Date of Completion

5-10-2014

Embargo Period

5-2-2014

Advisors

Dr. Joseph Burleson, Dr. Richard Stevens

Field of Study

Public Health

Degree

Master of Public Health

Open Access

Open Access

Abstract

Purpose of the Research:

The purpose of this study is to identify how differences in sexual behaviors related to HIV/AIDS are influenced by geographic location, specifically urban and rural regions of Tanzania. By analyzing populations from urban and rural areas, the social factors associated with the regions are hypothesized to influence HIV/AIDS-related behaviors differently with varied outcomes.

Methods Used:

This study used data from the 2011-12 Tanzania HIV/AIDS and Malaria Indicator Survey (THMIS). The data includes both individual and household responses concerning knowledge and attitudes about HIV/AIDS, access to health care and risky sexual behaviors. The sexual behaviors/practices included in the analysis include (1) multiple sexual partners, (2) age of first sexual intercourse, (3) condom use, and (4) paying for sexual intercourse.

Major Findings

Rural participants were found to be socioeconomically disadvantaged in wealth and education, but also had less HIV/AIDS-related knowledge, access to health care, and had more negative attitudes about HIV/AIDS than urban participants. Rural males were more likely than urban males to have ever paid anyone in exchange for sex, and rural participants were less likely to use a condom during the last sex with their most recent partner.

Rural males with HIV/AIDS-related knowledge (Score of 3.00) were significantly more likely to have ever paid anyone in exchange for sex (20%) than urban males with HIV/AIDS-related knowledge (15%).

Overall, participants who reported using a condom during the last sex with their most recent partner generally had adequate HIV/AIDS-related knowledge, compared to those who did not use a condom during the last sex with their most recent partner. However, there was a significant difference between urban and rural participants: 30% of urban participants with positive attitudes about HIV/AIDS (Score of 3.00) used a condom during the last sex with their most recent partner, compared to 22% of rural participants with positive attitudes about HIV/AIDS.

There was not a significant difference for HIV/AIDS-related knowledge and age at first sex among urban (M=15.9, SD=8.7) and rural participants (M=16.0, SD=9.7). Overall, participants with adequate access to health care had higher ages at first sex than those with less access to health care. Rural participants with access to health care had a significantly higher age at first sex (M=17.6, SD=8.6) than urban participants (M=17.5, SD=7.8). Urban participants in the richest quintile of wealth had a significantly higher age at first sex (M=15.3, SD=8.8) than rural participants in the richest quintile (M=15.2, 10.8). There is a significant association between education and age at first sex: participants with a higher number of years of education were more likely to have had a higher age at first sex than those with less education.

Conclusion

One of the fundamental tools which could help relieve the HIV/AIDS epidemic in Tanzania is by providing educational resources to people living throughout urban and rural regions. Education has been positively associated with HIV/AIDS-related knowledge, positive attitudes about HIV/AIDS and access to health care. An increase in knowledge about HIV/AIDS, positive attitudes and access to health care will ultimately decrease the stigma surrounding safe sex practices and people living with HIV/AIDS.

Additional Files
Approval Page_AshleyERobinette.pdf (14 kB)
Approval Page

Major Advisor

Dr. Trini Mathew

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