MMed, Epidemiology and Biostatistics,University of the Witwatersrand, 2009 / Background: South Africa is one of the countries with the highest Human Immunodeficiency Virus (HIV) prevalence in the world. The main mode of transmission in South Africa is via heterosexual intercourse. Thus there is the need to identify factors associated with HIV high risk sexual behaviour to inform future intervention programmes. Objective: To determine the association between alcohol consumption and high risk sexual behaviour in South African adults in 2006. Methods: Secondary data analysis of cross sectional study involving 1544 adult males and females, between 16-65 years interviewed in the Soul City National Survey. A multi-stage, stratified and clustered probability sampling technique was used. Univariate and multivariate analysis was done using student t test, chi square test and logistic regression models. Results: The prevalence of alcohol consumption in the week prior to the survey was 24.4% (95%CI: 22.2-26.6). The prevalence of heavy episodic drinking in last one month was 17.5% (95%CI: 15.5-19.4). There was an association between broad socioeconomic conditions and sexual behaviour particularly age, sex and race (P<0.05). The mean age at sexual debut was 17.13 (SD 2.61) years in the males and 17.91 (2.45 SD) years in females (P<0.001). Of the sexually active respondents, 12.7% and 4.2% of the men and women respectively had multiple partners currently (P<0.001). Generally consistent condom use was more in men although, only 10.3% of the men and 5.6% of the women used the condoms consistently with their casual partners (P=0.28). Multivariate regression showed that alcohol use predicted having multiple partners (AOR 2.37; 95%CI 1.19-4.69 and AOR 4.15; 95%CI 1.37-11.97) for moderate and problem drinkers respectively. Also, heavy episodic drinking predicted having multiple partners by three times (AOR 3.21; 95%CI 1.69-6.39). There was a significant dose response relationship for having multiple partners (P<0.05). As regards unprotected sexual intercourse, although not significant, female drinkers were found to be protected from inconsistent condom use with a casual partner. Male drinkers on the other hand, were found to be at a higher risk of having unprotected sex with casual partners. Perceptions of susceptibility to HIV (AOR 0.31; 95%CI 0.17-0.56), and alcohol related harm (AOR 0.17; 95%CI; 0.22-0.71) influenced consistent condom use with casual partners. Also regards gender differences, women who drank alcohol (AOR 9.68; 95%CI 1.31-17.45 vs. 1.17; 0.28-4.89) or were heavy episodic drinkers (AOR 4.45; 95%CI 1.46-3.55 vs. 2.43; 1.03-5.92) had a higher probability of having multiple partners than men. Conclusion: There is a strong association between risky alcohol use and high risk sexual behaviours. HIV prevention programmes need to address reduction in alcohol intake and changes in drinking pattern. Further research to disentangle the relationship between condom use and alcohol use is needed.

ABSTRACT Although sub-Saharan Africa continues to bear the brunt of the global HIV/AIDS pandemic and other sexually transmitted diseases (UNAIDS and WHO 2008; Fatusi and Wang 2009), very few studies in the region and for that matter Ghana have systematically and exclusively examined adolescent risky sexual behaviour in a manner that is theoretically consistent with the unique socio-cultural norms that govern sexuality in the society. Given that involvement in risky sexual behaviour constitutes sexual deviance in the Ghanaian context, and from the ontological position that behaviour is a product of structure and human agency (Sewell 1992), this study extends the theories of social control (Hirschi 1969), power control (Hagan et al. 1979, 1985,1987, 2002; McCarthy et al. 1999) and rational choice (Cornish and Clarke 1986) in examining the predictors of risky sexual behavior among Ghanaian adolescents. Using the 2004 Ghana National Adolescent Survey data (N=3985), the study employs descriptive statistics, measures of association and complementary log-log regression models in predicting the likelihood of being sexually active before marriage, having more than one lifetime sexual partner and condom use. Overall findings provide mixed support for the theoretical expectations. From the perspective of Hirschi’s control theory, the findings suggest among others that while some measures of conventional behaviour do not discourage premarital sex, they do so with respect to multiple sexual partnerships. A puzzle that needs further elaboration is the finding that highly educated adolescents who hold leadership positions have a higher significant taste for premarital sex and multiple sexual relations than their uneducated counterparts who are not leaders. Overall findings regarding the predictions of power control theory are consistent with the revised version offered by McCarthy and Colleagues (1999) and Hagan and colleagues (2002); that daughters in less patriarchal or matriarchal households are more likely than sons to have premarital sex and be in multiple sexual partnerships. Findings regarding the predictions of rational theory suggest a mixed rationality; condom use among adolescents in many instances is inconsistent with rational choice behaviour. General and specific policy implications of the findings and direction for future research are also discussed. / Thesis (Master, Sociology) -- Queen's University, 2010-07-31 02:18:09.013

Magister Artium (Psychology) - MA(Psych) / The effects of risky sexual behaviour (RSB) amongst adolescents are devastating in South Africa. Recent studies show that parent-child (PC) communication about RSB is associated with positive outcomes such as delayed sexual debut and increased autonomy among adolescents. There are however challenges on how to define caregivers within the South African context due the historical background of South Africa such as Apartheid and labour migration. For the purposes of this study, caregivers would be regarded as individuals who the have sole responsibility of caring for a child. The aim of this study was to explore caregiver-child communication in relation to RSB to gain an in-depth and contextualized understanding of how South African families interact, feel and experience their communication and the challenges they face, it therefore uses a qualitative approach. These aims translate into the following objectives a) exploring the process of communication i.e. how they communicate in terms of style, content, timing and frequency b) exploring the experiences of communication of RSB for both caregivers and children in terms of their thoughts and feelings as well as the challenges faced. Conducting focus group discussions and individual interviews was the method of data collection. Four focus groups (two focus groups with male adolescents and two focus groups with female adolescents) were conducted as well as three individual interviews with caregivers a total of 23 participants were used. Both groups of participants are of mixed racial backgrounds and from the Northern sub district of Cape Town. The data was analyzed by using thematic analysis. All ethical principles were adhered to. This study found mothers to be an influential source of sexual communication with their children and this communication hinged more on the health risks of early sexual debut and negative social outcomes. Caregivers highlight the barriers to communication with their adolescents which create caregiver anxiety and avoidance of sexual communication. School has also been identified as highly influential to both caregivers and adolescents especially with regards to the biological and physiological aspects of sex education. Two types ‘educational systems’ have been identified within the South African context. The impact of these systems on the quality of education and nature of the resources provided to both caregivers and learners are discussed in relation to sexual education and communication. The community and extended family of the participants are very involved in the socialisation of the adolescents in this study and often assist caregivers. Caregiver monitoring is the most utilized strategy used to ensure that adolescent whereabouts and activities are known at all times. Possible interventions such as additional strategies for caregivers to consider and communication workshops for caregivers and educators are discussed. The limitations of this study such as the limited amount of caregivers interviewed and the lack of male caregiver insight were identified and recommendations for future studies are provided.

Philosophiae Doctor - PhD / Adolescent sexual development forms a crucial role in the process of identity formation and the establishment of healthy romantic and social relationships. However, some adults are uncomfortable with the notion of adolescent sexuality, and would choose to remain in a state of denial or ignorance. It is pivotal that adults address the topic of adolescent sexuality. Numerous adolescents are not adequately guided by parents, educators, and church leaders. Hence, their lack of basic sexual knowledge or simply having erroneous ideas appertaining to sexuality may cause them to make very unwise sexual decisions. A number of adolescents routinely engage in behaviours that unknowingly put their health at risk. Amongst South African adolescents, sexual risk-taking behaviours including early coitarche, unprotected sex, multiple sex-partners and low contraceptive use are quite common.

<p>Since the early 1980&rsquo / s when the first case of HIV was diagnosed, AIDS remains a serious and threatening health crisis in the world. Sub-Saharan Africa is the region most affected by the HIV/AIDS pandemic having 67 % of the 33 million people infected with HIV globally in 2007. Young people aged 15-24&nbsp / account for an estimated 45% of all new HIV infections worldwide. The study aimed to assess the knowledge and attitudes on HIV/AIDS and sexual&nbsp / behavior among 15-19 year olds in Kenya. A descriptive, cross-sectional survey was conducted among 96 students randomly selected from five public&nbsp / schools in Ngong sub-district. Descriptive and bivariate analysis was conducted using Epi Info 3.3 and SPSS. The main findings indicate that a third&nbsp / (31/96) of respondents were sexually experienced. Knowledge level was however found to be inadequate (below 60 %) indicating a poorly informed sample on knowledge about HIV transmission and prevention. The study showed poor attitudes towards the risk to HIV as only 40 % of both males and females supported the use of condoms even when the sexual partners know each other well. Inaddition, risky sexual behaviors were reported by sexually&nbsp / &nbsp / experienced respondents where condom use in last sexual intercourse was (57 %) among males and (20 %) among females.</p>

<p>Aim: The purpose of the study was to assess the knowledge of the transmission and prevention of HIV/AIDS among secondary school students in Bekwarra, Cross River State, Nigeria / to appraise the students&rsquo / attitudes towards HIV/AIDS / to describe the risky sexual and other behaviours they engaged in and what factors influenced such behaviours. This study was conducted in the area to systematically examine the widely held notion that adolescents were deviating from the strict sexual mores of the Bekwarra people, thereby exposing themselves to the risk of acquiring HIV. Methods: Information was collected using a cross-sectional survey based on a 64 item questionnaire adapted from the Family Health International HIV/AIDS/STD Behavioural . Surveillance Surveys. A random sample of 381 male and female students aged 14 to 18 selected from 12 secondary schools participated in the survey. Results: The level of general awareness of HIV/AIDS was high - 56.9% of participants knew how HIV is transmitted - but their knowledge of STI symptoms was low. Only 24.7% knew at least two STI symptoms in women, while only 20.7% knew at least two STI symptoms in men. One hundred and twenty three (32.2%) students constituting 68 males (17.8%) and 55 females (14.4%) had experienced sexual intercourse. The mean age at first sexual experience was 15.06 years for males and 14.95 years for female students. There was a statistical association between age and experience of sexual intercourse (p = .024). Two thirds (65.0%) of the 123 sexually experienced students had intercourse in the last six months, and only 30 of them (24.4%) had used a condom during their last intercourse. The use of condom was most frequent (10.6%) at age 18 and least frequent (.8%) at age 14. About one quarter (26.1%) of the students had taken&nbsp / alcohol: 17.3% occasionally, 5.5% moderately, and 2.6% frequently. There was a statistical association between taking alcohol and age (p = .038). Over a half (56.1%) of those who had not had sexual intercourse also had not taken alcohol. In contrast, 14.2% had sexual intercourse and also took alcohol, indicating significant statistical association (p &lt / .001). 66.8% of the students had neither used drugs nor taken alcohol, whilst 6.8% had both used drugs and taken alcohol, indicating significant association, (p &lt / .001). There was a similar association between sexual intercourse and using drugs, (p = .002). Conclusions: The study revealed significant high risk sexual behaviour among adolescents in Bekwarra. The high level of risky sexual behaviour and lack of basic knowledge about STIs indicated that access to information is currently insufficient. Health and educational authorities in Bekwarra should utilize the key findings highlighted from this study to design more effective local strategies for sexual health promotion that may help to slow the spread of STIs including HIV/AIDS. Intensive child-friendly programmes for pre-teenagers organized by educators to promote postponement of the early initiation of sexual intercourse may be effective. For adolescents who are unable to control their sexual initiation, improved education on safe sexual practices, especially the use of condoms appears to be necessary.</p>

No description available.

<p>Aim: The purpose of the study was to assess the knowledge of the transmission and prevention of HIV/AIDS among secondary school students in Bekwarra, Cross River State, Nigeria / to appraise the students&rsquo / attitudes towards HIV/AIDS / to describe the risky sexual and other behaviours they engaged in and what factors influenced such behaviours. This study was conducted in the area to systematically examine the widely held notion that adolescents were deviating from the strict sexual mores of the Bekwarra people, thereby exposing themselves to the risk of acquiring HIV. Methods: Information was collected using a cross-sectional survey based on a 64 item questionnaire adapted from the Family Health International HIV/AIDS/STD Behavioural . Surveillance Surveys. A random sample of 381 male and female students aged 14 to 18 selected from 12 secondary schools participated in the survey. Results: The level of general awareness of HIV/AIDS was high - 56.9% of participants knew how HIV is transmitted - but their knowledge of STI symptoms was low. Only 24.7% knew at least two STI symptoms in women, while only 20.7% knew at least two STI symptoms in men. One hundred and twenty three (32.2%) students constituting 68 males (17.8%) and 55 females (14.4%) had experienced sexual intercourse. The mean age at first sexual experience was 15.06 years for males and 14.95 years for female students. There was a statistical association between age and experience of sexual intercourse (p = .024). Two thirds (65.0%) of the 123 sexually experienced students had intercourse in the last six months, and only 30 of them (24.4%) had used a condom during their last intercourse. The use of condom was most frequent (10.6%) at age 18 and least frequent (.8%) at age 14. About one quarter (26.1%) of the students had taken&nbsp / alcohol: 17.3% occasionally, 5.5% moderately, and 2.6% frequently. There was a statistical association between taking alcohol and age (p = .038). Over a half (56.1%) of those who had not had sexual intercourse also had not taken alcohol. In contrast, 14.2% had sexual intercourse and also took alcohol, indicating significant statistical association (p &lt / .001). 66.8% of the students had neither used drugs nor taken alcohol, whilst 6.8% had both used drugs and taken alcohol, indicating significant association, (p &lt / .001). There was a similar association between sexual intercourse and using drugs, (p = .002). Conclusions: The study revealed significant high risk sexual behaviour among adolescents in Bekwarra. The high level of risky sexual behaviour and lack of basic knowledge about STIs indicated that access to information is currently insufficient. Health and educational authorities in Bekwarra should utilize the key findings highlighted from this study to design more effective local strategies for sexual health promotion that may help to slow the spread of STIs including HIV/AIDS. Intensive child-friendly programmes for pre-teenagers organized by educators to promote postponement of the early initiation of sexual intercourse may be effective. For adolescents who are unable to control their sexual initiation, improved education on safe sexual practices, especially the use of condoms appears to be necessary.</p>

<p>Since the early 1980&rsquo / s when the first case of HIV was diagnosed, AIDS remains a serious and threatening health crisis in the world. Sub-Saharan Africa is the region most affected by the HIV/AIDS pandemic having 67 % of the 33 million people infected with HIV globally in 2007. Young people aged 15-24&nbsp / account for an estimated 45% of all new HIV infections worldwide. The study aimed to assess the knowledge and attitudes on HIV/AIDS and sexual&nbsp / behavior among 15-19 year olds in Kenya. A descriptive, cross-sectional survey was conducted among 96 students randomly selected from five public&nbsp / schools in Ngong sub-district. Descriptive and bivariate analysis was conducted using Epi Info 3.3 and SPSS. The main findings indicate that a third&nbsp / (31/96) of respondents were sexually experienced. Knowledge level was however found to be inadequate (below 60 %) indicating a poorly informed sample on knowledge about HIV transmission and prevention. The study showed poor attitudes towards the risk to HIV as only 40 % of both males and females supported the use of condoms even when the sexual partners know each other well. Inaddition, risky sexual behaviors were reported by sexually&nbsp / &nbsp / experienced respondents where condom use in last sexual intercourse was (57 %) among males and (20 %) among females.</p>

Sexuality is central to our individual lives, our society, and our evolution, but its etiology is not thoroughly understood. Using data from 4904 Australian twins who completed a questionnaire on sexual attitudes and behaviours, I investigated the genetic and environmental influences underlying variation in and covariation between psychological and behavioural aspects of sexuality. Moreover, I explored the role of sexuality traits in several different contexts: evolution, mental health, public health, personality, and problematic behaviour. Before presenting reports of the four main empirical studies in this thesis, I make the case for the importance of studying human sexuality, outline previous findings on the etiology of individual differences in sexuality, and describe the behavioural genetic principles and techniques that were used in the investigations. I also present an additional fifth paper reporting a behavioural genetic analysis of EEG power, which I undertook in order to learn twin data modelling and complex multivariate techniques. In the first empirical paper I investigated sexual orientation from an evolutionary perspective. As sexual orientation is genetically influenced, it is not known how homosexuality, which tends to lower reproductive success, is maintained in the population at a relatively high frequency. I tested the hypothesis that while genes predisposing to homosexuality reduce homosexuals’ reproductive success, they may confer some advantage for heterosexuals who carry them. Results showed that psychologically masculine females and feminine men are 1) more likely to be nonheterosexual, but 2) when they are heterosexual have more opposite-sex sexual partners. Genetic modelling revealed that both these relationships are partly due to pleiotropic genetic influences common to each trait. Further, heterosexuals with a nonheterosexual twin had more opposite-sex partners than do heterosexual twin pairs. Taken together, these results suggest that genes predisposing to homosexuality may confer a mating advantage in heterosexuals, which could contribute to the evolution and maintenance of homosexuality in the population. In the second empirical paper I investigated sexual orientation from the perspective of mental health risk. Large epidemiological studies have shown that homosexuals are at much greater risk of psychiatric disorder than the general population. This has been assumed, with some supporting evidence, to be because of the prejudice and discrimination experienced by homosexuals in a heterosexist society. Here I tested the viability of alternative explanations, using Eysenck’s Neuroticism and Psychoticism scales as markers for psychiatric vulnerability. Firstly, I tested whether apparent sexual orientation differences in psychiatric vulnerability simply mirror sex differences – for our traits, this would predict nonheterosexual males having elevated Neuroticism scores as females do, and nonheterosexual females having elevated Psychoticism scores as males do. The results contradicted this idea, with nonheterosexual men and women scoring significantly higher on both Neuroticism and Psychoticism than their heterosexual counterparts, suggesting an overall elevation of psychiatric risk in nonheterosexuals. Secondly, I used the genetically informative sample to assess the viability of explanations invoking a common cause of both nonheterosexuality and psychiatric vulnerability. We found significant genetic correlations between sexual orientation and both Neuroticism and Psychoticism, but no corresponding environmental correlations, suggesting that if there is a common cause of both nonheterosexuality and psychiatric vulnerability it is likely to have a genetic basis rather than an environmental basis. The third empirical paper investigated the etiology of risky sexual behaviour, which is relevant to public health and welfare through its role in STD transmission and unwanted pregnancies. Results showed that variation in risky sexual behaviour is due to genetic, shared environmental, and unshared environmental influences to approximately equal degrees. The genetic influences partly overlapped with genetic influences on dispositional factors, with significant genetic correlations between risky sexual behaviour and Eysenck’s Impulsivity, Extraversion, Psychoticism, and Neuroticism. This suggests that the genetic influences that shape our personality may also predispose us to risky sexual behaviour. The fourth empirical paper investigated the etiology of a strong association (r = .50) between risky sexual behaviour and adolescent misconduct. Results indicated that the association is due to overlapping genetic and environmental influences, but that in males genes are the primary source of the association whereas in females shared environment plays the greater role. These findings suggest that a general predisposition to risky behaviour may manifest in different potentially harmful ways in adolescence (misconduct) and adulthood (risky sexual behaviour), and that different processes are involved in male and female etiology. Following the empirical reports, I provide a general discussion of my research findings and the study of human sexuality more generally. After summarising the findings and their implications, I then provide a detailed description of potential limitations of the research and to what extent they qualify the conclusions drawn. I also critically discuss the absence of sexuality traits from the major models of personality, and why this and other shortcomings make the personality models inadequate from an evolutionary perspective. Finally, I suggest directions for future research in light of the research and discussion presented in this thesis.