Changes in Sexual Behaviour and HIV Prevalence among Married Fishermen along Lake Victoria at two Time Points: A Scorecard for Prevention Efforts
Kwena, Z. A.
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Background: There are considerable efforts towards reducing new HIV infections in key affected populations such as fishermen. Assessing changes in sexual behaviour and HIV prevalence is an important feedback to these prevention efforts. We evaluated changes in sexual behaviour and HIV prevalence among married fishermen in fish-landing beaches in Kisumu County, Kenya. Methods: We analyzed data from two surveys conducted in 2005/6 with 164, and 2011/2 with 545 married fishermen to evaluate changes in their sexual behaviour and HIV prevalence at two time points. The participating fishermen in both surveys were randomly sampled from all 33 fish-landing beaches in Kisumu County. The numbers sampled from each beach were proportional to the population size of the beaches. In both surveys, we collected data on socio-economic, sexual behaviour and HIV sero-status. Results: A higher proportion of fishermen in 2011/2 survey compared to 2005/6 survey reported drinking alcohol before sex with extra-marital partners (27.7% versus 11.4%; p=0.05) and being involved in transactional sex (65.8% versus 25.0%; p<0.01). However, more fishermen in 2011/2 compared to 2005/6 survey used condoms with extra-marital partners (34.2% versus 5.4%). Overall HIV prevalence in 2011/2 survey was marginally lower compared to 2005/6 (21.0% versus 28.0%; p=0.07). However, there was significant 15 percentage point drop in HIV prevalence among fishermen below 25years old that represent recent infections. Conclusions: Despite increases in other high risk sexual behaviours, condom use with extra-marital partners in this key affected population increased explaining significant drop in HIV prevalence among youth who represent recent infections.