Towards the end of the — West African outbreak, sexually-transmitted Ebola virus re-emerged from Ebola virus disease EVD survivors in all three hardest hit countries. We explore sex and awareness of the risk of Ebola virus transmission among EVD survivors and their partners. We administered a questionnaire to all respondents, estimated Kader keita wife sexual dysfunction sexual practices and risk awareness and conducted in-depth interviews.
We recruited EVD survivors, sexual Kader keita wife sexual dysfunction of survivors and 65 individuals in the comparison group from five prefectures in Guinea. EVD survivors were Kader keita wife sexual dysfunction than five times as likely to engage in Kader keita wife sexual dysfunction sexual behaviour
Kader keita wife sexual dysfunction with the comparison group aOR 5.
We disclose here a need to improve knowledge of the disease and close the gap between knowledge and practice found in EVD survivors and their partners. Community-level fears and attitudes that enable stigmatisation should be addressed. Safe sex interventions targeting EVD survivors and their partners should be prioritised.
Since the discovery of the Ebola virus in northern Democratic Republic of Congo at that time Zaire insporadic Ebola virus disease EVD outbreaks have been regularly reported in central Africa.
Communication to EVD survivors of the viral persistence in their semen has been difficult in Guinea. Evidence that infectious virus could be hosted in the semen for longer periods of time has steadily grown throughout the outbreak. Therefore, research findings could not Kader keita wife sexual dysfunction keita wife sexual dysfunction easily translated strict recommendations.
By the end Kader keita wife sexual dysfunction the outbreak, research programmes were coordinated by the National Coordination for the fight against Ebola CNLEB to ensure a nationwide semen testing programme which also informed EVD survivors on sexual health issues. To better understand the risk of EVD re-emergence due to sexual transmission after the end of an EVD outbreak, it is critical to understand the barriers that may be encountered in communicating with patients who survived EVD Kader keita wife sexual dysfunction have to deal with the stigma associated with it.
We aimed to recruit as many eligible survivors as possible. Invited EVD survivors were asked to bring along their sexual partner s. For every three recruited EVD survivors, we aimed to recruit one individual from the same neighbourhood for the comparison group. Individuals in the comparison group were from the same communities as survivors and partners. They were not matched to them, but each regression model we adjusted for region and zone of residence.
All interviews were face-to-face and were done at the prefectural centres of the CNLEB in urban areas, and in the closest healthcare centres in rural areas. All interviewers were either medical
Kader keita wife sexual dysfunction or socioanthropologists from Guinea, able to speak one or more local languages in addition to French, and trained in Good Clinical Practice.
Every participant signed a written informed consent. The following data collection tools were used: In addition, recording devices
Kader keita wife sexual dysfunction used for in-depth interviews. Sexual behaviour, Kader keita wife sexual dysfunction awareness and other indicators were assessed through a questionnaire.
HIV- and syphilis-positive patients were referred to the closest hospital to access treatment. The questionnaire was interviewer-assisted. This short questionnaire was validated using a pilot study: These people were Kader keita wife sexual dysfunction included in the final study.
The validation was done comparing the scores with the true knowledge of participants on the subject, in its turn assessed through in-depth interviews with all participants of the pilot study. Zone of residence urban versus ruralregion of residence, age, years in education and employment this last divided into three categories based on the expected income: Zone of residence was assessed by interviewers based on the
Kader keita wife sexual dysfunction of residence declared by the study participants.
We used logistic regression to look at the association of sexual behaviour with study group and examine factors associated with awareness of the risk of sexual transmission of Ebola virus among survivors and their partners. To adjust for
Kader keita wife sexual dysfunction study design, region of residence and zone of residence urban versus rural were forced variables of each model.
Age, years Kader keita wife sexual dysfunction education and employment were treated as potential confounders. Interactions of region of residence with zone of residence urban versus rural as well as years in education with employment, region of residence and zone of residence were explored by LRT using final logistic regression models with the following outcomes: In total, 25 EVD survivors, 25 partners and 10 individuals of the comparison group were interviewed in the five different prefectures of Kader keita wife sexual dysfunction study.
Participants were chosen using the following criteria: Thematic analysis was used to define the main clusters of concepts related to the knowledge of the disease, the awareness of risk of transmission of Ebola virus and the barriers to condom use for EVD survivors and partners. Volunteer stakeholders were recruited in the local hospital of the prefectures visited during the study. Interviews were registered on recording devices and transcribed
Kader keita wife sexual dysfunction two independent interviewers before analysis.
Direct observations eg, interactions between Kader keita wife sexual dysfunction and interviewee were to contextualise the individual interviews.
We invited EVD male survivors to participate in the study. We asked the participants to bring their sexual partner s to the interview.
All partners were females. Of those, three had been discharged from the ETU for more than 2 years, three for 1. All four reported having had Kader keita wife sexual dysfunction sexual behaviour and no use of condom the last time they had sex with a casual partner. The comparison group served as the reference group. This was strongly associated with their awareness of EVD transmission potential after recovery aOR Partners, all women, were excluded from this analysis because too few individuals in the comparison group were females.
We report here key findings that emerged from the qualitative analysis to help contextualise survey results: EVD survivors already experienced physical and emotional pain as well as deep stigmatisation.
They perceived informing the partner about their potential infectiousness as being sick. Some were even forced to move to another community:. Moreover, increasing scientific knowledge on the potential length of viral persistence led to contrasting recommendations: This Kader keita wife sexual dysfunction confusion among EVD survivors and some lost their faith in health authorities.
In-depth interviews also showed that the vast majority of the study participants associated condom use with infidelity. Other main were lack of sexual pleasure, conception desire and lack of knowledge. Few participants reported refusing condom use because it was unacceptable for their faith.
Stakeholder interviews with health workers from public and NGO structures highlighted the challenge for health workers to communicate to a cured person the potentially long-lasting persistence of the virus. This study highlights a need to improve communication on the persistence of the Ebola virus, which should include recruitment of partners of EVD survivors in follow-up programmes.
Survivors from the capital, Conakry, were less likely to be aware of this risk than those from lower Guinea and forested Guinea. These results are difficult to interpret and may be unreliable Kader keita wife sexual dysfunction to a potential interaction between region of residence and years in education that could not be fully explored due to lack of data Supplementary table 1.
Our results are comparable to those of another similar study in Liberia, and may be applicable to other Ebola-affected populations in the sub-Saharan African region. The recent emergence of Ebola virus in West Africa and the consequent recent discovery of its long persistence in the semen should raise awareness of the importance of prioritising social support and psychosocial interventions, focusing not only on EVD survivors but also on their sexual partners, which include casual partners and those partners in polygamous marriages, common in the three Ebola-affected countries.
In fact, this lack of EVD knowledge among at-risk couples and, in particular, among partners is alarming and must be urgently addressed. Additional counselling on disclosure among partners, as in the case of AIDS, needs to be developed. However, it is important that associations are not Kader keita wife sexual dysfunction by personal or financial reasons. To avoid this, they could be integrated in the national public health system. Future research should focus on improving clinical and virological knowledge about the duration of virus persistence in semen, important to improve awareness among health workers and, as a consequence, among the general population.
Our study is
Kader keita wife sexual dysfunction based on self-reporting information, and it may therefore be susceptible to social desirability bias, in particular for the group of EVD survivors, leading to an overestimation of safe sexual behaviour. Selection bias may have occurred among the individuals recruited in the comparison group. The lack of female individuals in this group was not planned, and it was likely due to the higher reluctance of Guinean women, compared with men, to talk about sexual practices.
Therefore, the comparison group was mainly used to draw conclusions when compared with male EVD survivors rather than female partners. Ebola re-emergence from an EVD survivor has not been reported for over a year. Future efforts should focus on avoiding low-risk awareness coupled with risky sex practices and Ebola-related stigma may influence disclosure following an Ebola outbreak, especially after widespread transmission that produces large cohorts of Kader keita wife sexual dysfunction survivors.
LS and LG did the double data and validation. LS analysed the data and wrote the manuscript. All authors revised the manuscript.
The funding source had no role in the study design, data collection, data Kader keita wife sexual dysfunction, data interpretation or writing of the report.
The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication.
Provenance and peer review: Not commissioned; externally peer reviewed. For additional unpublished data, please contact the corresponding author. National Center for Biotechnology InformationU. Published Kader keita wife sexual dysfunction Sep Author information Article notes Copyright and License information Disclaimer.
Correspondence to Dr Lorenzo Subissi; moc. No commercial use is permitted unless otherwise expressly granted. This article has been cited by other articles in PMC. Abstract Introduction Towards the end of the — West African outbreak, sexually-transmitted Ebola virus re-emerged from Ebola virus disease EVD survivors in all three hardest hit countries. Results We recruited EVD survivors, sexual partners of survivors 65 individuals in the comparison group from five prefectures in Guinea.
Conclusions We disclose here a need to improve knowledge of the disease and close the gap between knowledge and practice found in survivors Kader keita wife sexual dysfunction their partners. What is already known about this topic?
One study from Liberia reported EVD survivor sexual behavioural data, but had no comparison group and was mainly focused on semen testing. One study from Sierra Leone reported qualitative findings from in-depth interviews with survivors, including their knowledge on sexual transmission risk.
What are the new findings? Ebola survivors were five times as likely to engage in safe sex practices, relative to the comparison group. More than half of the partners were unaware of the risk of getting Ebola associated with having unsafe sex with a survivor, and most often the only source of information was the survivor himself.