High-Risk Sexual Behavior at Social Venues in Madagascar

MEASURE Evaluation Project, University of North Carolina, Chapel Hill, North Carolina, USA.
Sex Transm Dis (Impact Factor: 2.84). 06/2008; 35(8):738-45. DOI: 10.1097/OLQ.0b013e3181724383
Source: PubMed


Persistent high levels of sexually transmitted infection (STI) in Madagascar indicate current prevention strategies are inadequate. STI/HIV prevention based in social venues may play an important role in reaching individuals at risk of infection. We identified venues where people meet sexual partners and measured the need and potential for venue-based prevention.
Interviews were conducted in 7 Madagascar towns with 1) community informants to identify social venues, 2) individuals socializing at a sample of venues to assess sexual behavior among venue patrons, and 3) venue representatives to assess the potential for venue-based intervention.
Community informants identified numerous venues (range: 67-211 venues, depending on the town); streets, bars, and hotels were most commonly reported. Among 2982 individuals socializing at venues, 78% of men and 74% of women reported new sexual partnership or sex trade for money, goods, or services in the past 4 weeks and 19% of men and 18% of women reported symptoms suggestive of STI in the past 4 weeks. STI symptom levels were disproportionately high among respondents reporting either sex trade or new sexual partnership in the past 4 weeks. Twenty-eight percent of men and 41% of women reported condom use during the last sex act with a new partner. Although 24% to 45% of venues had hosted STI/HIV interventions, interventions were deemed possible at 73% to 90% venues according to 644 interviews with venue representatives.
Venue-based intervention is possible and would reach a spectrum of populations vulnerable to STI/HIV including sex workers, their clients, and other high-risk populations.

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    • "Using a well-developed system for rapid community assessments, Weir and colleagues (2003) mapped the linkages among places where people meet new sex partners and places where people drink alcohol. Studies that have used Weir’s PLACE methodology show a consistent overlap among drinking behaviors and sexual risks in alcohol-serving venues (Figueroa et al. 2007; Khan et al. 2008). For example, in Zimbabwe, 47 percent of women ages 15–19 years surveyed at night clubs and other drinking places had two or more sex partners in a 1-year period compared with less than 5 percent of young women surveyed outside of drinking places (Singh et al. 2009). "
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