Research Article
Determinants of Higher-Risk Sexual Behavior in Some Selected
African Countries
Adikwor Ewoenam Puplampu,
1
Seth Afagbedzi,
1
Samuel Dery,
1
Dzifa Adimle Puplampu,
2
and Chris Guure
1
1
Department of Biostatistics, School of Public Health, University of Ghana, Legon, Accra, Ghana
2
Center for Climate Change and Sustainable Studies, University of Ghana, Legon, Accra, Ghana
CorrespondenceshouldbeaddressedtoChrisGuure;cbguure@ug.edu.gh
Received 5 July 2021; Accepted 24 August 2021; Published 6 September 2021
AcademicEditor:Jos´ eA.Castro
Copyright©2021AdikworEwoenamPuplampuetal.isisanopenaccessarticledistributedundertheCreativeCommons
AttributionLicense,whichpermitsunrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalworkis
properly cited.
Background.Althoughhigher-risksexualbehavior(H-RSB)isamajorcontributortotherapidrisingrateofnewHIVinfections,
thereexistspaucityofcomprehensiveevidenceacrossthesub-SaharanAfricanregion.epurposeofthisstudywastodetermine
theprevalenceofH-RSBanditsdeterminantsacrosssub-SaharanAfricatoinformpolicy. Method.Datawereobtainedfromthe
DemographicandHealthSurvey(DHS)oftensub-SaharanAfrican(SSA)countrieswiththeirthreemostcurrentDHSsurveys
from 2000 to 2016. Only participants who ever had sexual encounters in their lifetime were included in the study. Weighted
adjustedCoxregressionwithrobustvarianceandconstanttimewasusedtoinvestigatedisparitiesofH-RSBamongthetenSSA
countries. Relationships between sociodemographic, socioeconomic, knowledge, mass media, and H-RSB were investigated.
Results. e trend and prevalence of higher-risk sexual behavior show that Lesotho experienced a decreasing trend of the
prevalenceofH-RSBfrom8.92inperiodoneto6.42inperiodthree.Ghanaexperiencedamarginalincreasefrom6.22inperiod
oneto6.76inperiodtwoandthento6.43inthethirdperiod.However,Malawi,Zambia,andZimbabweobtainedamarginal
increasingtrendintheprevalenceofH-RSBfromperiodonetothree:2.75to3.74,4.33to6.24,and6.11to7.99,respectively.
Meanwhile,theprevalenceofH-RSBinNamibiaandUgandadecreasedinperiodtwoto1.84and5.76butincreasedinperiod
threeto2.01and6.83,respectively.Generally,determinantsofH-RSBamongthecountriesincludeage,sex,religiousaffiliation,
marital status, educational level, employment status, economic status, age at first sex, and status of circumcision. Conclusion.
TrendofrelativelyhighprevalenceofH-RSBhasbeenfoundacrossmajorityofthecountrieswithkeysociodemographicfactors
influencingH-RSB.erefore,differenttargetedinterventionalapproachesareneededinallthecountriestohelpreduceH-RSB
andtheoverallHIVincidence.Ifissuesregardingsexualbehaviorandsexualhealtharenotaddressedadequately,H-RSBcan
negate all the appreciable efforts aimed at ending the HIV pandemic by 2030.
1. Introduction
Sub-Saharan Africa is home to an estimated 12% of the
worldwidepopulationyetaccountsformorethan70%ofthe
globalburdenofHIVinfections[1,2].eadultprevalence
ofHIVintheregionishighcomparedtootherregionsofthe
globe.In2014,70%oftheinfectionsintheworldand66%of
newinfectionsanddeathsrelatedtoHIVeachoccurredin
the subregion [1]. Again in 2017, an estimated 71% of the
world’sinfections,65%ofnewinfections,and75%ofdeaths
relatedtoAIDSwererecordedintheregion[3].ereexists
asignificantdifferenceintheseverityoftheepidemicwithin
the subregion [4]. ere is also an association between
geographical distributions and the spread of the HIV epi-
demicinsomepartsoftheregion[5].Althoughmostofthe
countriesintheregionshareaconsiderablenumberofthe
epidemiologic attributes, substantial subregional variation
exists in the severity of these epidemics [6]. Adult HIV
prevalence is generally highest (>10%) in Southern Africa,
intermediateinCentralandEastAfrica,andlower(<5%)in
West Africa. e trends in new HIV infections across
countries in SSA have shown a decline by more than 33%
Hindawi
Scientifica
Volume 2021, Article ID 8089293, 13 pages
https://doi.org/10.1155/2021/8089293