Effects of anti-retroviral therapy on sexual behaviour among people living with HIV/AIDS in Kibera slums in Nairobi, Kenya
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Date
2011-11-18
Authors
Otieno, Beatrice Akinyi
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Abstract
The effects antiretroviral therapy on sexual behaviour among people living with HIV/AIDS has been obscure. This has implications on the ability to combat the spread of the virus through behaviour change. With the rapid urbanization amid economic deterioration, it is imperative that we understand the sexual behaviour of PLWHA in general and the poor ones in particular. Moreover as a result of the success of ART in dramatically decreasing morbidity and mortality from HIV infection, many HIV infected persons are now living healthier and more sexually active lives. Since 2002, the feasibility of providing ART in resource poor settings has been recognized in Kenya. Currently increasing attention is being focused on a comprehensive approach to the management of HIV/AIDS which involves provision of ARV drugs as well as care and support services. However risky sexual behaviour by PLWHA is an area of concern because they risk transmitting the virus and re-infecting themselves with new drug resistant strains of the virus. This work therefore taps two rich data sets (qualitative and quantitative) to present a portrait of how ART influences the sexual behaviour of PLWHA I Kibera slum. A two-stage random sampling was applied in which a total of 340 respondents were selected to participate in the study. Data was collected using questionnaires, key informant interview schedules and focus group discussions. Quantitative data analysis was done using SPSS in which data was subjected to tests such as Chi square and correlation. Verbatim reports were recorded as direct quotations. The study results indicated that most 229 (87.9%) of the respondents had improved health status following ART. There was a significant difference in having sexual partners among married and unmarried PLWHA (x2 = 35.92, p <_ 0.05). There existed a positive correlation (r = 0.162, p<_0.05) between improved health status among PLWHA and having multiple sexual partners. There was no significant difference in the PLWHA level of ART awareness (x2 = 108.84, p:5 0.05). Majority of the respondents were found to use condoms, there was a positive correlation (r=0.128, p<_0.05) between condom use and level of ART awareness. Nonetheless a significant difference was noted in condom use between the married and the unmarried PLWHA (x2 = 27.16, p _< 0.05). Less than half 57 (41.3%) of those who had disclosed their status to their sexual partners had fair level of understanding while those with poor level of awareness had the least disclosure. A few 25 (13.7%) of PLWHA who were married had other sexual partners other than their spouses while majority 117 (74.1%) of their unmarried counterparts admitted that they had multiple sexual partners in the 12 months preceding the assessment. Pearson correlation results showed that there was a significant positive correlation (r = 0.94, p <_ 0.05) between ART level of awareness and having multiple sexual partners. The findings are therefore significant to policy makers, programme managers and donors in understanding the functioning, utilization, effectiveness and sexual impact of ART in low socioeconomic set ups. The results suggest that there is a need to plan for the most efficient interventions and review of current strategies such BCC and VCT, which will ultimately enhance the quality of life of PLWHA while at the same time ensuring positive sexual behaviour change.
Description
Department of Pre-clinical Sciences, 79p. The RC 6067.O82 2008
Keywords
Antiretroviral agents--Kenya, Nairobi, Kibera, Retrovirus, Infections, HIV infections