Predictors of cigarette smoking among adolescents in rural Zambia: results from a cross sectional study from Chongwe [corrected] district.

INTRODUCTION: Cigarette smoking is a leading cause of morbidity and mortality globally. There are limited data on the prevalence of and factors associated with smoking among in-school adolescents in developing countries. OBJECTIVES: To estimate prevalence of those who have smoked cigarettes and to identify associated socio-demographic factors among adolescents in Chongwe district, Chongwe [corrected] Province, Zambia. METHODS: Data used was from the Zambia Global Youth Tobacco Survey, which was conducted using standardized methodology among in-school adolescents in 2002. Data were analyzed to assess if selected socio-demographic variables were associated with having smoked cigarettes. Bivariate and multivariate logistic regression analysis was used to assess the associations. RESULTS: A history of having smoked cigarettes ranged from 20.5% among 15 year olds to 37.2% among males younger than 12 years old. In females, 20.7% of 13 year olds and 37.7% of those less than 12 years old had smoked. Parental smoking, friends smoking, a lack of perception that smoking was harmful, and exposure to pro-tobacco advertisements were associated with having smoked cigarettes. Adolescents who had smoked cigarettes were more likely to allow others smoke in their presence. CONCLUSIONS: Many adolescents in rural Chongwe[corrected], Zambia had tried cigarette smoking. The identification of predictors for smoking should guide the design and implementation of programs aimed to prevent initiation and maintenance of tobacco use among adolescents.

Sex differences in prevalence rates and predictors of cigarette smoking among in-school adolescents in Kilimanjaro, Tanzania.

An analysis of the Global Youth Tobacco Survey for Kilimanjaro, Tanzania was carried out to assess sex differences in the prevalence rates and predictors of current cigarette smoking among in-school adolescents. A total of 2323 adolescents participated in the study of whom 53% were females and 47% males. The prevalence of current cigarette smoking was 3.0% and 1.4% among males and females, respectively. The common factors that were significantly positively associated with cigarette smoking between sexes were: having more pocket money, closest friend smoked cigarettes, seeing actors smoke on TV, videos or movies, and seeing advertisements for cigarettes at social gatherings. Seeing anti-smoking messages at social gatherings were negatively associated with smoking among both sexes. While having had something such as a t-shirt or pen with a cigarette brand logo on it was positively associated with cigarette smoking among males, it was negatively associated with cigarette smoking among females. Male adolescents older than 15 years, those in their 9th year of schooling, and those who had seen cigarette brand names on TV were more likely to smoke. Meanwhile, male respondents who were in their 8th year of schooling, had seen anti-smoking media messages, and advertisements for cigarettes in newspapers or magazines were less likely to smoke. Among female adolescents, those who had parents who smoked, and surprisingly those who perceived that cigarette smoking as harmful were more likely to smoke. Interestingly, seeing advertisement for cigarettes on billboards was negatively associated with smoking among female adolescents. Interventions aimed to reduce adolescent smoking need to be designed and implemented with due consideration of sex differences in these associated factors.

Socio-demographic characteristics and sexual health related attitudes and practices of men having sex with men in central and southern Malawi.

An exploratory study of men having sex with men (MSM) was conducted in central and southern Malawi in order to understand their socio-demographic characteristics, sexual behaviours, and perceptions about confidentiality and stigma. A total of 97 men participated in the study of whom 84 (86.6%) were in the age group 17-32 years. The majority, 73 (75.3%) of MSM had never married, 26 (32.5%) reported not always using condoms during sexual intercourse, and 23 (23.7%) had ever received money or gifts in exchange of sex. Only 17 (17.5%) of the participants reported being exposed to HIV prevention messages targeted at MSM. Fear of sexual orientation disclosure and discrimination were reported by 27 (30.7%) of MSM. Many of the study participants reported that HIV intervention programmes are not accessible to them. In conclusion, HIV intervention programmes may not be reaching out to the majority of MSM. We suggest an exploration of the feasibility of HIV prevention interventions targeting MSM in this country where the practice is illegal.

Equity in access to ARV drugs in Malawi.

This paper discusses the issue of equity in the distribution of ARV drugs in the Malawi health system. Malawi is one of the countries most severely affected by HIV/AIDS in southern Africa. It is also one of the poorest countries in the world. ARV drugs are expensive.The Malawi government, with assistance from the Global Fund on Tuberculosis, Malaria and HIV/AIDS, started providing free ARV drugs to eligible HIV-infected people in September 2004. The provision of free drugs brought the hope that everyone who was eligible would access them. Based on data collected through a qualitative research methodology, it was found that achieving equity in provision would face several challenges including policy, operational and socio-economic considerations. Specifically, the existing policy framework, shortage of medical personnel, access to information and inadequacy of effective community support groups are some of the key issues affecting equity.