Page 125 - SAHCS HIVMed Journal Vol 20 No 1 2019

Southern African Journal of HIV Medicine
ISSN: (Online) 2078-6751, (Print) 1608-9693
Page 1 of 9 Original Research

Cognitive and behavioural determinants of multiple

sexual partnerships and condom use in South Africa:

Results of a national survey

Authors: Background: Human immunodeficiency virus (HIV) risky behaviours including multiple
Patience G. Manjengwa sexual partnership (MSP) and non-condom use (nCU) are known to be drivers of the spread of
1,2
Kerry Mangold 3
Alfred Musekiwa HIV; cognitive factors including perceived susceptibility of HIV, self-efficacy and attitudes
1
Lazarus R. Kuonza 1,2 play a significant role in influencing risky sexual behaviours.
Affiliations: Objectives: We sought to investigate personal beliefs, perceptions, thoughts and actions that
1 South African Field are associated with MSP and nCU in South Africa.
Epidemiology Training
Programme, National Methods: We analysed nationally representative data from the 2012 National HIV
Institute of Communicable Communication Survey (NCS) that included about 10 000 participants aged 16–55 years. Five
Diseases, Johannesburg, constructs were created to measure psychosocial and cognitive determinants. Cronbach’s
South Africa
alpha coefficient for internal consistency reliability was calculated. Multivariable logistic
2 School of Health Systems regression was used to determine factors associated with MSP and nCU.
and Public Health, University
of Pretoria, Pretoria, Results: Of the 6061 sexually active respondents, 13% (95% CI: 11.47–13.12) reported MSP and
South Africa 52.7% (n = 3158 of 6039) (95% CI: 51.0–53.55) nCU at last sex. Factors associated with MSP
included perceived benefits, adjusted odds ratio (aOR) = 2.16 (95% CI: 1.80–2.58), perceived
3 South African National susceptibility to HIV, aOR = 2.22 (95% CI: 1.83–2.69) and engaging in intergenerational sex,
AIDS Council Trust, Pretoria, aOR = 2.14 (95% CI: 1.78–2.56). Predictors of nCU were perceived benefits, aOR = 1.25 (95% CI:
South Africa
1.09–1.43); perceived susceptibility to HIV, aOR = 1.6 (95% CI: 1.39–1.83); and personal beliefs,
Corresponding author: aOR = 1.35 (95% CI: 1.13–1.62).
Patience Manjengwa,
manjengwa.patience Conclusion: Cognitive and behavioural factors were found to be predictors of risky sexual
@gmail.com behaviours for HIV. This highlights the importance of considering personal perception and
reasoning when attempting to understand and influence an individual’s sexual behaviour.
Dates:
Received: 07 May 2018 This could be done through enhancing awareness of HIV risk in the general population and by
Accepted: 14 Feb. 2019 influencing cognitive behaviour change through community mobilisation, advocacy and
Published: 10 June 2019 creating activities to improve self-esteem.
How to cite this article: Keywords: HIV; Multiple sexual partnerships; Non-condom use; Cognitive factor;
Manjengwa PG, Mangold K, Intergenerational sex; Perceived benefits; Perceived susceptibility; Personal beliefs.
Musekiwa A, Kuonza LR.
Cognitive and behavioural
determinants of multiple
sexual partnerships and Introduction
condom use in South Africa: Globally, human immunodeficiency virus (HIV) poses a major public health concern, causing
Results of a national survey.
1
S Afr J HIV Med. 2019;20(1), high rates of mortality and morbidity. In 2013, there were 35.3 million people living with HIV,
a868. https://doi.org/10.4102/ with approximately 2.3 m new HIV infections and more than 1.6 m HIV-related deaths. In sub-
2
sajhivmed.v20i1.868 Saharan Africa, it was estimated that there were 23.5 m people living with HIV in March 2015. In
2
2012, HIV prevalence in South Africa (SA) among all age groups was 12.2%, an increase from
Copyright:
2
© 2019. The Authors. 10.6% reported in 2008. With an HIV incidence rate of 4.5%, the increased prevalence of HIV in
Licensee: AOSIS. This work 2012 could be attributed to the combined effects of new infections and a successfully expanded
is licensed under the antiretroviral treatment (ART) programme. 2
Creative Commons
Attribution License.
Numerous societal, cultural and personal intrinsic factors have been identified as important social
and structural drivers of the HIV epidemic in SA, including high population mobility and
inequalities in wealth and gender. Other contributing drivers of HIV include attitudes and
3
Read online: behaviours of men, intergenerational sex, gender and sexual violence, stigma and untreated viral
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infections. One of the goals of the South African National Strategic Plan on HIV, STIs and
2,6
http://www.sajhivmed.org.za 118 Open Access