DETERMINANTS OF HIGH-RISK SEXUAL-BEHAVIOR AND CONDOM USE AMONG ADULTSIN THE ARUSHA REGION, TANZANIA

Determinants of multiple sexual partners and condom use among adults w ere assessed through a population-based survey in one urban, one semi- urban and one rural community in the Arusha region, northern Tanzania. The study samples were obtained by randomly selecting clusters of 10 households from the 3 communities. Informed verbal consent was sought from each respondent for participation in the study. High-risk sexual behaviours and condom use were assessed using a structured questionnai re. It was observed that significantly more men than women reported ha ving multiple sexual partners (49% vs 25.2%; OR=1.69; 95% CI=1.51-1.90 ) and urban men were significantly more likely to report having multip le sexual partners than men in rural areas. In both men and women, ear ly sexual debut was associated with having multiple sexual partners wh ile travel, alcohol use, and sex under the influence of alcohol were s ignificantly associated with multiple sexual partners in men only. AID S-related discussion was significantly associated with having fewer se xual partners in both men and women. Of the 1551 respondents, 320 (20. 6%) reported having ever used a condom and of the 320 respondents who had ever used a condom, 34 (10.6%) reported having used it at the last sexual intercourse. Significantly more men than women reported having ever used a condom (34.1% vs 14.1%; OR=1.77; 95% CI=1.56-2.01). In bo th men and women, early sexual debut and being young, unmarried, trave lling out of the Arusha region and having multiple sexual partners wer e associated with increased condom use. For both men and women, freque nt discussion of AIDS with family members or friends was associated wi th increased condom use. These data suggest that interventions targeti ng adolescents and young adults may be effective for control of HIV tr ansmission in Tanzania. In particular, creation of opportunities for p eople to come together and discuss AIDS might be an important strategy .