Targeting vulnerable populations : a synthetic review on alcohol use and risky sexual behaviour among migrant populations

Background: Research has demonstrated a link between alcohol use and risky sexual behaviour among different types of migrant populations. Therefore, research investigating risk factors associated with alcohol consumption among them is a public health priority. This review aimed to explore the intersection between migration, alcohol consumption and risky sexual behaviour. Methods: This article is a synthetic review of empirical studies on the association of alcohol and high-risk sexual behaviour among different types of the migrant populations, focusing on measurable outcomes generated from quantitative data. A descriptive analysis generated from global and situational studies was used to interpret the reviewed research and to discuss critically the factors that drive migrants to engage in alcohol consumption and high-risk behaviour. Results: This review found out that there is a significant and positive association between global and situational alcohol use and several outcomes of risky sexual behaviour among different types of migrant populations. This association was however mainly observed at high quantities and frequencies of alcohol use, mainly among male migrants, and was often tied to a specific situation or context, for instance the type of sexual partner, the level of mobility and to environmental factors such as living arrangements and entertainment venues. Conclusions: The study supports previous research that alcohol use is associated with risky sexual behaviour among different types of migrant populations. Therefore, future interventions should target mobile, male migrant heavy drinkers. Additional research is needed using more event-level and longitudinal methodologies that overcome prior methodological limitations

Factors influencing risky sexual behaviour among Mozambican miners : a socio-epidemiological contribution for HIV prevention framework in Mozambique

Background: Information dealing with social and behavioural risk factors as well as their mechanisms among Mozambican migrants working in South African mines remains undocumented. This study aims to understand the various factors influencing HIV-related risk behaviours and the resulting HIV positive status of Mozambican miners employed by South African mines. This analysis was undertaken in order to inform a broader and more effective HIV preventive framework in Mozambique. Method: This study relied upon data sourced from the first Integrated Biological and Behavioural Survey among Mozambican miners earning their living in South African mines. It employs quantitative techniques using standard statistical tools to substantiate the laid-down objectives. The primary technique applied in this paper is the multivariable statistical method used in the formulation and application of a proximate determinants framework. Results: The odds of reporting one sexual partner were roughly three times higher for miners working as perforators as opposed to other types of occupation. As well, the odds of condom use - always or sometimes - for miners in the 31-40 age group were three times higher than the odds of condom use in the 51+ age group. Miners with lower education levels were less likely to use condoms. The odds of being HIV positive when the miner reports use of alcohol or drugs (sometimes/always) is 0.32 times lower than the odds for those reporting never use of alcohol or drugs. And finally, the odds of HIV positive status for those using condoms were 2.16 times that of miners who never used condoms, controlling for biological and other proximate determinants. Conclusion: In Mozambique, behavioural theory emphasising personal behavioural changes is the main strategy to combat HIV among miners. Our findings suggest there is a need to change thinking processes about how to influence safer sexual behaviour. This is viewed to be the result of a person's individual decision, due to of the complexity of social and contextual factors that may also influence sexual behaviours. This only stresses the need for HIV prevention strategies to exclusively transcend individual factors while considering the broader social and contextual phenomena influencing HIV risk among Mozambican miners

Joint models for mixed categorical outcomes: a study of HIV risk perception and disease status in Mozambique

<p>Two types of bivariate models for categorical response variables are introduced to deal with special categories such as ‘unsure’ or ‘unknown’ in combination with other ordinal categories, while taking additional hierarchical data structures into account. The latter is achieved by the use of different covariance structures for a trivariate random effect. The models are applied to data from the INSIDA survey, where interest goes to the effect of covariates on the association between HIV risk perception (quadrinomial with an ‘unknown risk’ category) and HIV infection status (binary). The final model combines continuation-ratio with cumulative link logits for the risk perception, together with partly correlated and partly shared trivariate random effects for the household level. The results indicate that only age has a significant effect on the association between HIV risk perception and infection status. The proposed models may be useful in various fields of application such as social and biomedical sciences, epidemiology and public health.</p

Joint models for mixed categorical outcomes: a study of HIV risk perception and disease status in Mozambique

<p>Two types of bivariate models for categorical response variables are introduced to deal with special categories such as ‘unsure’ or ‘unknown’ in combination with other ordinal categories, while taking additional hierarchical data structures into account. The latter is achieved by the use of different covariance structures for a trivariate random effect. The models are applied to data from the INSIDA survey, where interest goes to the effect of covariates on the association between HIV risk perception (quadrinomial with an ‘unknown risk’ category) and HIV infection status (binary). The final model combines continuation-ratio with cumulative link logits for the risk perception, together with partly correlated and partly shared trivariate random effects for the household level. The results indicate that only age has a significant effect on the association between HIV risk perception and infection status. The proposed models may be useful in various fields of application such as social and biomedical sciences, epidemiology and public health.</p