Prevalence and social drivers of HIV among married and cohabitating heterosexual adults in south-eastern Tanzania: analysis of adult health community cohort data

Figures & data

Fig. 1 Participant flow diagram.

Box 1. Variables evaluated in the analysis

Dependent variable	HIV positive (yes/no)
Independent variables	1. Social and demographic characteristics:  • sex (men/women)  • age (four age categories)  • religion (Muslim, Christian-Catholic, Christian-other, and other)  • ethnicity (North- Western, North- Eastern, and Southern)  • employment (being engaged in income generating activity, yes/no)  • education (received formal education, yes/no) 2. Gender norms:  • ‘a woman can ask her husband to use a condom when she know he has a disease’ (yes, no) 3. Marriage characteristics:  • ‘being in a polygamous in or a monogamous marriage’ (yes/no)  • ‘being in a first or subsequent (second) marriage’ (yes/no). 4. Sexual behavior characteristics:  • number of lifetime sexual partners (1, 2–4, ≥5)  • ‘used condom at first sex’ (yes/no). concurrent partnership (yes/no) 5. Health care utilization:  • ‘ever received VCT’ (yes/no). 6. Lifestyle characteristics:  • ‘ever drank alcohol’ (yes/no)

Table 1 Characteristics of the study population^a: frequency distribution (n=3,737)

Variable	Number of respondents (n)	%
Total	3,988	100.0
Social and demographic characteristics
Sex
Male	1,340	33.6
Female	2,648	66.4
Age (years)^b
≤20	175	4.4
21–30	1,265	31.8
31–40	1,159	29.1
41–50	613	15.4
50+	770	19.3
Mean=38.4, SD=14.5, Min=13, Max=99	–	–
Performs any income-generating activity
Yes	2,909	72.9
No	1,079	27.1
Ever had formal education
Yes	3,494	87.6
No	494	12.4
Religion
Muslim	1,559	39.1
Christian-Catholic	2,087	52.3
Other Christian	322	8.1
Other/none	20	0.5
Ethnic group
Northern Western	307	7.7
Northern Eastern	133	3.3
Southern	3,548	89.0
Marital characteristics
Marital status
Polygamous	104	2.61
Monogamous	3,884	97.39
Remarried
Yes	674	16.9
No	3,314	83.1
Sexual behavior characteristics
Lifetime number of sexual partners^b
1	901	24.1
2–4	1,837	49.2
5+	999	26.7
Mean=4.6, SD=7.2, Min=1, Max=100	–	–
Condom use at first sex^b
Yes	525	13.3
No	3,384	85.8
Don't know	33	0.8
Concurrent partnerships
No	3,719	93.3
Yes	269	6.7
Gender norms
Beliefs a woman is justified to ask their husbands to use a condom if she knows he has a disease)
Yes	3,454	86.6
No	534	13.4
Health care utilization
Ever received VCT
Yes	1,008	25.3
No	2,980	74.7
Lifestyle characteristics
Ever drank alcohol
Yes	1,103	27.7
No	2,885	72.3

^aCurrently married and cohabitating heterosexuals adults who participated in MZIMA adult health community cohort conducted in Ifakara, Tanzania.

^bMissing data for some respondents.

Table 2 Prevalence of HIV by background characteristics and cross tabulation (n=3,737^a)

Variable	% HIV positive	p
Overall	6.7	–
Social demographic characteristics
Sex
Male	5.9	0.163
Female	7.1
Age (years)
≤20	4.6	0.473
21–30	6.7
31–40	7.4
41–50	7.0
50+	5.7
Performs any income-generating activity
Yes	6.8	0.571
No	6.3
Ever had formal education
Yes	6.4	0.081
No	8.5
Religion
Muslim	7.3	0.618
Christian-Catholic	6.2
Other Christian	6.5
Other/none	5.0
Ethnic group
Northern Western	7.5	0.514
Northern Eastern	4.5
Southern	6.7
Marital characteristics
Marital status
Polygamous	2.8	0.117
Monogamous	6.7
Remarried
Yes	9.8	<0.001
No	6.0
Sexual behavior characteristics
Lifetime number of sexual partners
1	4.9	0.053
2–4	7.2
5+	7.2
Condom use at first sex
Yes	6.1	0.245
No	6.9
Don't know	0.0
Concurrent partnerships
No	6.9	0.079
Yes	4.1
Gender norms
Beliefs that a woman is justified to ask their husbands to use a condom if she knows he has a disease
Yes	6.4	0.080
No	8.4
Health care utilization
Ever had VCT
Yes	7.8	0.086
No	6.3
Lifestyle characteristics
Ever drank alcohol
Yes	7.3	0.362
No	6.5

^aCurrently married and cohabitating heterosexuals adults who participated in MZIMA adult health community cohort conducted in Ifakara, Tanzania.

Table 3 HIV positive status by background characteristics: multivariate logistic regression (n=3,737)^a

Variable	Odds ratio (OR)	95% Confidence interval (CI)	p
Social demographic characteristics
Sex
Male (ref)	1.00	–	–
Female	1.23	0.90–1.67	0.189
Ever had formal education
Yes (ref)	1.00	–	–
No	1.31	0.90–1.90	0.153
Marital characteristics
Remarried
No (ref)	1.00	–	–
Yes	1.49	1.08–2.04	0.014
Sexual behavior characteristics
Lifetime number of sexual partners
1 (ref)	1.00	–	–
2–4	1.47	1.02–2.11	0.038
5+	1.61	1.05–2.47	0.028
Gender norms
Woman's status (believing that a woman is justified to ask their husbands to use a condom if she knows he has a disease)
Yes (ref)	1.00	–	–
No	1.51	1.06–2.17	0.024
Health care utilization
Ever had VCT
Yes (ref)	1.00	–	–
No	0.76	0.57–1.01	0.061

Ref=reference/baseline category.

^aCurrently married and cohabitating heterosexuals adults who participated in MZIMA adult health community cohort conducted in Ifakara, Tanzania.