Tag Archives: Mali

The Association of Female Circumcision with HIV Status and Sexual Behavior in Mali: A Multilevel Analysis.

J Acquir Immune Defic Syndr. 2013 Dec 27. [Epub ahead of print]

The Association of Female Circumcision with HIV Status and Sexual Behavior in Mali: A Multilevel Analysis.

Smolak A.

ABSTRACT

OBJECTIVE: In the regions of Africa where female circumcision (FC) is practiced it is often regarded as a protective against HIV infection because it is believed to help women resist “illicit” sexual acts. This study examines the association between FC, HIV status, and sexual risk behavior in Mali, while taking into account multilevel factors. The following hypothesis was tested: FC is associated with HIV positive status, but not with decreased sexual behavior.

DESIGN:: The sample consists of 13,015 Malian women of reproductive age (15-49 years old). The sample is a nationally representative survey of randomly selected respondents using a stratified multistage sampling strategy. Measures included biospecimens for HIV antibody testing and survey results reporting on: number of partners, sexual debut, premarital sex, and sociodemographics.

METHODS:: Multilevel modeling (MLM) was used to assess the significance of difference in HIV status and sexual behavior with FC. MLM was also used to adjust for age, education, ethnicity, wealth, religion, region, household, and community membership. Multiple imputation with 10 imputations corrected for 10% missing data.

RESULTS:: Participants with FC were at 2.100 (p<0.001; 95% CI: 1.844, 2.389) higher odds of being HIV positive. Women with FC did not significantly differ from women without FC in number of sexual partners (p=0.634), age of sexual debut (p=0.888), or odds of having premarital sex (p=0.575).

CONCLUSION:: FC is associated with HIV positive status, but not with a decrease in sexual risk behavior. These findings have important implication for FC and HIV prevention.

Female Genital Cutting Practices in Burkina Faso and Mali and Their Negative Health Outcomes

Stud Fam Plann. Sept 1999 30(3): 219–230

Female Genital Cutting Practices in Burkina Faso and Mali and Their Negative Health Outcomes

Jones H, Diop N, Askew I, Kaboré I

ABSTRACT

Observations of the types of female genital cutting and possible associated gynecological and delivery complications were undertaken in 21 clinics in rural Burkina Faso and in four rural and four urban clinics in Mali. Women who came to the clinics for services that included a pelvic exam were included in the study, and trained clinic staff observed the presence and type of cut and any associated complications. Ninety-three percent of the women in the Burkina Faso clinics and 94 percent of the women in the Mali clinics had undergone genital cutting. In Burkina Faso, type 1 (clitoridectomy) was the most prevalent (56 percent), whereas in Mali the more severe type 2 cut (excision) was the most prevalent (74 percent); 5 percent of both samples had undergone type 3 cutting (infibulation). Logistic regression analyses show significant positive relationships between the severity of genital cutting and the probability that a woman would have gynecological and obstetric complications.

This article can be purchased in this LINK

The association between female genital mutilation and intimate partner violence

BJOG: An International Journal of Obstetrics & Gynaecology. Online 24 AUG 2012The association between female genital mutilation and intimate partner violence

Salihu HM, August EM, Salemi JL, Weldeselasse H, Sarro YS, Alio AP

ABSTRACT

Objective  To determine whether female genital mutilation (FGM) is a risk factor for intimate partner violence (IPV) and its subtypes (physical, sexual and emotional).

Design  Population-based cross-sectional study.

Setting  The study used the 2006 Demographic and Health Survey (DHS) conducted in Mali.

Population  A total of 7875 women aged 15–49 years who responded to the domestic violence and female circumcision modules in the 2006 administration of the DHS in Mali.

Methods  Multivariable logistic regression was used to compute adjusted odds ratios (aOR) and 95% confidence intervals (CI) to measure risk for IPV.

Main outcome measures  The outcomes of interest were IPV and its subtypes.

Results  Women with FGM were at heightened odds of IPV (aOR 2.71, 95% CI 2.17–3.38) and IPV subtypes: physical (aOR 2.85, 95% CI 2.22–3.66), sexual (aOR 3.24, 95% CI 1.80–5.82), and emotional (aOR 2.28, 95% CI 1.68–3.11). The odds of IPV increased with ascending FGM severity (P for trend <0.0001). The most elevated odds were observed among women with severe FGM, who were nearly nine times as likely to experience more than one IPV subtype (aOR 8.81, 95% CI 5.87–13.24).

Conclusions  Study findings underscore the need for multi-tiered strategies, incorporating policy and education, to reduce FGM and IPV, potentially improving the holistic health and wellbeing of Malian women.

This article can be purchased in this LINK