PLoS ONE (Jan 2024)

Hotspot areas of risky sexual behaviour and associated factors in Ethiopia: Further spatial and mixed effect analysis of Ethiopian demographic health survey.

  • Denekew Tenaw Anley,
  • Melkamu Aderajew Zemene,
  • Asaye Alamneh Gebeyehu,
  • Natnael Atnafu Gebeyehu,
  • Getachew Asmare Adella,
  • Gizachew Ambaw Kassie,
  • Misganaw Asmamaw Mengstie,
  • Mohammed Abdu Seid,
  • Endeshaw Chekol Abebe,
  • Molalegn Mesele Gesese,
  • Yenealem Solomon,
  • Natnael Moges,
  • Berihun Bantie,
  • Sefineh Fenta Feleke,
  • Tadesse Asmamaw Dejenie,
  • Ermias Sisay Chanie,
  • Wubet Alebachew Bayih,
  • Natnael Amare Tesfa,
  • Wubet Taklual,
  • Dessalegn Tesfa,
  • Rahel Mulatie Anteneh,
  • Anteneh Mengist Dessie

DOI
https://doi.org/10.1371/journal.pone.0303574
Journal volume & issue
Vol. 19, no. 5
p. e0303574

Abstract

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IntroductionSexual behaviour needs to take a central position in the heart of public health policy makers and researchers. This is important in view of its association with Sexually Transmitted Infections (STIs), including HIV. Though the prevalence of HIV/AIDS is declining in Ethiopia, the country is still one of the hardest hit in the continent of Africa. Hence, this study was aimed at identifying hot spot areas and associated factors of risky sexual behavior (RSB). This would be vital for more targeted interventions which can produce a sexually healthy community in Ethiopia.MethodsIn this study, a cross-sectional survey study design was employed. A further analysis of the 2016 Ethiopia Demographic and Health Survey data was done on a total weighted sample of 10,518 women and men age 15-49 years. ArcGIS version 10.7 and Kuldorff's SaTScan version 9.6 software were used for spatial analysis. Global Moran's I statistic was employed to test the spatial autocorrelation, and Getis-Ord Gi* as well as Bernoulli-based purely spatial scan statistics were used to detect significant spatial clusters of RSB. Mixed effect multivariable logistic regression model was fitted to identify predictors and variables with a p-value ≤0.05 were considered as statistically significant.ResultThe study subjects who had RSB were found to account about 10.2% (95% CI: 9.64%, 10.81%) of the population, and spatial clustering of RSB was observed (Moran's I = 0.82, p-value = 0.001). Significant hot spot areas of RSB were observed in Gambela, Addis Ababa and Dire Dawa. The primary and secondary SaTScan clusters were detected in Addis Ababa (RR = 3.26, LLR = 111.59, PConclusionIn this study, spatial clustering of risky sexual behaviour was observed in Ethiopia, and hot spot clusters were detected in Addis Ababa, Dire Dawa and Gambela regions. Therefore, interventions which can mitigate RSB should be designed and implemented in the identified hot spot areas of Ethiopia. Interventions targeting the identified factors could be helpful in controlling the problem.