1. Acknowledgement: NIH/NICHD #1 R21 HD061021-Elias Mpofu –PI
Personal and parental religiosity influences on safer-sex behaviour among Pentecostal Botswana youth
Cleo Protogerou¹ ²
E. Mpofu³, F. Nkomazanaª, M. Dubeª, O. Nkomazanaª
¹University of Liverpool, UK, ²University of Cape Town, South Africa, ³University of Sydney, Australia, ªUniversity of Botswana, Botswana.
Acknowledgement: NIH/NICHD #1 R21 HD Elias Mpofu –PI

2. Botswana 2013 Global AIDS Response Report
HIV Prevalence by Residence Location
319,750 HIV infections
(2.1 million population)
HIV prevalence rates:
general population: 18.5%
females at 19.2%
males 14.1%,
highest: 30.4% in women aged
Botswana AIDS Impact Survey IV (BAIS IV, 2013)

3. Religiosity & Safer-sex
80% of Botswana youth are affiliated with the Pentecostal church (Botswana Christian Council, 2003).
Religiosity :
Adherence to beliefs, practices, and/or moral conducts of a faith ,and active engagement in its rituals (Miller & Thoresen, 2003).
Consistently linked to better psycho-physical health and less risk-taking.
May have protective effects on HIV risk .

4. The present study Research questions
Would religiosity (intrinsic - extrinsic; personal - parental) associate with safer-sex behaviour?
Would demographics of interest (age, gender, length of time affiliated with the church & congregation, place of residence, & educational level) moderate the religiosity – safer sex behaviour relationship?
Would impulsivity mediate the religiosity – safer sex behaviour relationship?

5. Method: Setting, sampling, design
A major Pentecostal Church (8 / 26 congregations).
Stratified random sampling for congregation size and location.
N = 261 youth.
Ethics approval from the Universities of Botswana & Sydney.
Cross-sectional design.
The Botswana Youth Health Survey (Mpofu, Nkomazana, & Ntinda, 2010).

6. Measures: The Botswana Youth Health Survey (Mpofu, Nkomazana, & Ntinda, 2010)
Demographics.
Personal religiosity & perceived parental religiosity.
Intrinsic - extrinsic religiosity dimensions.
Health and risk-taking measures.
Safer-sex measures:
Perceived confidence in engaging in safer-sex behaviours (non-behavioural measure).
Actual engagement in safer-sex
behaviours (behavioural measure).

7. Measures: The Sensation-seeking and Impulsive Decision-making scale (Donohew et al., 2000).
Impulsivity items: increased sense of urgency and diminished premeditation.

8. Questionnaire item examples
Botswana Youth Health Survey
Impulsive Decision-making scale
How often do you attend: church services, church choir, bible study...
How often do you: meditate, pray, ask for guidance...
How often does your mother / father attend church services, talk about faith...
I feel confident talking about STIs / AIDS prevention with a sexual partner.
My sexual partner and I use condoms in sexual intercourse.
I do the first thing that comes into mind.
I act on the spur of the moment.
I like to do things as soon as I think about them.

9. Data analyses Descriptives.
Hierarchical regression analysis with the PROCESS macro for SPSS (Hayes, 2009; 2013).
Mediation analyses: direct and indirect effects computed using a series of ordinary least squares (OLS) regressions and the bootstrapping procedure (Preacher & Hayes, 2004; 2008).
IBM SPSS version 22.

10. Results Key participant characteristics
Sexually active = 68
55% use condoms
Female = 169 (64.8%)
Age range = 12-23
Living in urban areas = 188 (72%)
Students = 212 (81.2%)
Secondary education = 145 (55.6%)

11. Results & Discussion Personal religiosity influences
Personal religiosity (composite ) was positively associated with confidence in engaging in safer sex for younger participants [b = 4.14, 95% CI (1.54, 6.74), t = 3.27, p < .01].
Church choir participation was linked to perceived (r = .41, p < .05) and actual (r = .35, p < .05) safer-sex engagement - all participants.

12. Results & Discussion Paternal religiosity influences
Confidence in engaging in safer-sex was higher for participants who believed that their fathers based everyday decisions on religion (M = 2.52, SD = .86), than not [M = 1.61, SD = .74, t (7) = -2.33, p < .05 (two-tailed)].
Intrinsic paternal religiosity was consistently positively associated with confidence in safer-sex engagement.

13. Results & Discussion Maternal religiosity influences
Confidence in engaging in safer-sex behaviours was inversely associated with:
the extent to which mothers talked about religion and the church (r = -.325, p < .05);
the extent to which mothers were perceived as basing every day decisions and actions on religious beliefs (r = -.30, p < .05).
Patriarchal context.

14. Results & Discussion The impact of impulsivity
Parental religiosity influences on safer sex engagement (perceived & actual) through impulsivity were negative, i.e., higher levels of participant impulsivity diminished the impact of parental religiosity on safer sex.
𝜅² effect sizes between small and medium ( 𝜅² = .065 for the non-behavioural; 𝜅² =.092 for the behavioural outcome).
Personal dispositions are at play.

15. Results & Discussion Demographic influences
Urban place of residence linked to perceived safer-sex (r = .32, p < .03).
Safer-sex behaviour was higher for participants living in a in urban location (M = 2.07, SD = 1.40), than in a rural setting [M = 1.40, SD = 1.02, t (36) = -1.88, p = .06 (two-tailed)].

16. To recap… Safer-sex engagement was linked to:
Personal religiosity - participating in church music and dance.
Father religiosity – especially intrinsic.
Living in an urban location.
Younger participants.
Religiosity influences on safer-sex were explained, at least partly, by impulsivity.

17. Insights for safe-sex promotion with the Pentecostal Botswana youth
Participating in & consuming church music, song, and dance.
Tailoring interventions as a function of age and sexual experience.
Including fathers and other male role models in safe-sex interventions, capitalizing on the influence exerted by father religiosity.

18. Thank you for being here!
Cleo Protogerou, PhD
Department of Health Services Research, University of Liverpool, UK & Department of Psychology, University of Cape Town, South Africa.