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The impact of gender norms on condom use among HIV-positive adults in KwaZulu-Natal, South Africa

The impact of gender norms on condom use among HIV-positive adults in KwaZulu-Natal, South Africa
The impact of gender norms on condom use among HIV-positive adults in KwaZulu-Natal, South Africa
Critical to preventing the spread of HIV is promoting condom use among HIV-positive individuals. Previous studies suggest that gender norms (social and cultural constructions of the ways that women and men are expected to behave) may be an important determinant of condom use. However, the relationship has not been evaluated among HIV-positive women and men in South Africa. We examined gender norms and condom use at last sex among 550 partnerships reported by 530 sexually-active HIV-positive women (372) and men (158) who had sought care, but not yet initiated antiretroviral therapy in a high HIV-prevalence rural setting in KwaZulu-Natal, South Africa between January 2009 and March 2011. Participants enrolled in the cohort study completed a baseline questionnaire that detailed their socio-demographic characteristics, socio-economic circumstances, religion, HIV testing history and disclosure of HIV status, stigma, social capital, gender norms and self-efficacy. Gender norms did not statistically differ between women and men (p = 0.18). Overall, condoms were used at last sex in 58% of partnerships. Although participants disclosed their HIV status in 66% of the partnerships, 60% did not have knowledge of their partner’s HIV status. In multivariable logistic regression, run separately for each sex, women younger than 26 years with more equitable gender norms were significantly more likely to have used a condom at last sex than those of the same age group with inequitable gender norms (OR = 8.88, 95% CI 2.95–26.75); the association between condom use and gender norms among women aged 26+ years and men of all ages was not statistically significant. Strategies to address gender inequity should be integrated into positive prevention interventions, particularly for younger women, and supported by efforts at a societal level to decrease gender inequality
1932-6203
1-19
Fladseth, K.
eb3bad55-d75b-4422-b3a8-f3919f6d1258
Gafos, M.
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Newell, M.L.
c6ff99dd-c23b-4fef-a846-a221fe2522b3
McGrath, N.
b75c0232-24ec-443f-93a9-69e9e12dc961
Fladseth, K.
eb3bad55-d75b-4422-b3a8-f3919f6d1258
Gafos, M.
6b7dc4c0-c442-448b-af8c-036526f6e226
Newell, M.L.
c6ff99dd-c23b-4fef-a846-a221fe2522b3
McGrath, N.
b75c0232-24ec-443f-93a9-69e9e12dc961

Fladseth, K., Gafos, M., Newell, M.L. and McGrath, N. (2015) The impact of gender norms on condom use among HIV-positive adults in KwaZulu-Natal, South Africa. PLoS ONE, 10 (4), 1-19. (doi:10.1371/journal.pone.0122671). (PMID:25853870)

Record type: Article

Abstract

Critical to preventing the spread of HIV is promoting condom use among HIV-positive individuals. Previous studies suggest that gender norms (social and cultural constructions of the ways that women and men are expected to behave) may be an important determinant of condom use. However, the relationship has not been evaluated among HIV-positive women and men in South Africa. We examined gender norms and condom use at last sex among 550 partnerships reported by 530 sexually-active HIV-positive women (372) and men (158) who had sought care, but not yet initiated antiretroviral therapy in a high HIV-prevalence rural setting in KwaZulu-Natal, South Africa between January 2009 and March 2011. Participants enrolled in the cohort study completed a baseline questionnaire that detailed their socio-demographic characteristics, socio-economic circumstances, religion, HIV testing history and disclosure of HIV status, stigma, social capital, gender norms and self-efficacy. Gender norms did not statistically differ between women and men (p = 0.18). Overall, condoms were used at last sex in 58% of partnerships. Although participants disclosed their HIV status in 66% of the partnerships, 60% did not have knowledge of their partner’s HIV status. In multivariable logistic regression, run separately for each sex, women younger than 26 years with more equitable gender norms were significantly more likely to have used a condom at last sex than those of the same age group with inequitable gender norms (OR = 8.88, 95% CI 2.95–26.75); the association between condom use and gender norms among women aged 26+ years and men of all ages was not statistically significant. Strategies to address gender inequity should be integrated into positive prevention interventions, particularly for younger women, and supported by efforts at a societal level to decrease gender inequality

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Accepted/In Press date: 24 February 2015
Published date: 8 April 2015
Organisations: Primary Care & Population Sciences

Identifiers

Local EPrints ID: 375940
URI: http://eprints.soton.ac.uk/id/eprint/375940
ISSN: 1932-6203
PURE UUID: d3c114d8-bc67-4d05-b767-2b6e362af6c3
ORCID for M.L. Newell: ORCID iD orcid.org/0000-0002-1074-7699
ORCID for N. McGrath: ORCID iD orcid.org/0000-0002-1039-0159

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Date deposited: 13 Apr 2015 13:09
Last modified: 10 Dec 2019 01:35

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Contributors

Author: K. Fladseth
Author: M. Gafos
Author: M.L. Newell ORCID iD
Author: N. McGrath ORCID iD

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