Women who want sex in Belize

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Women who want sex in Belize

Try out PMC Labs and tell us what you think. Learn More. New York, NY. Chapel Hill, NC. Guatemala City, Guatemala. Tegucigalpa, Honduras. research suggests that migration and high rates of multiple sexual partnerships are major drivers of the epidemic.

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Among both men and women, temporary migration in the last year was associated with an increased likelihood of multiple sexual partnerships and with concurrency, though only the association between migration and multiple sexual partnerships among men was statistically ificant Adjusted Prevalence Ratio 1. Research conducted among men and women at elevated risk of HIV should continue to incorporate measures of mobility, including history of internal migration.

Recent estimates place the national prevalence at 0. While a multitude of factors contributed to the initial spread of HIV in Honduras, epidemiologists attribute it in part to the increased presence of foreign military forces in the s and the corresponding surge in commercial sex work 34. Numerous studies show that temporary migration can alter existing sexual partnerships, and provide mobile individuals opportunities to acquire new partners. Migrants physically separated from their usual social norms and networks may experience social isolation 23 — 25 and feel emotionally distanced from partners at home 2426which can result in the uptake of substance use and other HIV-related risk behaviors that increase the probability of unprotected sex and exposure to HIV 242527 — Whether they remain home or migrate Women who want sex in Belize different destinations, partners of migrants may also engage in other sexual relationships during periods of separation 121331 — If remittances from migrant partners are delayed or insufficient, women may exchange sex for money in order to cover individual or familial expenses 1331 Such patterns of migration facilitate sexual concurrency overlapping sexual partnershipsas migrants and their partners may initiate new partnerships while separated and relations during periods of reunification 2334 — While a of studies have documented the increased vulnerability to HIV and other STIs faced by Mexican and Central American migrants and their partners 35epidemiologic evidence has not consistently linked the mobility of these groups to increased s of sexual partners, or to increases in sexual concurrency.

In contrast, social norms consistently proscribed women having more than one sexual partner at a given time 17 Participants were chosen through simple random sampling within selected households, with a maximum of one male and one female participant per household. Field staff visited the household of selected individuals to invite them to participate.

If the selected individual was not available, the study staff obtained permission from other household residents to make up to Women who want sex in Belize additional visits to recruit the individual. Willing and eligible individuals were given a written invitation to visit the closest study site and complete the related study procedures. Data collection occurred at seven public health centers, each located near the community or district from which individuals were recruited. At these clinical sites, study staff administered informed consent forms and obtained participant atures prior to the initiation of study procedures.

In a private area, trained interviewers administered a standardized survey on an electronic tablet or on paper if technical difficulties arose. The survey covered subject demographics, HIV knowledge and attitudes, history of HIV testing, drug and alcohol use, and a detailed history of sexual behavior and recent sexual partnerships.

After administering the introductory section, interviewers provided participants with sufficient literacy the option to self-administer the survey, aside from the section covering sexual concurrency, which was administered by the interviewer. Interviewers provided instructions on how to use the electronic tablets, and remained in the same private area with the participant as they completed the questionnaire to address any questions or concerns.

All surveys were administered in Spanish. A of survey items captured details regarding the recent migration history of participants and their partners. Participants were asked how much time they spent outside their current city or community of residence in the last 12 months. Participants who reported having a partner who had worked elsewhere were also asked how much time that partner had spent outside the city or community where the respondent resided in the last 12 months.

Individuals were defined as having migrated if they spent more than one month outside their community of residence in the last 12 months. This measure was specific to a substantial length of time away from home that allowed for repeated or prolonged exposure to other sexual partners, regardless of whether that migration was employment-related. Participants were defined as having migrant partners if they reported having a partner in the last 12 months who spent more than one month away from the community where the respondent resided.

Additional information on where participants and their partners worked and traveled within and outside of Honduras was also collected. Key outcomes were: 1 multiple sexual partnerships and 2 concurrent sexual partnerships in the last 12 months.

Participants were asked to report their total of sexual partners in the last 12 months, and were reminded that this count could include stable, casual, and commercial partners. Participants reporting two or more sexual partners in the last 12 months were defined as having multiple sexual partnerships. To assess the presence of concurrent sexual partnerships, participants were asked to provide detailed profiles of their last three sexual partners within the last 12 months, including the dates of first and last sex.

Interviewers were required to administer this section of the survey to maximize data quality, and received detailed training in concurrency assessment prior to the initiation of data collection.

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When necessary, interviewers facilitated participants' recall of the start and end dates of sexual relationships through prompting when these occurred relative to important dates on their personal or social calendar, such as birthdays or holidays. Participants were defined as having concurrent partnerships if, based on these dates, there was temporal overlap between two or more of the three most recent sexual partnerships within the last year. While UNAIDS recommends assessing the presence of temporal overlap of partnerships six months prior to the interview date 54we adapted the measure by using the date of interview as the reference point in order to maximize participant comprehension and recall.

Our definition was conservative, such that participants with two or more sexual partners in the last year were defined as not having concurrent partnerships if a temporal overlap between two or more recent partners could not definitively be established due to incomplete or missing data.

As we hypothesized that migration experiences, partnership patterns, and their association may differ between men and women, all analyses were conducted separately by gender. Descriptive statistics regarding population demographics, migration history, and recent sexual partnership characteristics are presented as raw counts accompanied by proportions weighted to reflect the individual probability of inclusion in the sample, based on the clustered and stratified sampling de and the likelihood Women who want sex in Belize non-response across the entire study population.

A of demographic and behavioral variables were evaluated for their potential to confound the association between migration and having 1 multiple or 2 concurrent sexual partnerships, including age, urban residence, marital status, education, current employment status, income, presence of economic dependents, age at first sex, and experience of forced or transactional sex.

We compared the sociodemographic profile, exposure and outcome frequencies, and the distribution of recent sexual partnership indicators of men and women in our sample, and used the de-based Pearson's chi-squared test statistic to assess whether ificant differences existed. Univariate, bivariate, and multivariable binomial regression analyses were conducted using Stata svy commands to adjust parameter estimates and standard errors to for the sampling de, with the primary sampling unit defined as the community or district from which the participant was selected, and with each sampling unit grouped into either the urban or rural stratum.

Probability weights were constructed by multiplying the inverse of the total individual probability of selection by the non-response factor based on the fraction of the expected sample who participated. In order to maximize the precision of effect estimates, covariates were dropped from the regression model if doing so did not result in more than a ten percent change in the main effect estimate or increase the standard error corresponding to that estimate.

Sensitivity analyses were conducted to determine the effect of missing values for participants' concurrency status; we produced bounds on the estimated prevalence of concurrency and association between migration and concurrency by redefining participants with indeterminate concurrency status either all non-concurrent minimum prevalence bound or all concurrent maximum prevalence bound. All analyses were conducted using Stata version Of the individuals selected to participate in the survey, provided informed consent. We analyzed data from the individuals men and women whose completed survey responses were available.

The mean age of survey participants was The overall age distribution was similar among men and women, though a higher Women who want sex in Belize of men were under age 25 Table I. Forty-three percent of the population was rural, and roughly half Men were ificantly more likely to be employed than women Women were more likely than men to be married or in a union libre similar to a common-law marriage, usually implying cohabitationand to have economic dependents, though the differences were not ificant.

Migration experience in the last year was substantial, and as expected, differed by gender Table II. Among all men, Fifteen percent of all men spent more than one month outside their home community in the last 12 months. Men who migrated were more likely to be married A smaller proportion of women were migrants 8. The most common destinations to migrate for work among both men and women were San Pedro Sula and La Ceiba -- the second and third largest cities in Honduras, respectively -- and the smaller coastal cities of Trujillo and Tela.

Less than two percent of men and one percent of women worked outside of Honduras in the 12 months, though greater proportions of both men 9. Women were ificantly more likely than men to have migrant partners; Among the sociodemographic and behavioral variables investigated, only age emerged as a ificant correlate of migration among women; Men reported a greater of sexual partners in the last year compared to women mean 2. Men were also more likely to report having sexual partners outside their home community Men were more than four times as likely to have had multiple sexual partnerships in the last 12 months, compared to women In an adjusted binomial regression model Table IIImen who spent more than one month away from home had an increased likelihood of multiple sexual partnerships in the last 12 months APR 1.

Multiple sexual partnerships were more likely among men aged and men who were not currently married or in a union libre APRs 1. Migrant women were more likely to have multiple sexual partners in the last 12 months than non-migrant women, though precision was poor and the association was not ificant APR 3. Having multiple sexual partnerships was ificantly less likely among women who were 18 or older at sexual debut APR 0.

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Among the respondents who reported having at least two partnerships in the last year, only 80 provided sufficient information to determine whether they had concurrent partnerships. Thus, bounds were applied to the estimates of concurrency by defining all those with indefinite status as non-concurrent minimum bound or concurrent maximum bound as described above. Among those with complete information, In contrast, only 2. In both unadjusted and adjusted models, migrant men had a higher prevalence of sexual concurrency in the last year compared to non-migrant men APR 1.

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In adjusted models, the only major correlates of sexual concurrency were having less education APR 0. The main effect estimates and corresponding confidence intervals for the association between migration and concurrency were minimally altered when the minimum and maximum prevalence bounds of concurrency were used as described above adjusted prevalence ratios ranged from 1.

Concurrency was also more prevalent among migrant women, though the low incidence of the outcome resulted in very low precision for the estimated prevalence ratio APR 3. The effect estimate was also sensitive to defining missing outcomes as either concurrent or non-concurrent, as the corresponding adjusted prevalence ratios for having migrated ranged from 2.

In the final model omitting observations missing concurrency values, younger age years old was associated with an increased probability of concurrency APR 3. Initially, we sought to investigate whether within-partnership migration migration of either an individual or their partner was associated with multiple sexual partnerships or concurrency.

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However, only five men reporting having a partner who spent more than one month away from home, limiting our ability to investigate the effect of partners' migration on men's Women who want sex in Belize of concurrency. Among women who reported having at least one partner in the last 12 months, those with migrant partners were less likely to have multiple sexual partners themselves, relative to women whose partners did not migrate APR 0.

Thus, we did not combine partner's migration history with individual migration history as a single exposure variable, as they had opposing effects on the probability of having multiple sexual partnerships among women. There were no women with migrant partners who reported having concurrent partnerships themselves.

However, the evidence is less compelling for the association between temporary migration and concurrency, which was less prevalent than expected. It is possible that in this context, migration more meaningfully impacts sexual partnership patterns by increasing the likelihood of partnership dissolution and the of serial partnerships, rather than through facilitating concurrent partnerships.

Prior research conducted among Mexican men and Puerto Rican women indicates that extensive time in the United States is associated with union dissolution 5657but less is known about the impact of shorter-term internal migration on marital and non-marital partnerships in Central America.

Among women, there was a strong association between temporary migration and having multiple sexual partnerships in the last 12 months, though the corresponding confidence interval was wide and included the null. In recent studies conducted in sub-Saharan Africa, female migrants were similarly shown to have a ificantly higher of lifetime partners 58 and recent partners 59 relative to non-migrants. In our sample, the magnitude of association between temporary migration and having multiple sexual partners was even larger among women than among men APR 3.

APR 1. Still, the impact of women's mobility on sexual behavior merits further inquiry 59 Recent sex work and recent experiences of forced sex were rare in this sample, and were not associated with recent migration. Prior literature has described the social spaces that both migrant and non-migrant Latino men access to meet sexual partners 252661but has not provided sufficient characterization of the social environments and types of venues in which migrant women in Central America meet consensual, non-commercial partners. Additional research in this area may enhance the effectiveness of both surveillance and intervention efforts Women with migrant partners may be monitored by peers and family members during their partner's absence, as has been reported elsewhere in the region 3263thus limiting the opportunity to form new partnerships.

In the wave of this surveillance study, Among youth, increases in perceived risk of HIV acquisition and modest attitudinal changes acknowledging the benefits of sexual fidelity have also been observed 50 Thus, it is possible that increased HIV awareness has contributed to a reduction in sexual partners.

A of limitations may have affected the validity and generalizability of our. Research involving mobile populations necessarily involves methodological challenges.

Women who want sex in Belize

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