Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
Department of Midwifery, College of Medicine and Health Science, Wolaita Sodo University, Wolaita Sodo, Ethiopia.
PLoS One. 2024 May 31;19(5):e0303574. doi: 10.1371/journal.pone.0303574. eCollection 2024.
INTRODUCTION: Sexual behaviour needs to take a central position in the heart of public health policy makers and researchers. This is important in view of its association with Sexually Transmitted Infections (STIs), including HIV. Though the prevalence of HIV/AIDS is declining in Ethiopia, the country is still one of the hardest hit in the continent of Africa. Hence, this study was aimed at identifying hot spot areas and associated factors of risky sexual behavior (RSB). This would be vital for more targeted interventions which can produce a sexually healthy community in Ethiopia. METHODS: In this study, a cross-sectional survey study design was employed. A further analysis of the 2016 Ethiopia Demographic and Health Survey data was done on a total weighted sample of 10,518 women and men age 15-49 years. ArcGIS version 10.7 and Kuldorff's SaTScan version 9.6 software were used for spatial analysis. Global Moran's I statistic was employed to test the spatial autocorrelation, and Getis-Ord Gi* as well as Bernoulli-based purely spatial scan statistics were used to detect significant spatial clusters of RSB. Mixed effect multivariable logistic regression model was fitted to identify predictors and variables with a p-value ≤0.05 were considered as statistically significant. RESULT: The study subjects who had RSB were found to account about 10.2% (95% CI: 9.64%, 10.81%) of the population, and spatial clustering of RSB was observed (Moran's I = 0.82, p-value = 0.001). Significant hot spot areas of RSB were observed in Gambela, Addis Ababa and Dire Dawa. The primary and secondary SaTScan clusters were detected in Addis Ababa (RR = 3.26, LLR = 111.59, P<0.01), and almost the entire Gambela (RR = 2.95, LLR = 56.45, P<0.01) respectively. Age, literacy level, smoking status, ever heard of HIV/AIDS, residence and region were found to be significant predictors of RSB. CONCLUSION: In this study, spatial clustering of risky sexual behaviour was observed in Ethiopia, and hot spot clusters were detected in Addis Ababa, Dire Dawa and Gambela regions. Therefore, interventions which can mitigate RSB should be designed and implemented in the identified hot spot areas of Ethiopia. Interventions targeting the identified factors could be helpful in controlling the problem.
简介：性行为需要成为公共卫生政策制定者和研究人员关注的核心。鉴于性行为与性传播感染（STIs），包括艾滋病毒的关联，这一点很重要。尽管艾滋病毒/艾滋病在埃塞俄比亚的流行率正在下降，但该国仍是非洲受影响最严重的国家之一。因此，本研究旨在确定危险性行为（RSB）的热点地区和相关因素。这对于更有针对性的干预措施至关重要，这些措施可以在埃塞俄比亚产生一个性健康的社区。 方法：在这项研究中，采用了横断面调查研究设计。对 2016 年埃塞俄比亚人口与健康调查的数据进行了进一步分析，共对 10518 名年龄在 15-49 岁的男女进行了加权样本分析。ArcGIS 版本 10.7 和 Kuldorff 的 SaTScan 版本 9.6 软件用于空间分析。采用全局 Moran's I 统计量检验空间自相关，采用 Getis-Ord Gi*和基于 Bernoulli 的纯空间扫描统计量检测 RSB 的显著空间聚类。拟合混合效应多变量逻辑回归模型以确定预测因子，并且 p 值≤0.05 的变量被认为具有统计学意义。 结果：研究对象中，有 RSB 的人约占人口的 10.2%（95%CI：9.64%，10.81%），并且观察到 RSB 的空间聚类（Moran's I = 0.82，p 值= 0.001）。在 Gambela、亚的斯亚贝巴和 Dire Dawa 观察到 RSB 的显著热点地区。在亚的斯亚贝巴检测到初级和二级 SaTScan 集群（RR = 3.26，LLR = 111.59，P<0.01），几乎整个 Gambela（RR = 2.95，LLR = 56.45，P<0.01）。年龄、文化程度、吸烟状况、是否听说过艾滋病毒/艾滋病、居住地和地区被发现是 RSB 的显著预测因子。 结论：在这项研究中，观察到埃塞俄比亚危险性行为存在空间聚类，在亚的斯亚贝巴、Dire Dawa 和 Gambela 地区检测到热点集群。因此，应该在埃塞俄比亚确定的热点地区设计和实施可以减轻 RSB 的干预措施。针对确定因素的干预措施可能有助于控制这一问题。
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