title: Predictors of extra-marital partnerships among women married to fishermen along Lake Victoria in Kisumu County, Kenya.
abstract: BACKGROUND
  The vulnerability of women to HIV infection makes establishing predictors of women's involvement in extra-marital partnerships critical. We investigated the predictors of extra-marital partnerships among women married to fishermen.
  
  
  METHODS
  The current analyses are part of a mixed methods cross-sectional survey of 1090 gender-matched interviews with 545 couples and 12 focus group discussions (FGDs) with 59 couples. Using a proportional to size simple random sample of fishermen as our index participants, we asked them to enrol in the study with their spouses. The consenting couples were interviewed simultaneously in separate private rooms. In addition to socio-economic and demographic data, we collected information on sexual behaviour including extra-marital sexual partnerships. We analysed these data using descriptive statistics and multivariate logistic regression. For FGDs, couples willing to participate were invited, consented and separated for simultaneous FGDs by gender-matched moderators. The resultant audiofiles were transcribed verbatim and translated into English for coding and thematic content analysis using NVivo 9.
  
  
  RESULTS
  The prevalence of extra-marital partnerships among women was 6.2% within a reference time of six months. Factors that were independently associated with increased likelihood of extra-marital partnerships were domestic violence (aOR, 1.45; 95% CI 1.09-1.92), women reporting being denied a preferred sex position (aOR, 3.34; 95% CI 1.26-8.84) and spouse longer erect penis (aOR, 1.34; 95% CI 1.00-1.78). Conversely, women's age--more than 24 years (aOR, 0.33; 95% CI 0.14-0.78) and women's increased sexual satisfaction (aOR, 0.92; 95% CI 0.87-0.96) were associated with reduced likelihood of extra-marital partnerships.
  
  
  CONCLUSIONS
  Domestic violence, denial of a preferred sex positions, longer erect penis, younger age and increased sexual satisfaction were the main predictors of women's involvement in extra-marital partnerships. Integration of sex education, counselling and life skills training in couple HIV prevention programs might help in risk reduction.
authors.affiliation: Center for Microbiology Research, Kenya Medical Research Institute, Kisumu, Kenya.
authors.forename: Zachary
authors.initials: Z
authors.lastname: Kwena
authors.affiliation: Department of Community Health, Kenyatta University, Nairobi, Kenya.
authors.forename: Isaac
authors.initials: I
authors.lastname: Mwanzo
authors.affiliation: Department of Geography, Kenyatta University, Nairobi, Kenya.
authors.forename: Chris
authors.initials: C
authors.lastname: Shisanya
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Sciences, University of California at San Francisco, San Francisco, California, United States of America.
authors.forename: Carol
authors.initials: C
authors.lastname: Camlin
authors.affiliation: Department of Health Care Organization and Policy, University of Alabama at Birmingham, Birmingham, Alabama, United States of America.
authors.forename: Janet
authors.initials: J
authors.lastname: Turan
authors.affiliation: Center for Microbiology Research, Kenya Medical Research Institute, Kisumu, Kenya.
authors.forename: Lilian
authors.initials: L
authors.lastname: Achiro
authors.affiliation: Center for Microbiology Research, Kenya Medical Research Institute, Kisumu, Kenya.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Bukusi
mesh_terms: D005260:Female; D017144:Focus Groups; D006801:Humans; D007630:Kenya; D008297:Male; D008393:Marriage; D012725:Sexual Behavior
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