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Peer norms moderate the association between mental health and sexual risk behaviors among young men living in Dar es Salaam, Tanzania.

Publication ,  Journal Article
Hill, LM; Moody, J; Gottfredson, NC; Kajula, LJ; Pence, BW; Go, VF; Maman, S
Published in: Soc Sci Med
January 2018

BACKGROUND: Young men living in Dar es Salaam's informal settlements face environmental stressors that may expose them to multiple determinants of HIV risk including poor mental health and risky sexual behavior norms. We aimed to understand how these co-occurring risk factors not only independently affect men's condom use and sexual partner concurrency, but also how they interact to shape these risk behaviors. METHODS: Participants in the study were male members of 59 social groups known as "camps" in Dar es Salaam, Tanzania. We assessed moderation by changes in peer norms of the association between changes in symptoms of anxiety and depression and sexual risk behaviors (condom use and sexual partner concurrency) among 1113 sexually active men. Participants nominated their three closest friends in their camp and reported their perceptions of these friends' behaviors, attitudes, and encouragement of condom use and concurrency. Anxiety and depression were measured using the HSCL-25, and condom use and sexual partner concurrency were assessed through self-report. RESULTS: Perceptions of decreasing condom use among friends (descriptive norms) and decreasing encouragement of condom use were associated with lower levels of condom use. Perceptions of increasing partner concurrency and acceptability of partner concurrency (injunctive norms) among friends were associated with higher odds of concurrency. Changes in perceived condom use norms (descriptive norms and encouragement) interacted with changes in anxiety symptoms in association with condom use such that the negative relationship was amplified by norms less favorable for condom use, and attenuated by more favorable norms for condom use. CONCLUSIONS: These results provide novel evidence of the interacting effects of poor mental health and risky sexual behavior norms among a hard to reach population of marginalized young men in Dar es Salaam. Our findings provide important information for future norms-based and mental health promotion interventions targeting HIV prevention in this key population.

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Published In

Soc Sci Med

DOI

EISSN

1873-5347

Publication Date

January 2018

Volume

196

Start / End Page

77 / 85

Location

England

Related Subject Headings

  • Young Adult
  • Tanzania
  • Social Norms
  • Sexual Partners
  • Sexual Behavior
  • Self Report
  • Risk-Taking
  • Risk Factors
  • Public Health
  • Peer Influence
 

Citation

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Hill, L. M., Moody, J., Gottfredson, N. C., Kajula, L. J., Pence, B. W., Go, V. F., & Maman, S. (2018). Peer norms moderate the association between mental health and sexual risk behaviors among young men living in Dar es Salaam, Tanzania. Soc Sci Med, 196, 77–85. https://doi.org/10.1016/j.socscimed.2017.10.030
Hill, L. M., J. Moody, N. C. Gottfredson, L. J. Kajula, B. W. Pence, V. F. Go, and S. Maman. “Peer norms moderate the association between mental health and sexual risk behaviors among young men living in Dar es Salaam, Tanzania.Soc Sci Med 196 (January 2018): 77–85. https://doi.org/10.1016/j.socscimed.2017.10.030.
Hill LM, Moody J, Gottfredson NC, Kajula LJ, Pence BW, Go VF, et al. Peer norms moderate the association between mental health and sexual risk behaviors among young men living in Dar es Salaam, Tanzania. Soc Sci Med. 2018 Jan;196:77–85.
Hill, L. M., et al. “Peer norms moderate the association between mental health and sexual risk behaviors among young men living in Dar es Salaam, Tanzania.Soc Sci Med, vol. 196, Jan. 2018, pp. 77–85. Pubmed, doi:10.1016/j.socscimed.2017.10.030.
Hill LM, Moody J, Gottfredson NC, Kajula LJ, Pence BW, Go VF, Maman S. Peer norms moderate the association between mental health and sexual risk behaviors among young men living in Dar es Salaam, Tanzania. Soc Sci Med. 2018 Jan;196:77–85.
Journal cover image

Published In

Soc Sci Med

DOI

EISSN

1873-5347

Publication Date

January 2018

Volume

196

Start / End Page

77 / 85

Location

England

Related Subject Headings

  • Young Adult
  • Tanzania
  • Social Norms
  • Sexual Partners
  • Sexual Behavior
  • Self Report
  • Risk-Taking
  • Risk Factors
  • Public Health
  • Peer Influence