.46-37.71); 25-29 years (OR = 6.75, CI = 3.16-14.45); 30-34 years (OR = 7.75, CI = 3.61-16.65) and 35-39 years (OR = 5.05, CI = 2.29-11.12) compared to women aged 45-49 years. CONCLUSION: As direct policy measure; information, education and communication programmes on family planning among poor and middle income women, and all women in reproductive ages should be strengthened.

Socioeconomic and behavioural determinants of overweight/obesity among adults in Botswana: a cross-sectional study.

OBJECTIVE: To undertake a comprehensive assessment of socioeconomic and behavioural determinants of overweight/obesity among adult population in Botswana. DESIGN: The study adopted a cross-sectional design by selecting adult respondents in 3 cities and towns, 15 urban villages and 15 rural areas across Botswana using a multistage probability sampling technique. SETTING: The study was conducted in selected rural and urban areas of Botswana. PARTICIPANTS: The study sample consisted of 1178 adult males and females aged 15 years and above. PRIMARY OUTCOME MEASURES: Objectively measured overweight/obesity. RESULTS: Prevalence of overweight/obesity in the study population was estimated at 41%. The adjusted OR (AOR) of overweight/obesity were highest among women (AOR=2.74, 95% CI 1.92 to 3.90), in ages 55-64 years (AOR=5.53, 95% CI 2.62 to 11.6), among individuals with secondary (AOR=1.70, 95% CI 1.11 to 2.61) and tertiary education (AOR=1.99, 95% CI 1.16 to 3.38), smokers (AOR=2.16, 95% CI 1.22 to 3.83) and people with poor physically activity (AOR=1.46, 95% CI 1.03 to 3.24). These were statistically significant at 5% level. CONCLUSION: Women, older adults, people with high education level, smokers and people who reported poor physical activity were found to have higher odds of being overweight/obesity. These findings suggest the need for broad based strategies encouraging physical activity among different socioeconomic groups.

HIV counselling and testing of pregnant women attending antenatal clinics in Botswana, 2001.

This study examined the extent to which women accessing antenatal-care services in Botswana were offered HIV-related information and counselling and an opportunity to take an HIV test as part of the Prevention of Mother-to-Child Transmission of infection, and how these women responded. Data for this study were drawn from the Botswana AIDS Impact Survey 2001, a nationally-representative sample survey. The survey successfully interviewed over 4,494 of 4,728 eligible women on various issues relating to HIV/AIDS at both household and individual levels. Frequencies, cross tabulations, and logistic regression were used for data analysis. Over half (57.9%) of the women were offered HIV/AIDS-related information, counselling, or testing. Age, education, and residence were important predictors of being offered HIV counselling or testing. Younger and more-educated women and those residing in towns were more likely to be offered both HIV counselling and testing than older, less-educated, and rural women. Seventy-nine percent of the women who were offered HIV testing agreed to undergo the test regardless of their background characteristics. The number of pregnant women who underwent HIV testing during antenatal care accounted for only a fifth (21%) of all antenatal-care attendees in 2001. Lack of capacity to deliver voluntary counselling and testing services to all pregnant women attending antenatal care is one of the biggest challenges to increased use of voluntary counselling and testing services.

Factors associated with non-use of maternal health services in Botswana.

The study investigated individual and household factors associated with non-use of maternal health services in Botswana. Nationally-representative data, drawn from the 1996 Botswana Family Health Survey, were used. A weighted sample of 19,031 women, aged 15-49 years, who had at least one pregnancy history in the five years prior to the survey was considered for analysis. Both simple cross-tabulations and logistic regression were used for analyzing the data. Consistently, the teenagers were less likely to seek prenatal care, to have their babies delivered by a qualified person, and to seek postnatal check-up. Using results from logistic regression analysis, it can be observed that low-parity women were less likely to use maternal services. Another consistent finding is that women with low educational level, those residing in rural areas, and those with low socioeconomic status were less likely to use maternal services. More focussed investigation is needed, but understanding the differentials of the use of maternal services allows policy-makers to identify problem areas that need attention.

Male Circumcision; willingness to undergo safe male circumcision and HIV risk among men in Botswana

This paper uses data from the 2008 Botswana AIDS Impact Survey to explore the association between male circumcision or willingness to undergo safe male circumcision; and men's sexual and HIV risk behaviours in Botswana. Bivariate and multivariate regression analysis techniques are used. The results show that being circumcised; or expressing willingness to be circumcised; was associated with significant increase in the likelihood of having two or more current sexual partners; and having had sex with multiple partners during the year leading to the survey; even after controlling for confounding variables. There is a need for further research to examine the association between male circumcision and men's sexual practices in Botswana. Such context specific research will provide the necessary evidence base for HIV prevention and impact mitigation programs; interventions and strategies and to provide rigorous estimates of the extent men's sexual risk compensation and 'sexual disinhibition' associated with the reduced risk of HIV infection accorded by safe male circumcision. Current efforts to promote male circumcision as an integral part of the country's HIV prevention and control strategy need to be accompanied by continuous education to address myths and misconceptions relating to safe male circumcision

HIV counselling and testing of pregnant women attending antenatal clinics in Botswana, 2001.

This study examined the extent to which women accessing antenatal-care services in Botswana were offered HIV-related information and counselling and an opportunity to take an HIV test as part of the Prevention of Mother-to-Child Transmission of infection, and how these women responded. Data for this study were drawn from the Botswana AIDS Impact Survey 2001, a nationally-representative sample survey. The survey successfully interviewed over 4,494 of 4,728 eligible women on various issues relating to HIV/AIDS at both household and individual levels. Frequencies, cross tabulations, and logistic regression were used for data analysis. Over half (57.9%) of the women were offered HIV/AIDS-related information, counselling, or testing. Age, education, and residence were important predictors of being offered HIV counselling or testing. Younger and more-educated women and those residing in towns were more likely to be offered both HIV counselling and testing than older, less-educated, and rural women. Seventy-nine percent of the women who were offered HIV testing agreed to undergo the test regardless of their background characteristics. The number of pregnant women who underwent HIV testing during antenatal care accounted for only a fifth (21%) of all antenatal-care attendees in 2001. Lack of capacity to deliver voluntary counselling and testing services to all pregnant women attending antenatal care is one of the biggest challenges to increased use of voluntary counselling and testing services.

Factors associated with non-use of maternal health services in Botswana.

The study investigated individual and household factors associated with non-use of maternal health services in Botswana. Nationally-representative data, drawn from the 1996 Botswana Family Health Survey, were used. A weighted sample of 19,031 women, aged 15-49 years, who had at least one pregnancy history in the five years prior to the survey was considered for analysis. Both simple cross-tabulations and logistic regression were used for analyzing the data. Consistently, the teenagers were less likely to seek prenatal care, to have their babies delivered by a qualified person, and to seek postnatal check-up. Using results from logistic regression analysis, it can be observed that low-parity women were less likely to use maternal services. Another consistent finding is that women with low educational level, those residing in rural areas, and those with low socioeconomic status were less likely to use maternal services. More focussed investigation is needed, but understanding the differentials of the use of maternal services allows policy-makers to identify problem areas that need attention.