Sexual partner change and condom use among urban factory workers in northwest Tanzania

Abstract

Objective: To describe sexual partner change and condom use at the intake of a cohort study of urban factory workers in Tanzania.

Methods: From October 1991 to March 1992, 926 male and 170 female factory workers were interviewed using a structured, pre-coded questionnaire. Questionnaire reliability was assessed by pre-testing and comparison with results of unstructured interviews and carrying out repeat questionnaires on a sub-sample.

Results: Almost half of both men and women had had sexual intercourse by their 17th birthday. The period of premarital sex had an interquartile range of 2 to 10 years in men and 0 to 2.5 years in women. Having had sexual intercourse in the past month with more than one partner was reported by 22% of the men and 5% of the women. Factors associated with multiple partners in men were being born in or near Mwanza Region, having low education and low income, and being married. Condoms had been used in the past month by 3% only, mainly with casual partners. Condom use in men was associated with being young, living in town, being born in Kagera Region, high education and high income, being circumcised, and having causal or steady (non- martial) partners.

Conclusion: Information, education and communication (IEC) on sexual relationships and condom use should start at an early age, and include education at primary schools. Much sexual partner change appears to occur through steady (non-marital) partnerships, indicating the need for IEC to be expanded beyond groups such as commercial sex workers and their clients.

PIP: A cohort study of urban workers was initiated in a factory in Mwanza Municipality, Tanzania, October 1991 to March 1992, in order to identify risk factors for HIV-1 seroconversion and for contracting other STDs. All respondents were interviewed for 30-45 minutes in Kiswahili using a structured and pre-coded questionnaire that was slightly different for men and women. In the first 19 weeks 1096 workers (926 male, 170 female) were enrolled. Participants were more likely to be under 25 years old. By the 15th birthday 16% of male and 6% of female respondents reported having had sexual intercourse; by the 17th birthday these percentages were 44% and 33%, respectively. In those who had ever married, the median period of having had premarital sexual intercourse was 5 years (interquartile range 2-10 years) in men and 1 year (interquartile range 0-2.5 years) in women. Marriage survival was slightly longer for men than for women (0.05 p 0.1). 724/926 (78%) of male and 76/170 (45%) of the female factory workers were married and living together with their spouse. Of the 724 married men 45 (6%) had 2 wives, the others had 1 wife only. Among the married respondents 607/717 (85%) of the men and 71/76 (93%) of the women reported having had sex with their spouse in the past 4 weeks (men: median 4 times, women: median 5 times). Having had more than one sexual partner in the past month was reported by 205/926 (22%) of men and 8/170 (5%) of women. Factors associated with having had multiple sexual partners in the past month were: being born in Mwanza or the neighboring Mara or Shinyanga Regions, having had less education or having a low income, and being married. Having had more than one sexual partner in the past month was also associated with having ever had a genital discharge. Overall, 141/924 (15%) of men and 30/170 (18%) of women had ever used a condom. Only 28/924 (3%) of men and 5/170 (3%) of women had used a condom in the past month.