Wealth and sexual behaviour among men in Cameroon

Area of Science:

• Epidemiology
• Public Health
• Sociology

Background:

• Cameroon's 2004 Demographic and Health Survey (DHS) indicated higher HIV prevalence among wealthier and more educated populations.
• Unsafe sexual behavior is a primary driver of HIV epidemics in sub-Saharan Africa.
• The study investigates the link between socioeconomic status and sexual practices in Cameroon.

Purpose of the Study:

• To examine the association between wealth and sexual behavior in Cameroon.
• To understand the role of sexual behaviors in the higher HIV prevalence observed in wealthier populations.

Main Methods:

• Analysis of data from 4409 sexually active men (aged 15-59) from the Cameroon DHS.
• Logistic regression models were used to determine odds ratios (OR) and confidence intervals (CI).
• Adjustments were made for confounding factors like marital status, residence, religion, and age.

Main Results:

• Wealthier men were less likely to use condoms with non-spousal partners (OR 0.43) and more likely to have multiple concurrent (OR 1.38) and lifetime (OR 1.97) partners.
• Educated men were less likely to use condoms (OR 0.24) and more likely to start sexual activity early (OR 2.73) and have multiple lifetime partners (OR 2.59).
• No significant differences were found in the purchase of sexual services based on wealth or education.

Conclusions:

• Wealthier and educated men exhibit higher-risk sexual behaviors, potentially explaining elevated HIV prevalence.
• Findings suggest a need for HIV prevention messages to reach all socioeconomic strata.
• Prevention efforts should not be solely focused on disadvantaged groups.