Date of Conferral

2020

Degree

Doctor of Public Health (DrPH)

School

Public Health

Advisor

Vasileios Margaritas

Abstract

Risky sexual behavior (RSB) is a major public health concern due to health outcomes, such as HIV/AIDS, sexually transmitted infections, and unwanted pregnancies. RSB has been identified as 1 of the main components contributing to the high HIV incidence rate in sub-Saharan Africa. The purpose of the current research was to investigate RSB and its association with education and economic status among men and women in 3 sub-Saharan African countries (i.e., Rwanda, Zimbabwe, and Cameroon) while controlling for gender, age, religion, and place of residence. The social cognitive theory provided the framework for this cross-sectional study that included data from the Demographic Health Survey (2011–2015), with a total combined sample size of 39,052 participants. Regression analysis revealed that the odds of people engaging in high RSB was greater for Cameroon (OR = 1.518, 95% CI = 1.267-1.913) and for rural areas (OR = 1.373, 95% CI = 1.150-1.639), while the odds of engaging in RSB was lower for the richest (OR = 0.702, 95% CI = 0.545-0.904), for those with higher education (OR = 0.214, 95% CI = 0.119-0.387), and for 35–49 age group (OR = 0.380, 95% CI = 0.310-0.465). The findings of this study can be used to provide a better understanding of RSB determinants, contributing to HIV/AIDS prevention practice, and estimating the socio-economic gap in RSB. Policy makers should design programs for specific countries that are aimed at enabling communities to limit RSB and make healthier choices in their sex lives.

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