Master of Medicine in Obstetrics and Gynaecology

Abstract

Background In 2005 AIDS claimed another 3 million lives and it relentlessly threatens millions more. Despite global and national efforts to quell the pandemic, 40.3 million people are currently living with HIV - the highest level ever. Nearly 5 million new cases occur each year, with almost every region of the world reporting increasing numbers. Yet amid the grim statistics an estimated 250,000 to 350,000 deaths have been prevented this past year alone because of access to antiretroviral therapy. Kenya has actually been able to lower its HIV prevalence rate from l3.4% in 2000 to 7% in 2003 and even lower if recent media reports are anything to go by. This has. been largely due to heavy investment in prevention programs. There is need to know the KAP of the medical students who are the future doctors in this country because they occupy a unique and privileged position to change people's behaviour and practice. Objective The objective ofthe study was to determine whether university medical students do avoid risky sexual behaviour and consider or practice sexual abstinence as a means of avoiding contracting HIV. Setting The Chiromo campus and the Kenyatta National Hospital campus of the Faculty of Medicine of the University of Nairobi. Study population All first year and fifth year medical students of the University of Nairobi. Study design This was a descriptive cross-sectional study conducted in form of a self administered questionnaire in one day. 356 Outcome measures These were knowledge of HIVIAIDS, sexual attitudes, sexual behaviour and attitudes and practice of abstinence. ") Results A total of 383 medical students completed the questionnaire. They consisted of 267 first year and 116 fifth year students. 54.5% were male and 45.5% were female. A majority (73.1%) of all the students were in the age bracket 19-24 years. There was a high level of knowledge of mVI AIDS among all the students, although fifth year students showed greater knowledge levels concerning the technical aspects 0f diagnosis of my. 34.9% of all the students got their information on HIV/AIDS from the print'eiectronic media. A larger number of fifth year students compared to first years (58.6% vis 38.9%; p=0.000) had undergone an HIV test. A majority of the students from both c1asses( 76.4% of first years and 70.7% of fifth years) deemed themselves at low/no risk of contracting HIV and of these 35.6% cited abstinence as the reason. Older male students were more likely to have multiple sexual partners (p= 0.03), engage in premarital sex (p=0.0l) and believed using condoms resulted in reduced sexual pleasure (p=0.001). Of the total population 54.8% were primary sexual abstainers and 5.5% were secondary abstainers. Females (79.7%) were more likely to practice abstinence than males (51.4%) in the abstinent sub group (p<0.00l). First year students (70.2%) were more likely to be abstinent than their fifth year (52.3%) counterparts (p=0.00l). Ofthe sexually active students, almost a third (32%) of the respondents had multiple sexual partners. Faith (80%) and moral values (86.9%) were cited as the main reasons for practicing abstinence. Only 1.3% of the study population were of the view that they cannot practice abstinence because it was not practical. Conclusjon HIVIAIDS awareness was universal in this study and the students were aware of, and a good number did practice, sexual abstinence as a means of prevention of HIV transmission. Age, sex and moral values l religious beliefs played a major role in determining the practice of abstinence.