Cell Phones, Sexual Behaviors and HIV Prevalence in Rakai, Uganda: A Cross Sectional Analysis of Longitudinal Data
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Date
2020
Journal Title
Journal ISSN
Volume Title
Publisher
AIDS and Behavior
Abstract
Cell phones have increased communication and connection across the globe and particularly in sub-Saharan Africa—with
potential consequences for the HIV epidemic. We examined the association among ownership of cell phones, sexual behaviors
(number of sexual partners, alcohol use before sex, inconsistent condom use), and HIV prevalence. Data were from
four rounds (2010–2016) of the Rakai Community Cohort Study (N = 58,275). Sexual behaviors and HIV prevalence were
compared between people who owned a cell phone to people who did not own a cell phone. We stratified analysis by younger
(15–24 years) and older (25+ years) age groups and by gender. Using logistic regression and after adjusting for sociodemographic
characteristics, we found cell phone ownership was independently associated with increased odds of having two or
more sexual partners in the past 12 months across age and gender groups (young men AOR 1.67, 95% CI 1.47–1.90; young
women AOR 1.28 95% CI 1.08–1.53; older men AOR 1.54 95% CI 1.41–1.69; older women AOR 1.44 95% CI 1.26–1.65).
Interestingly, young men who owned cell phones had decreased odds of using condoms inconsistently (AOR 0.66, 95% CI
0.57–0.75). For young women, cell phone ownership was associated with increased odds of using alcohol before sex (AOR
1.38 95% CI 1.17–1.63) and increased odds of inconsistent condom use (AOR 1.40, 95% 1.17–1.67). After adjusting for
sociodemographic characteristics, only young women who owned cell phones had increased odds of being HIV positive
(AOR 1.27 95% CI 1.07–1.50). This association was not mediated by sexual behaviors (Adjusted for sociodemographic
characteristics and sexual behaviors AOR 1.24, 95% CI 1.05–1.46). While cell phone ownership appears to be associated with
increased HIV risk for young women, we also see a potential opportunity for future cell phone-based health interventions.
Description
Keywords
Cell phones, Sexual behaviors, HIV prevalence, Sub-Saharan Africa
Citation
Nalugoda, F., Kreniske, P., Hofer, S., Zhong, X., Wei, Y., Grilo, S. A., ... & Santelli, J. S. (2020). Cell phones, sexual behaviors and hiv prevalence in Rakai, Uganda: a cross sectional analysis of longitudinal data. AIDS and Behavior, 24(5), 1574-1584. https://doi.org/10.1007/s10461-019-02665-8