Tanzania HIV/AIDS and Malaria Indicator Survey ... - Measure DHS

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HIV/AIDS-RELATED BEHAVIOUR 77.1 INTRODUCTIONThis chapter explores the prevalence of behaviours that relate to and influence the HIV/AIDSepidemic and other related infections. Discussed are issues such as age at sexual debut, multiplesexual partners, and sex with commercial sex workers, all of which are related to higher risk ofspreading HIV and other Sexually Transmitted Infections (STIs). The chapter also examines theprevalence of sexually transmitted infections and their symptoms among women and men age 15-49.Moreover, information on the prevalence of voluntary counselling and testing for HIV is discussed.Finally, information on the use of injections is examined. To show trends for selected indicators,comparisons are made with previous surveys, i.e., the 2003-04 Tanzania HIV/AIDS Indicator Survey(THIS) and the 2004-05 Tanzania Demographic and Health Survey (TDHS).7.2 AGE AT FIRST SEXUAL INTERCOURSEAge at first sexual intercourse is of particular interest as HIV in Tanzania is mainlytransmitted through heterosexual contact. Thus, analyzing data on age at first sex is a way tounderstand when individuals are first exposed to the risk of infection with the HIV virus. The 2007-08Tanzania HIV/AIDS and Malaria Indicator Survey (THMIS) collected information on the timing offirst sexual intercourse for both women and men. The data are presented in Table 7.1.Table 7.1 Age at first sexual intercoursePercentage of women and men age 15-49 who had first sexual intercourse by specific exact ages, percentagewho never had intercourse, and median age at first intercourse, according to current age, Tanzania HMIS2007-08Percentage who had first sexualintercourse by exact age:Current age 15 18 20 22 25WOMENPercentagewho neverhadintercourseNumberMedianage at firstintercourse15-19 10.7 na na na na 54.1 1,984 a20-24 11.5 58.8 82.4 na na 7.1 1,746 17.525-29 11.6 56.2 78.3 86.9 90.8 1.4 1,603 17.530-34 14.2 55.9 78.8 86.7 89.6 0.7 1,346 17.535-39 16.7 60.7 79.3 87.5 91.5 0.1 1,175 17.040-44 16.1 59.1 77.5 87.3 92.0 0.0 774 17.245-49 20.8 65.3 80.7 89.3 92.3 0.1 714 16.720-49 14.2 58.7 79.7 na na 2.1 7,359 17.325-49 15.1 58.6 78.8 87.3 91.0 0.6 5,613 17.315-24 11.1 na na na na 32.1 3,730 aMEN15-19 10.8 na na na na 64.4 1,768 a20-24 8.1 41.8 69.8 na na 17.8 1,148 18.525-29 7.1 40.7 67.3 82.6 92.2 4.5 1,004 18.530-34 9.3 40.9 70.0 83.9 92.9 0.8 1,004 18.535-39 9.1 40.2 67.2 82.0 89.7 0.8 842 18.540-44 8.1 39.4 65.6 81.1 88.2 0.3 628 18.645-49 5.8 39.1 63.9 80.9 89.7 0.3 581 18.620-49 8.0 40.6 67.8 na na 5.1 5,207 18.525-49 8.0 40.2 67.2 82.3 90.9 1.5 4,059 18.515-24 9.7 na na na na 46.1 2,916 ana = Not applicable because of censoringa = Omitted because less than 50 percent of the respondents had intercourse for the first time beforereaching the beginning of the age groupHIV/AIDS-Related Behaviour | 73
The data show that while women and men both initiate sexual activity early, it is particularlythe case for women. Fourteen percent of women age 20-49 first had sex before they were 15 andalmost six in ten (59 percent) had first sex before the age of 18. Looking at the median age at first sexby age group, there appears to be a tendency for younger women to delay sex compared with womenage 35-49. The median age at first sex for women is 17.3 years.Men initiate sexual activity somewhat later than women. Among men age 20-49, only 8percent had sex before they were 15, while 41 percent had sex before age 18 and 68 percent had sexby age 20. The median age at first sex for men is 18.5 years.Comparison of these results with data from the 2003-04 THIS indicates that there has beenlittle change in age at sexual debut. However, the median age at first sex for women 20-24 hasdeclined slightly from 17.7 to 17.5 years in 2007-08, while for men it has remained the same at 18.5years.7.3 RECENT SEXUAL ACTIVITYIn the absence of contraception, the chances of becoming pregnant are related to the frequencyof sexual intercourse. Thus, information on sexual activity can be used to refine measures ofexposure to HIV and other sexually transmitted infections, as well as pregnancy. Women and meninterviewed in the THMIS were asked when they last had sex. Tables 7.2.1 and 7.2.2 show thedistribution of women and men, respectively, according to the timing of last sexual activity, bybackground characteristics.The data show that over half of women and men age 15-49 were sexually active in the fourweeks preceding the survey (56 percent of women and 55 percent of men), while about three-quartershad had sex in the 12 months before the survey. Thirteen percent of women and 20 percent of menage 15-49 had never had sexual intercourse at the time of the survey.Among women, the level of recent sexual activity (within the four weeks preceding thesurvey) reaches a broad peak at ages 25-44. In the youngest age groups, recent sexual activity amongmen is lower than that among women; however, from ages 25-29, the proportion of men who havehad sex in the past month exceeds that for women. As expected, recent sexual activity is far morecommon among currently married women and men than among those who never married or who aredivorced, separated, or widowed (Figure 7.1). For example, 78 percent of currently married womenand 86 percent of currently married men reported having had sex in the four weeks before the survey,compared with only 13 percent of never-married women and 17 percent of never-married men. Recentsexual activity does not decline with the duration of marriage; in fact, among married men, theproportion who had sex in the four weeks before the survey is highest among those married for 25years or more (93 percent).Both women and men in rural areas are more likely to have had sex in the four weeks beforethe survey than their urban counterparts. The proportion of women who reported recent sexual activityranges from 45 percent in Kilimanjaro and Iringa regions to 67 percent in Shinyanga region. Therange is greater among men, from 39 percent in Kilimanjaro region to 69 percent in Lindi region.Women and men with more education are less likely than those with less education to have had sex inthe past four weeks. Recent sexual activity by household wealth status generally decreases withincreasing wealth quintile, especially for men.74 | HIV/AIDS-Related Behaviour
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TanzaniaHIV/AIDS and MalariaIndicat
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The 2007-08 Tanzania HIV/AIDS and M
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3.5 Access to Mass Media ..........
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12.2 Orphans and Vulnerable Childre
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Table 4.3Table 4.4Table 4.5Table 4.
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Figure 9.2 HIV Prevlence by Region/
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FOREWORDThis report presents the ma
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SUMMARY OF FINDINGSThe 2007-08 Tanz
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HIV prevalence among youth (women a
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xxii | Map of Tanzania
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1.2 NATIONAL POLICY ON HIV/AIDSIn r
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To assess levels and trends in know
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1.8 FIELDWORKData collection was ca
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Table 1.1 Results of the household
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Figure 2.1 presents a graphic pictu
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Table 2.3.1 Educational attainment
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Educational attainment is higher in
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2.5.1 Energy SourcesTable 2.5 prese
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The most common items are agricultu
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The 2007-08 THMIS included aquestio
Page 45 and 46: Table 3.1—ContinuedBackgroundchar
Page 47 and 48: Education is positively related to
Page 49 and 50: Table 3.3.2 Employment status: MenP
Page 51 and 52: Table 3.4.1 Exposure to mass media:
Page 53 and 54: 3.6 CURRENT MARITAL STATUSMarriage
Page 55 and 56: Polygyny also varies by household w
Page 57 and 58: Four in ten women age 20-49 marry b
Page 59 and 60: There is a positive relationship be
Page 62 and 63: FERTILITY AND REPRODUCTIVE HEALTH 4
Page 64 and 65: Table 4.2 Fertility by background c
Page 66 and 67: infertility, 1 or the inability to
Page 68 and 69: 4.3 ADOLESCENT FERTILITYAdolescent
Page 70 and 71: Table 4.7 Antenatal carePercent dis
Page 72: Table 4.8 Place of antenatal carePe
Page 75 and 76: Table 5.1 Knowledge of AIDSPercenta
Page 77 and 78: The use of condoms as an effective
Page 79 and 80: Table 5.3.2 Comprehensive knowledge
Page 81 and 82: more education) and those in the fo
Page 83 and 84: Table 5.5.1 Exposure to HIV educati
Page 85 and 86: 5.6 KNOWLEDGE AND ATTITUDE CONCERNI
Page 87 and 88: Table 5.6.2 Knowledge and attitudes
Page 89 and 90: Table 6.1.1 Accepting attitudes tow
Page 91 and 92: Stigma is also found to vary with l
Page 93 and 94: 6.3 ATTITUDES OF ADULTS TOWARDS EDU
Page 98 and 99: Table 7.2.1 Recent sexual activity:
Page 100 and 101: Figure 7.1 Recent Sexual Intercours
Page 102 and 103: Table 7.3.2 Multiple sexual partner
Page 104 and 105: Table 7.4 Payment for sexual interc
Page 106 and 107: Table 7.5.1 Coverage of prior HIV t
Page 108 and 109: Figure 7.2 Prior HIV Testing by Edu
Page 110 and 111: 7.7 PREVALENCE OF SEXUALLY TRANSMIT
Page 112 and 113: Figure 7.3 Prevalence of STIs and S
Page 114: Table 7.8 Prevalence of medical inj
Page 117 and 118: Table 8.1 Comprehensive knowledge a
Page 119 and 120: Table 8.2 Age at first sexual inter
Page 121 and 122: Never-married women and men age 15-
Page 123 and 124: Figure 8.3 Condom Use at Premarital
Page 125 and 126: Table 8.5.2 Higher-risk sexual inte
Page 127 and 128: Table 8.6 Age-mixing in sexual rela
Page 129 and 130: 8.9 HIV TESTING AMONG YOUNG PEOPLEK
Page 132 and 133: HIV PREVALENCE 99.1 INTRODUCTIONPri
Page 134 and 135: Table 9.1 Coverage of HIV testing b
Page 136 and 137: Table 9.1—ContinuedBackgroundchar
Page 138 and 139: Table 9.3 HIV prevalence by ageAmon
Page 140 and 141: There are large variations in HIV p
Page 142 and 143: Table 9.5 shows that men who are cu
Page 144 and 145: Women who said they had higher-risk
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Table 9.8 shows data on HIV prevale
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Table 9.11 HIV prevalence by male c
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INFANT AND CHILD MORTALITY 1010.1 I
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As expected, the level of infant an
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category (1.41) is 41 percent highe
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11.1 OWNERSHIP AND USE OF MOSQUITO
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carrying mosquitoes. Much of the fi
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11.2 USE OF ANTIMALARIAL DRUGS DURI
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11.3 TREATMENT OF CHILDREN WITH FEV
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11.4.1 Type and Timing of Antimalar
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11.4.2 Availability of Drug at Home
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11.6 SOURCE OF MOSQUITO NETSUntil l
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In spite of steady increases in ITN
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ORPHANS AND VULNERABLE CHILDREN 12P
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12.2 ORPHANS AND VULNERABLE CHILDRE
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12.3.1 School Attendance by Survivo
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While there are no differences in p
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Table 12.7 Widows dispossessed of p
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Table 12.9 External support for orp
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REFERENCESAgot, K.E., J.O. Ndinya-A
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SAMPLE IMPLEMENTATIONAPPENDIX AAppe
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Table A.2 Sample implementation: Me
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Table A.4 Coverage of HIV testing a
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Table A.6 Coverage of HIV testing a
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where h represents the stratum whic
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Table B.2 Sampling errors for Natio
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Table B.4 Sampling errors for Rural
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Table B.6 Sampling errors for Mainl
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Table B.8 Sampling errors for Mainl
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Table B.10 Sampling errors for Zanz
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Table B.12 Sampling errors for Nort
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Table B.14 Sampling errors for Sout
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Table B.16 Sampling errors for East
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Table B.18 Sampling errors for Dodo
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Table B.20 Sampling errors for Kili
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Table B.22 Sampling errors for Moro
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Table B.24 Sampling errors for Dar
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Table B.26 Sampling errors for Mtwa
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Table B.28 Sampling errors for Irin
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Table B.30 Sampling errors for Sing
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Table B.32 Sampling errors for Rukw
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Table B.34 Sampling errors for Shin
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Table B.36 Sampling errors for Mwan
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Table B.38 Sampling errors for Many
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Table B.40 Sampling errors for Pemb
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216 | Appendix B
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Joyce MbambaYulitha MwakasoleRemigi
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QUESTIONNAIRESAppendix DAppendix D
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HOUSEHOLD SCHEDULEIntroduction and
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IF AGE 0-17 YEARSIF AGE 5 YEARS OR
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IF AGE 0-17 YEARSLINE SICK CARE SUR
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HOUSEHOLD CHARACTERISTICSNO. QUESTI
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NO. QUESTIONS AND FILTERS CODING CA
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SUPPORT FOR SICK PEOPLENO. QUESTION
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NO.QUESTIONS AND FILTERSSUPPORT FOR
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NO.QUESTIONS AND FILTERSCODING CATE
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CHILD 4 CHILD 5 CHILD 6502 LINE NUM
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515 CHECK 509:NUMBER OF CHILDREN WI
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UNITED REPUBLIC OF TANZANIATANZANIA
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213 214 215 216217 218219 220221222
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LAST BIRTH NEXT-TO-LAST BIRTH SECON
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LASTSEXUAL PARTNERSECOND-TO-LASTSEX
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SECTION 7 - HIV TESTTHIS PAGE TO BE
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