Cell Phones, Sexual Behaviors and HIV Prevalence in Rakai, Uganda: A Cross Sectional Analysis of Longitudinal Data.

Journal: AIDS and behavior

Volume: 24

Issue: 5

Year of Publication: 2020

Affiliated Institutions:  Rakai Health Sciences Program, Kalisizo, Uganda. HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY, USA. pk@columbia.edu. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA. Icahn School of Medicine at Mount Sinai, New York, NY, USA. Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA. Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, NY, USA.

Abstract summary 

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.

Authors & Co-authors:  Nalugoda Fred F Kreniske Philip P Hofer Sarah S Zhong Xiaobo X Wei Ying Y Grilo Stephanie A SA Chen Ivy I Kigozi Ssebaggala D SD Kigozi Godfrey G Lutalo Tom T Ssekubugu Robert R Nakawooya Hadijja H Kagaayi Joseph J Chang Larry W LW Wawer Maria J MJ Gray Ronald H RH Wang Qianshu Q Santelli John S JS

Study Outcome 

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Statistics
Citations :  Giedd JN. The Digital Revolution and Adolescent Brain Evolution. J Adolesc Health Off Publ Soc Adolesc Med. 2012;51(2):101–105. doi:10.1016/j.jadohealth.2012.06.002
Authors :  18
Identifiers
Doi : 10.1007/s10461-019-02665-8
SSN : 1573-3254
Study Population
Men,Women
Mesh Terms
Adolescent
Other Terms
Cell phones;HIV prevalence;Sexual behaviors;Sub-Saharan Africa
Study Design
Cohort Study,,Cross Sectional Study,Longitudinal Study
Study Approach
Country of Study
Uganda
Publication Country
United States