Kwena Zachary, Mwanzo Isaac, Shisanya Chris, Camlin Carol, Turan Janet, Achiro Lilian, Bukusi Elizabeth
Center for Microbiology Research, Kenya Medical Research Institute, Kisumu, Kenya.
Department of Community Health, Kenyatta University, Nairobi, Kenya.
PLoS One. 2014 Apr 18;9(4):e95298. doi: 10.1371/journal.pone.0095298. eCollection 2014.
The vulnerability of women to HIV infection makes establishing predictors of women's involvement in extra-marital partnerships critical. We investigated the predictors of extra-marital partnerships among women married to fishermen.
The current analyses are part of a mixed methods cross-sectional survey of 1090 gender-matched interviews with 545 couples and 12 focus group discussions (FGDs) with 59 couples. Using a proportional to size simple random sample of fishermen as our index participants, we asked them to enrol in the study with their spouses. The consenting couples were interviewed simultaneously in separate private rooms. In addition to socio-economic and demographic data, we collected information on sexual behaviour including extra-marital sexual partnerships. We analysed these data using descriptive statistics and multivariate logistic regression. For FGDs, couples willing to participate were invited, consented and separated for simultaneous FGDs by gender-matched moderators. The resultant audiofiles were transcribed verbatim and translated into English for coding and thematic content analysis using NVivo 9.
The prevalence of extra-marital partnerships among women was 6.2% within a reference time of six months. Factors that were independently associated with increased likelihood of extra-marital partnerships were domestic violence (aOR, 1.45; 95% CI 1.09-1.92), women reporting being denied a preferred sex position (aOR, 3.34; 95% CI 1.26-8.84) and spouse longer erect penis (aOR, 1.34; 95% CI 1.00-1.78). Conversely, women's age--more than 24 years (aOR, 0.33; 95% CI 0.14-0.78) and women's increased sexual satisfaction (aOR, 0.92; 95% CI 0.87-0.96) were associated with reduced likelihood of extra-marital partnerships.
Domestic violence, denial of a preferred sex positions, longer erect penis, younger age and increased sexual satisfaction were the main predictors of women's involvement in extra-marital partnerships. Integration of sex education, counselling and life skills training in couple HIV prevention programs might help in risk reduction.
女性感染艾滋病毒的易感性使得确定女性参与婚外性伴侣关系的预测因素至关重要。我们调查了嫁给渔民的女性中婚外性伴侣关系的预测因素。
当前的分析是一项混合方法横断面调查的一部分，该调查包括对545对夫妇进行的1090次性别匹配访谈以及对59对夫妇进行的12次焦点小组讨论（FGD）。以与规模成比例的简单随机抽样方式选取渔民作为我们的指标参与者，要求他们与其配偶一起参与研究。同意参与的夫妇在 separate private rooms（应是“单独的私人房间”）中同时接受访谈。除了社会经济和人口数据外，我们还收集了包括婚外性伴侣关系在内的性行为信息。我们使用描述性统计和多变量逻辑回归分析这些数据。对于焦点小组讨论，邀请愿意参与的夫妇，他们同意后由性别匹配的主持人分开进行同步焦点小组讨论。对产生的音频文件进行逐字转录，并翻译成英语以便使用NVivo 9进行编码和主题内容分析。
在六个月的参考时间内，女性中婚外性伴侣关系的患病率为6.2%。与婚外性伴侣关系可能性增加独立相关的因素包括家庭暴力（调整后的比值比[aOR]，1.45；95%置信区间[CI] 1.09 - 1.92）、报告被拒绝偏好的性交体位的女性（aOR，3.34；95% CI 1.26 - 8.84）以及配偶阴茎勃起更长（aOR，1.34；95% CI 1.00 - 1.78）。相反，女性年龄超过24岁（aOR，0.33；95% CI 0.14 - 0.78）以及女性性满意度增加（aOR，0.92；95% CI 0.87 - 0.96）与婚外性伴侣关系可能性降低相关。
家庭暴力、被拒绝偏好的性交体位、阴茎勃起更长、年龄较小以及性满意度增加是女性参与婚外性伴侣关系的主要预测因素。在夫妻艾滋病毒预防项目中纳入性教育、咨询和生活技能培训可能有助于降低风险。
