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      Determinants of demand for condoms to prevent HIV infections among barmaids and guesthouse workers in two districts, Tanzania

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          Abstract

          Background

          Condoms are scientifically recommended as potential products for preventing infections attributable to human immuno-deficiency viruses (HIV). However, evidence on factors leading to their inadequate use in developing countries is still scanty. This paper reports an exploratory study of factors constraining condoms use in Tanzania from the perspectives of barmaids, guest-house workers and retailers.

          Methods

          Data were collected in two districts—Mpwapwa in Dodoma Region and Mbeya Rural in Mbeya Region—between October and December 2011, using structured interviews with 238 individuals including barmaids, guesthouse workers and 145 retailers. Data analysis was performed using STATA 11 software.

          Results

          Awareness about condoms was high among all study groups. Male condoms were more popular and available than female ones. A considerable proportion of the barmaids and guesthouses were disappointed with condoms being promoted and distributed to young children and disliked condom use during sexual intercourse. Accessibility of condoms was reported as being lowered by condom prices, shortage of information concerning their availability; short supply of condoms; some people shying away to be watched by children or adult people while purchasing condoms; retailers’ using bad languages to condom customers; occasionally condom shops/kiosks found closed when they are urgently needed; and prevailing social perception of condoms to have low/no protective efficacy. Regression analysis of data from barmaids and guesthouse-workers indicated variations in the degree of condom acceptability and methods used to promote condoms among respondents with different demographic characteristics.

          Conclusion

          A combination of psychosocial and economic factors was found contributing to lower the demand for and actual use of condoms in study communities. Concerted measures for promoting condom use need to address the demand challenges and making operational research an integral element of monitoring and evaluation of the launched interventions, hence widening the evidence for informed policy decisions.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s13104-015-1621-y) contains supplementary material, which is available to authorized users.

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          Most cited references34

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          Methodological challenges in research on sexual risk behavior: II. Accuracy of self-reports.

          Assessing sexual behavior with self-report is essential to research on a variety of health topics, including pregnancy and infertility, sexually transmitted infections, and sexual health and functioning. Recent methodological research has provided new insights regarding the accuracy of self-reports of sexual behavior. We review these studies, paying particular attention to a promising new development: the use of computer-assisted assessments. The collection of sexual risk behavior data with computers has increased dramatically in recent years, but little is known about the accuracy of such assessments. We summarize the evidence, discuss methodological issues that arise in studies evaluating the accuracy of self-reports, and offer recommendations for future research.
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            Socioeconomic inequalities in HIV/AIDS prevalence in sub-Saharan African countries: evidence from the Demographic Health Surveys

            Introduction Extant studies universally document a positive gradient between socioeconomic status (SES) and health. A notable exception is the apparent concentration of HIV/AIDS among wealthier individuals. This paper uses data from the Demographic Health Surveys and AIDS Indicator Surveys to examine socioeconomic inequalities in HIV/AIDS prevalence in 24 sub-Saharan African (SSA) countries, the region that accounts for two-thirds of the global HIV/AIDS burden. Methods The relative and generalized concentration indices (RC and GC) were used to quantify wealth-based socioeconomic inequalities in HIV/AIDS prevalence for the total adult population (aged 15-49), for men and women, and in urban and rural areas in each country. Further, we decomposed the RC and GC indices to identify the determinants of socioeconomic inequalities in HIV/AIDS prevalence in each country. Results Our findings demonstrated that HIV/AIDS was concentrated among higher SES individuals in the majority of SSA countries. Swaziland and Senegal were the only countries in the region where HIV/AIDS was concentrated among individuals living in poorer households. Stratified analyses by gender showed HIV/AIDS was generally concentrated among wealthier men and women. In some countries, including Kenya, Lesotho Uganda, and Zambia, HIV/AIDS was concentrated among the poor in urban areas but among wealthier adults in rural areas. Decomposition analyses indicated that, besides wealth itself (median = 49%, interquartile range [IQR] = 90%), urban residence (median = 54%, IQR = 81%) was the most important factor contributing to the concentration of HIV/AIDS among wealthier participants in SSA countries. Conclusions Further work is needed to understand the mechanisms explaining the concentration of HIV/AIDS among wealthier individuals and urban residents in SSA. Higher prevalence of HIV/AIDS could be indicative of better care and survival among wealthier individuals and urban adults, or reflect greater risk behaviour and incidence. Moreover, differential findings across countries suggest that effective intervention efforts for reducing the burden of HIV/AIDS in the SSA should be country specific.
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              Effects of condom social marketing on condom use in developing countries: a systematic review and meta-analysis, 1990-2010

              OBJECTIVE: To examine the relationship between condom social marketing programmes and condom use. METHODS: Standard systematic review and meta-analysis methods were followed. The review included studies of interventions in which condoms were sold, in which a local brand name(s) was developed for condoms, and in which condoms were marketed through a promotional campaign to increase sales. A definition of intervention was developed and standard inclusion criteria were followed in selecting studies. Data were extracted from each eligible study, and a meta-analysis of the results was carried out. FINDINGS: Six studies with a combined sample size of 23 048 met the inclusion criteria. One was conducted in India and five in sub-Saharan Africa. All studies were cross-sectional or serial cross-sectional. Three studies had a comparison group, although all lacked equivalence in sociodemographic characteristics across study arms. All studies randomly selected participants for assessments, although none randomly assigned participants to intervention arms. The random-effects pooled odds ratio for condom use was 2.01 (95% confidence interval, CI: 1.42-2.84) for the most recent sexual encounter and 2.10 (95% CI: 1.51-2.91) for a composite of all condom use outcomes. Tests for heterogeneity yielded significant results for both meta-analyses. CONCLUSION: The evidence base for the effect of condom social marketing on condom use is small because few rigorous studies have been conducted. Meta-analyses showed a positive and statistically significant effect on increasing condom use, and all individual studies showed positive trends. The cumulative effect of condom social marketing over multiple years could be substantial. We strongly encourage more evaluations of these programmes with study designs of high rigour.
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                Author and article information

                Contributors
                gmubyazi@nimr.or.tz , gmmubyazi@gmail.com
                amonexavery@yahoo.com
                filemonitenu@hotmail.com
                jmassaga@nimr.or.tz
                jovita.rugemalila@nbs.go.tz
                hmalebo@nimr.or.tz
                vwiketye@nimr.or.tz
                emakundi@nimr.or.tz
                jikingura@nimr.or.tz
                adiel.mushi@gmail.com
                smalekia@nimr.or.tz
                amziray@nimr.or.tz
                jwilfredy@yahoo.co.uk
                akahwa@hotmail.com
                mkafuye@nimr.or.tz
                mmalecela@nimr.or.tz
                Journal
                BMC Res Notes
                BMC Res Notes
                BMC Research Notes
                BioMed Central (London )
                1756-0500
                2 November 2015
                2 November 2015
                2015
                : 8
                : 630
                Affiliations
                [ ]National Institute for Medical Research (NIMR), P.O Box 9653, Dar es Salaam, Tanzania
                [ ]Ifakara Health Institute (IHI), P.O Box 78373, Dar es Salaam, Tanzania
                [ ]Amani Medical Research Centre (MRC), P.O Box 81, Muheza, Tanzania
                [ ]National Bureau of Statistics (NBS), P.O Box 796, Dar es Salaam, Tanzania
                [ ]NIMR Ngongongare Research Station, Usa River, P.O Box 514, Arusha, Tanzania
                [ ]Muhimbili Medical Research Centre, P.O Box 5004, Dar es Salaam, Tanzania
                Article
                1621
                10.1186/s13104-015-1621-y
                4630838
                26526184
                2ad4f1f3-2dcf-4d5f-ba80-714a69162026
                © Mubyazi et al. 2015

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 23 September 2013
                : 26 October 2015
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2015

                Medicine
                hiv/aids,condoms,poverty,social-marketing,stigma,risk behaviour,tanzania
                Medicine
                hiv/aids, condoms, poverty, social-marketing, stigma, risk behaviour, tanzania

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