Page 127 - SAHCS HIVMed Journal Vol 20 No 1 2019

Page 3 of 9 Original Research

BOX 1: Single-item questions from the questionnaire of the National HIV Communication Survey 2012 used to create cognitive and social behaviour constructs.
Multiple sexual partnership
Perception susceptibility: An individual’s view about HIV risk perception
What do you think your chances are of getting infected with HIV
Condom self-efficacy: A person’s feeling about ability to effectively use condoms
Sometimes, in the morning after having sex without a condom, I think ‘my God, what did I do?’
I can use a condom even when I have too much to drink
I can refuse to have sex if someone I like refuses to use a condom
I can buy a condom without feeling embarrassed
[WOMEN] I am confident that I can correctly put a condom on a man when having sex with him
Personal beliefs: An individual’s views about HIV-related issues
If someone ever has trouble putting on a condom, they will be embarrassed to try to use a condom again
Men who use condoms with their wives are opening the door for her to have sex with other men
Using a condom will make your partner think you do not trust him or her
Now and then, I go to someone else besides my main partner because the sex is so good
It is ok to have sex with others as long as your main partner does not find out
Perceived benefits: An individual’s perception of positive consequences brought by a certain behaviour
When you use a condom, you cannot get enough pleasure
If you have good communication with your partner, you can be sexually satisfied with one person
I need someone else to fill the gap in case I ever break up with my main partner
Now and then, I go to someone else besides my main partner because the sex is so good
Self-esteem: An individual’s confidence in his or her self-worth
If someone has problems putting a condom, they will be ashamed to put it again
Using a condom will make your partner think you do not trust him or her
I feel that I am a person of worth, at least on an equal plane with others
I take a positive attitude towards myself
Social capital and norms: How an individual thinks about HIV and other issues that affect people in their community
People in my community take HIV and AIDS seriously
People in my community are joining together to help people with HIV and AIDS
If you wait to have sex, you will find the right person for yourself
When a relationship ends, you should wait a few months and do not rush into a sexual relationship

as not using either a male or a female condom at last sex. considered statistically significant. All analyses were
Intergenerational sex was defined as having a sexual conducted using STATA 13.0 (Stata Corporation, College
relationship with someone with a 5 year or more age Station, TX, USA).
difference.
Ethical consideration
Statistical analysis All procedures performed in studies involving human
A descriptive cross-sectional analysis was conducted to participants were in accordance with ethical standards of the
describe the demographic and risk factors by age, sex and institutional and/or national research committee and with
province. We used weighted data in our analysis to be the 1964 Helsinki Declaration and its later amendments or
representative of the SA population with respect to age, sex, comparable ethical standards. For this type of study, formal
province, population group and urban or rural residence. consent was not required.
Sample weights were corroborated using the 2007
Community Survey conducted by Statistics South Africa. Results
Chi-squared test was used to test for an association between
the outcomes MSP and nCU and psychosocial and cognitive The socio-demographic characteristics of the sampled
constructs. Univariate logistic regression was used to population are shown in Table 1. Of the total sample of 10 034
determine factors associated with the outcomes MSP and participants, 6061 reported that they had at least one sexual
nCU. Manual forward stepwise procedure was used to encounter in the past 12 months. Of these sexually active
select variables for the multivariable model. Multi- participants, 41% (2467 of 6061) were men. The overall mean age
collinearity tests were performed and only non-collinear was 31.3 years (s.d.: 11). Twenty-three per cent (1378 of 6061) of
variables were analysed. Multivariable logistic regression the participants were aged 20–24 years and 6% (371 of 6061)
was used to determine independent factors associated with were aged 45–49 years. Overall, 39% (2374 of 6061) lived in
outcome after adjusting for potential confounders such urban formal settlements, 37% (2158 of 6061) were from urban
as sex, employment, age, relationship type, geography, informal settlements, 11% (659 of 6061) lived in peri-urban areas
settlement type, HIV status, condom use at last sex, and only 2% (286 of 6061) lived in farming settlements. The
intergenerational sex (difference in ages by 5 years) and majority of participants had some form of education, but 1% (56
alcohol use at last sex, perceived susceptibility, personal of 6061) had no schooling. Participants with a high socio-
benefits, personal beliefs, social norms, self-esteem and economic status were 34.7% (2107 of 6061) and medium socio-
condom self-efficacy. A p-value of less than 0.05 was economic status was almost similar at 38.5% (2335 of 6061).

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