Voluntary counseling and testing in HIV infection: evaluation of individual risk perception in Nairobi
Abstract
This cross-sectional study was designed to evaluate perception of individual's risk of HIV infection and risky sexual behaviours among Voluntary Counselling and Testing (VCT) clients relative to their motives for seeking VCT services and their IDV sero-status.
The impact of HIV epidemic continues to be felt in developing countries. In Kenya like many other countries, this affects mainly the 15-49 year age group, which is the most sexually
active and economically productive group. This results in reduction in size and experience of
the labour force and increases health care expenditure.
The way forward in prevention of HIV transmission is setting realistic priorities that ensure
behaviour change among those with the most risky behaviour among others. These
interventions include Voluntary Counselling and Testing (VCT), promoting abstinence before marriage and faithfulness to one un-infected partner after marriage. Others include
strengthening such programs like control of sexually transmitted diseases (STDs), promoting
reduction of sex partners and the correct and consistent use of condoms.
Human behaviour change depends on weighing between perceived risks and benefits of
certain behaviour against those of an alternative behaviour. Individual risk perceptions are
deeply rooted in a person and are influenced not only by the level of knowledge but also the
socio-cultural norms of the individual. VCT services provide information on HIV infection, a motivation based behaviour change, thorough client's risk evaluation 3.Qdthe formulation of a client's specific behaviour change plan.
This study was specifically designed to establish the reasons for seeking VCT services, the
individual risk perception of getting HIV infection and evaluate the client's risky sexual
behaviour associated with HIV infection. The relationships between the above factors and
IDV sero-status of respondents were investigated through a cross-sectional descriptive study.
A total of 301 clients attending the Kenyatta National Hospital (KNH), Mugumo-ini and
Sokoni VCT centres were recruited for the study.
Theresults showed that 244 (81.1 %) of the respondents had been involved in sex in the
preceding six months and 57 (18.9%) had been in sexual abstinence for over six months.
The main reasons for the respondents seeking VCT services were, planning the future
(56.8%), client's past sexual risky behaviour (23.9%), worry and curiosity of self-status
(20.3%), planning to get married (11.3%) worried about partner's behaviour (10.6%) among
other reasons. Statistically significant associations were established between risk evaluation
and some reasons of seeking VCT services such as, client's past sexual risky behaviour,
worry and curiosity about self status and plan to get married with P values of 0, 0 and 0.04 respectively.
Individual risk perception showed a significant association with HIV sero-status of
respondents who were sexually active in the last six months (P value = 0.0288).
Using 17.5 mean score as the cut-off, 150 (61.5%) were scored low risk and 94 (38.5%) were
scored high-risk category. Among those scored high risk, 24 (25.5%) were HIV positive and
20 (13.3%) of those scored low risk were HIV positive. However, no statistically significant
relationship was established between sexual risk evaluation and HIV sero-status of the
respondents.
Individual risk perception of acquiring HIV infection was low (24%) and men were more
likely to perceive themselves at high risk of HIV infection than women. Socio- demographic
characteristics such as occupation and education level proved to be related to individual risk perception of HIV infection.
Therefore, the government through collaboration of the National AIDS Control Council
(NACC) and other stakeholders needs to support and sustain the on going awareness
campaign so as to change attitude and improve on individual risk perception of risk of HIV infection since has been shown to be very low. Laws that enhance and protect the rights of
women to empower them to make decisions on HIV testing without fear need to be enacted.
Citation
Masters in Public Health, University of Nairobi, 2002Publisher
University of Nairobi, School of Medicine