Heterosexual transmission of HIV in the Dominican Republic: gendered indicators are associated with disparities in condom useReportar como inadecuado




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BMC Public Health

, 15:1161

First Online: 23 November 2015Received: 08 September 2014Accepted: 20 October 2015DOI: 10.1186-s12889-015-2432-8

Cite this article as: Jimenez, M.M., Andrade, F.C.D., Raffaelli, M. et al. BMC Public Health 2015 15: 1161. doi:10.1186-s12889-015-2432-8

Abstract

BackgroundGendered dynamics in heterosexual relationships compromise women’s self-efficacy and increase their vulnerability to acquiring HIV. This study examines the impact of socioeconomic determinants, media exposure, and sexual expectations on sexual behaviors of men and women in the Dominican Republic DR.

MethodsWe analyzed cross-sectional data from 51,018 adults in the Dominican Republic age 15 to 45 years collected by the Demographics and Health Survey DHS in 2007. Measures included demographic and socioeconomic indicators, social exposures, sexual expectations and sexual behaviors. Logistic regression models explored gender differences in condom use.

ResultsStudy findings indicated that women were less likely to use a condom at last intercourse than men odds ratio OR = 0.29; 95 % CI = 0.27, 0.31. Among men, secondary OR = 1.43; 95 % CI = 1.16, 1.76 and higher education OR = 1.58; 95 % CI = 1.25, 2.00, being in the richest quintile OR = 1.25; 95 % CI = 1.07, 1.47, and living in a female-headed household OR = 1.13; 95 % CI 1.03, 1.23 increased the likelihood of condom use. Compared to never married men, currently and formerly married men were less likely to use condoms OR = 0.03; 95 % CI = 0.03, 0.04 and OR = 0.67; 95 % CI = 0.60, 0.75, respectively. The odds of condom use increased for young women 15–19 years old in comparison with women age 30–34 years, but decreased as they grew older. For women, being in the richer quintile OR = 1.28; 95 % CI = 1.06, 1.54, living in a female-headed household OR = 1.26; 1.12, 1.41, and having good access to media OR = 1.24; 95 % CI = 1.12, 1.42 increased the likelihood of condom use. Being currently married or formerly married and living in rural areas decreased such likelihood among women.

ConclusionsStudy findings provide evidence that, in the DHS, socioeconomic and cultural differences between men and women affects condom use. Efforts to reduce HIV transmission within heterosexual relationships in the DR call for tailored, gender-specific interventions that take into account gender differences of power and sexual behaviors.

KeywordsHIV risk Gender differences Condom use Heterosexual HIV transmission Electronic supplementary materialThe online version of this article doi:10.1186-s12889-015-2432-8 contains supplementary material, which is available to authorized users.

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Autor: Michelle M. Jimenez - Flavia C. D. Andrade - Marcela Raffaelli - Juliet Iwelunmor

Fuente: https://link.springer.com/







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