Mobile phones, sexual behaviors and HIV incidence in Rakai, Uganda from 2010-2018

Background: Sub-Saharan Africa has the highest HIV incidence and prevalence in the world. In the past decade mobile phone ownership has doubled – impacting social and sexual practices. Using longitudinal follow-up data, this study examined if mobile phone ownership was associated with sexual behaviors and HIV incidence for youth and adults. Methods: The Rakai Community Cohort Study gathers demographic and sexual health information and conducts HIV testing among an open cohort in southcentral Uganda every 12-18 months. Results: Of the 10,618 participants, 58% owned a mobile phone, 69% lived in rural locations and 77% were sexually active. Analyses were adjusted for time, location, religion and socioeconomic status. Phone ownership was associated with increased odds of ever having had sex for 15-19-year-olds (men AOR 2.12, 95% CI 1.78-2.52; women AOR 3.20, 95% CI 2.45-4.17). Among sexually active participants, owning a phone was associated with increased odds of having 2 or more concurrent sex partners (15-24-year-old men AOR 1.76, 95% CI 1.34-2.32; 25-49-year-old men AOR 1.81, 95% CI 1.54–2.13; 25-49-year-old women AOR 1.81, 95% CI 1.32-2.49). For men, phone ownership was associated with increased odds of circumcision (15-24-year-old men AOR 1.24, 95% CI 1.08-1.41; 25-49-year-old men AOR 1.12, 95% CI 1.01-1.24). Phone ownership was not associated with HIV incidence. Conclusion: Although mobile phone ownership was associated with sexual risk behaviors, it was not associated with increased risk of HIV acquisition. Research should continue exploring how phones can be used for reducing sexual health risk. Corresponding Author and Request for Reprints: Philip Kreniske, HIV Center for Clinical and Behavioral Studies New York State Psychiatric Institute and Columbia University, 1051 Riverside Drive # 15, New York, NY 10032, Phone: 001-646-774-7001, Division Fax number: (646) 774-6955 Conflict of Interest and Source of Funding: This project was supported by a grant from the National Institute of Child Health and Human Development (R01HD091003, Principal Investigator John Santelli, MD, MPH). In addition, Philip Kreniske’s contribution was also supported by grants from the National Institute of Mental Health (K01MH122319, Principal Investigator Philip Kreniske, PhD; T32 MH019139 Principal Investigator, Theodorus Sandfort, PhD) and an award to the HIV Center for Clinical and Behavioral Studies at the New York State Psychiatric Institute and Columbia University (P30MH43520, Principal Investigator: Robert Remien, PhD). * Co-first authors contributed equally to this manuscript. Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

JAIDS Journal of Acquired Immune Deficiency Syndromes

RESEARCH ARTICLE

https://journals.lww.com/jaids/Fulltext/9000/Mobile_phones,_sexual_behaviors_and_HIV_incidence.95721.aspx