Sexual behavior and perceived risk of AIDS among men in Kenya attending a clinic for sexually transmitted diseases

Multiple sex partners and perceived risk of HIV infection in Zambia: attitudinal determinants and gender differences

While there is much attention on perceived risk of HIV and subsequent cautionary behavior, evidence of the reciprocity of the relationship between recent risky sexual behavior and perceived risks of HIV infection remains scarce. This paper tests the hypothesis that having multiple sex partners within the last 12 months influences individual's perceived risk of HIV among Zambian men and women. It also examines attitudinal factors associated with having multiple sex partners and perceived HIV risk. Data come from the 2005 Household and Community Surveys of the Health Communication Partnership project. The sample includes 2610 men and women, and 445 community leaders in 36 districts. Tests of exogeneity confirm that having multiple sex partners is exogenous to perceived risk of HIV infection. Structural equation modeling is employed to test the hypothesis. Findings show that having multiple partners is the strongest predictor of perceived risk of HIV. Men were also more likely than women to have multiple sex partners, but less likely to consider themselves at risk of HIV, compared to women. Men were also more likely to be influenced by their peers and community members. Women were more likely than men to report some risk of HIV if they were aware of their partner's serostatus and had more interpersonal communication on HIV. Married women were less likely to consider themselves at risk than unmarried women. The findings indicate that it is essential for men to recognize the connections between unsafe sex behaviors and risks of HIV infection and that distinct intervention approaches to Zambian men and women are needed. While couple communication needs to be enhanced for both, community-based interventions that approach men are particularly important.

Healthcare-seeking behavior and sexual behavior of patients with sexually transmitted diseases in Nairobi, Kenya

BACKGROUND

Sexual and health-seeking behaviors are important components of sexually transmitted disease (STD) control.

GOALS

To generate data for improved STD prevention and care, and to assess sexual behavior and relevant health-seeking behavior.

STUDY DESIGN

A questionnaire to elicit social, demographic, healthcare-seeking, and sexual behavior information was administered to 471 patients attending the referral clinic for STDs in Nairobi, Kenya.

RESULTS

A large proportion of the patients had sought treatment in public and private sectors before attending the clinic for STDs. Women waited longer than men to seek medical care. In addition, women more than men engaged in sex while symptomatic, mostly with their regular partner. Condoms were used rarely during illness. In their self-reports, 68% of the men admitted to having extramarital affairs, and 30% to paying for sex, yet they blamed their wives for their STDs.

CONCLUSION

Health education messages in Kenya need adaptation to improve health-seeking behavior and safe sex practices.

Decreased incidence of sexually transmitted diseases among trucking company workers in Kenya: results of a behavioural risk-reduction programme

OBJECTIVE

To establish a cohort of high-risk individuals suitable for HIV-prevention trials, and to measure changes in sexual behaviour and sexually transmitted disease (STD) incidence after a behavioural intervention.

DESIGN

Prospective cohort study in trucking company depots in Mombasa, Kenya.

PARTICIPANTS

A total of 556 male HIV-seronegative employees of trucking companies.

INTERVENTIONS

HIV serological testing, individual counselling, condom promotion, STD diagnosis and management.

MAIN OUTCOME MEASURES

Sexual risk behaviour and symptomatic STD incidence.

RESULTS

Using time-trend modelling, significant declines in self-reported high-risk sexual behaviour were demonstrated during a 1-year follow-up. The percentage of men reporting any extramarital sex during the 3-month period prior to a follow-up visit decreased from 49% durig the first quarter of follow-up to 36% during the last quarter (P < 0.001). The decline in reported female sex worker contact was from 12% to 6% (P = 0.001). Approximately 30% of men reported consistent condom use during extramarital sex and this percentage remained unchanged during the study period. The incidence of STD declined from 34 per 100 person years (PY) during the first quarter to 10 per 100 PY during the last quarter (P = 0.001). Significant reductions in gonorrhoea (15 to five cases per 100 PY, P = 0.04), non-gonococcal urethritis (10 to two cases per 100 PY, P = 0.05), and genital ulcer disease (nine to two cases per 100 PY, P = 0.02) were observed.

CONCLUSIONS

Among truck company workers who participated in a cohort study in Mombasa, Kenya, there was a significant decrease in sex with high-risk partners, but no change in condom use. The change in heterosexual risk behaviour was accompanied by a significant decrease in incidence of gonorrhoea, non-gonococcal urethritis, and genital ulcer disease.