hiv communication programs, condom use at sexual debut, and protection from hiv in south africa 2005...
TRANSCRIPT
![Page 1: HIV Communication Programs, Condom Use at Sexual Debut, and Protection from HIV in South Africa 2005 Stella Babalola April 30 th, 2014](https://reader035.vdocuments.site/reader035/viewer/2022062518/56649ef35503460f94c04fe4/html5/thumbnails/1.jpg)
HIV Communication Programs, Condom Use at Sexual Debut, and
Protection from HIV in South Africa 2005
Stella Babalola
April 30th, 2014
![Page 2: HIV Communication Programs, Condom Use at Sexual Debut, and Protection from HIV in South Africa 2005 Stella Babalola April 30 th, 2014](https://reader035.vdocuments.site/reader035/viewer/2022062518/56649ef35503460f94c04fe4/html5/thumbnails/2.jpg)
Background
• Condom use at first sex linked with subsequent condom use– Also linked to reduced risk of STIs
• Communication programs for HIV prevention have been implemented in South Africa since the 1990’s– Designed to educate the public about HIV
and promote prevention methods
![Page 3: HIV Communication Programs, Condom Use at Sexual Debut, and Protection from HIV in South Africa 2005 Stella Babalola April 30 th, 2014](https://reader035.vdocuments.site/reader035/viewer/2022062518/56649ef35503460f94c04fe4/html5/thumbnails/3.jpg)
Background cont.
• Stabilization of HIV prevalence between 2002 and 2008
• Evidence of decrease in HIV incidence among youth
• Increased condom use is a possible reason for decreased incidence (Rehle et al., 2010)
![Page 4: HIV Communication Programs, Condom Use at Sexual Debut, and Protection from HIV in South Africa 2005 Stella Babalola April 30 th, 2014](https://reader035.vdocuments.site/reader035/viewer/2022062518/56649ef35503460f94c04fe4/html5/thumbnails/4.jpg)
Methods
• Analyzed results of the 2005 HSRC/Nelson Mandela national cross-sectional survey– 6829 adults reporting sexual intercourse in
last 12 months– Condom use at sexual debut measured by:
• Did you use a condom the first time you had sexual intercourse?
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Methods cont.
• Exposure to AIDS communication programs– measured by awareness of eight national
HIV-prevention campaigns
• HIV infection testing
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Analysis
• Multivariate causal attribution (MCA) analysis– structural equation modeling (SEM)– biprobit regression– propensity score matching (PSM)– sensitivity analysis
• Addresses threats to validity and strengthens claim of causality
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Results
![Page 8: HIV Communication Programs, Condom Use at Sexual Debut, and Protection from HIV in South Africa 2005 Stella Babalola April 30 th, 2014](https://reader035.vdocuments.site/reader035/viewer/2022062518/56649ef35503460f94c04fe4/html5/thumbnails/8.jpg)
Predicted condom use at 1st sex by predicted level of HIV program awareness
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Condom use at first sex and HIV negative status
• SEM: Odds ratio 1.38
• PSM: condom use at 1st sex increases HIV negative status by 3.6 percentage points
• Result robust to potential violations in the strong ignorability assumption
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Condom use at first sex and HIV negative status
• Estimated increase in HIV- status equivalent to a reduction of 25% in HIV+ status among those who used condom at 1st sex
• Estimated Infections averted: 139,835
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Discussion
• Communication programs have an indirect effect on HIV infection by increasing condom use at first sex
• Condom use at 1st sex increases the odds of remaining HIV negative
• Results are likely causal
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Limitations
• Cross-sectional data but analytic methods help to address most related threats
• Self-reported data subject to memory lapse and social desirability bias