Psychosocial And Sexual Practices, Attitudes And Challenges Of Persons Living With HIV/AIDS In Nairobi, Kenya

Abstract

HIV/AIDS pandemic remains the world's single most devastating epidemic particularly in developing countries where many governments have declared it a disaster. High risk practices of HlV infected persons serve as the principal source of HIV transmission in populations ill Kenya, the worst hit being the sexually active and economically productive age group or 15 - 54 years (MOH NACC 200I). This was a cross-sectional descriptive study that was executed over a period of () mouths from the month or January 2004 to June 2004. The study assessed the psychosocial and sexual practices, attitudes and challenges or persons living with HIV/AIDS in Nairobi, Kenya. The research subjects were aged 15 - 54 years.

The study sought to establish whether persons living with HIV/ AIDS in Nairobi, Kenya engaged in high-risk psychosocial and sexual practices. The study also sought to establish the psychosocial and sexual attitudes and challenges of persons living with HIV/AIDS in Nairobi, Kenya. A total of 385 HIV infected persons aged 15 - 54 years, who have been diagnosed at least six months before and had received both pre-test and post test counselling and were living in Nairobi, Kenya. were recruited into the study. Clusters of organisations /institutions that render services to HIV infected persons in Nairobi were

chosen. From these clusters, research subjects arc randomly selected. Their demographic data. data on their psychosocial and sexual practices, attitudes and challenges was collected using a semi structured questionnaire. The data was entered using Statistical Package for Social Sciences (SPSS), analysed by use of Chi square, Spcarmaus ranks order and Pearsons correlation coefficient and results presented in tables and figures.

Majority (71.2% n=274 ) of persons living with HIV/AIDS in Nairobi were sexually active, and were heterosexual (96.9%) with half of them (50.4%) having multiple sex partners. Majority of research subjects did not know the HIV status or their sex of persons living with HIV/AIDS in Nairobi accepted their own HIV positive status, however 38.8% were not in agreement with their own HIV positive status. Sixty one percent (61.0%,) of their spouses had not been tested for HIV, 32.7%, were concordant while 3.3% were discordant. Persons living with HIV/AIDS in Nairobi engage in high risk practices, including having multiple sex partners 50.4%, erratic and condom non use with sexual partners other than the spouse 69.4%, high risk cultural practices 13.8%, psycho active substance use 57.9)%, suffer from STDs 29.9%, violent sex (sexual masochism and sexual sadism) 8.6% dry sex whereby methods are used to reduce the normal lubrication of vaginal mucosa 6.9% and wet kissing 18.6%. In the post HIV positive diagnosis period, persons living with HIV/AIDS ill Nairobi

face challenges that hinder their sexual fulfillment. These include negative feelings of self esteem and self evaluation, loss or desire (Iibido) for sex 46.14% vaginal dryness 8.86%.

This study concluded that pre-test and post-test counselling is not achieving adequate behaviour change ill person diagnosed HIV infection in Nairobi. in terms of avoidance of high risk practices. These persons also experience challenges that hinder their sex fulfillment including negative feelings of self esteem and self evaluation, loss of desire (I ibido) for sex, vagina I dryness, dyspareunia, failure to attain orgasm and impotence.

The researcher recommends that HIV/AIDS counseling services in Nairobi be evaluated with the objective or strengthening and making these services more effective ill achieving better behaviour change ill the post J fly positive diagnosis life. There is also an urgent need to strengthen post-HIV positive diagnosis follow-up care concerted concerted efforts of the psychiatric team in order to address the identified psycho-social and sexual challenges facing pelSOI1S living with HIV/AIDS in Nairobi Kenya.