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Condom Negotiation, HIV Testing, and HIV Risks among Women from Alcohol Serving Venues in Cape Town, South Africa

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  • Eileen V Pitpitan
  • Seth C Kalichman
  • Demetria Cain
  • Lisa A Eaton
  • Kate B Carey
  • Michael P Carey
  • Ofer Harel
  • Leickness C Simbayi
  • Vuyelwa Mehlomakhulu
  • Kelvin Mwaba

Abstract

Background: Women in South Africa are at particularly high-risk for HIV infection and are dependent on their male partners' use of condoms for sexual risk reduction. However, many women are afraid to discuss condoms with male partners, placing them at higher risk of HIV infection. Purpose: To examine the association between fear of condom negotiation with HIV testing and transmission risk behaviors, including alcohol use and sexual risks among South African women. Method: Women (N = 1333) residing in a primarily Xhosa-speaking African township in Cape Town and attending informal alcohol-serving venues (shebeens) completed anonymous surveys. Logistic regression was used to test the hypothesis that fear of condom negotiation would be associated with increased risk for HIV. Results: Compared to women who did not fear condom negotiation, those who did were significantly less likely to have been tested for HIV, were more likely to have experienced relationship abuse, and to report more alcohol use and more unprotected sex. Conclusions: For women in South Africa, fear of condom negotiation is related to higher risk of HIV. HIV prevention efforts, including targeted HIV counseling and testing, must directly address gender issues.

Suggested Citation

  • Eileen V Pitpitan & Seth C Kalichman & Demetria Cain & Lisa A Eaton & Kate B Carey & Michael P Carey & Ofer Harel & Leickness C Simbayi & Vuyelwa Mehlomakhulu & Kelvin Mwaba, 2012. "Condom Negotiation, HIV Testing, and HIV Risks among Women from Alcohol Serving Venues in Cape Town, South Africa," PLOS ONE, Public Library of Science, vol. 7(10), pages 1-6, October.
    • Handle: RePEc:plo:pone00:0045631
    DOI: 10.1371/journal.pone.0045631
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    References listed on IDEAS

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    1. Raiford, J.L. & DiClemente, R.J. & Wingood, G.M., 2009. "Effects of fear of abuse and possible STI acquisition on the sexual behavior of young African American women," American Journal of Public Health, American Public Health Association, vol. 99(6), pages 1067-1071.
    2. Pitpitan, Eileen V. & Kalichman, Seth C. & Eaton, Lisa A. & Sikkema, Kathleen J. & Watt, Melissa H. & Skinner, Donald, 2012. "Gender-based violence and HIV sexual risk behavior: Alcohol use and mental health problems as mediators among women in drinking venues, Cape Town," Social Science & Medicine, Elsevier, vol. 75(8), pages 1417-1425.
    3. Morojele, Neo K. & Kachieng'a, Millicent A. & Mokoko, Evodia & Nkoko, Matsobane A. & Parry, Charles D.H. & Nkowane, Annette M. & Moshia, Kgaogelo M. & Saxena, Shekhar, 2006. "Alcohol use and sexual behaviour among risky drinkers and bar and shebeen patrons in Gauteng province, South Africa," Social Science & Medicine, Elsevier, vol. 62(1), pages 217-227, January.
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