Browsing by Author "Khanakwa, Sarah"

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    Correlates of Use of Timed Unprotected Intercourse to Reduce Horizontal Transmission Among Ugandan HIV Clients with Fertility Intentions
    (AIDS and Behavior, 2015) Wagner, Glenn J.; Goggin, Kathy; Mindry, Deborah; Beyeza-Kashesya, Jolly; Finocchario-Kessler, Sarah; Woldetsadik, Mahlet A.; Khanakwa, Sarah; Wanyenze, Rhoda K.
    We examined the correlates of use of safer conception methods (SCM) in a sample of 400 Ugandan HIV clients (75% female; 61% on antiretroviral therapy; 61% with HIV-negative or unknown status partners) in heterosexual relationships with fertility intentions. SCM assessed included timed unprotected intercourse, manual self-insemination, sperm washing, and pre-exposure prophylaxis (PrEP). In the 6 months prior to baseline, 47 (12%) reported using timed unprotected intercourse to reduce risk of HIV infection (or re-infection), none had used manual self-insemination or sperm washing, and 2 had used PrEP. In multiple regression analysis, correlates of use of timed unprotected intercourse included greater perceptions of partner’s willingness to use SCM and providers’ stigma of childbearing among people living with HIV, higher SCM knowledge, and desire for a child within the next 6 months. These findings highlight the need for policy and provider training regarding integration of couples’ safer conception counselling into HIV care.
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    He said, she said’: assessing dyadic agreement of reported sexual behaviour and decision-making among an HIV sero-discordant couples cohort in Uganda
    (BMJ, 2016) Birungi, Josephine; Maldoon, Cathrine; Kanters, Steve; King, Racheal; Nyonyintono, Moreen; Khanakwa, Sarah; Moore, David. M.
    Background The intimate nature of sexuality makes it challenging to accurately measure sexual behaviour. To assess response reliability, we examined agreement between couples in heterosexual HIV sero-discordant partnership on survey questions regarding condom use and sexual decision-making. Methods Data for this analysis come from baseline data from a cohort study of HIV sero- discordant couples in Jinja, Uganda. We examined the degree of agreement between male and female partners on standard measures of sexual behaviour using the kappa (κ) statistic and 95% confidence intervals (95% CIs). Results Among 409 couples, the median age for the male partner was 41 [interquartile range (IQR) 35–48] years and the female partner was 35 (IQR 30–40) years. Among 58.2% of the couples, the male was the HIV-positive partner. Questions with high or substantial couple agreement included condom use at last sex (κ=0.635, 95% CI 0.551–0.718) and frequency of condom use (κ=0.625, 95% CI 0.551–0.698). Questions with low or fair couple agreement included decision-making regarding condom use (κ=0.385, 95% CI 0.319–0.451), wanting more biological children (κ=0.375, 95% CI 0.301– 0.449) and deciding when to have sex (κ=0.236, 95% CI 0.167–0.306). Conclusions Survey questions assessing condom use had the highest level of couple agreement and questions regarding sexual decision-making and fertility desire had low couple agreement. Questions with high agreement have increased reliability and reduced measurement bias; however, questions with low agreement between couples identify important areas for further investigation, particularly perceived relationship control and gender differences.