Factors influencing HIV/AIDS prevention campaigns-: a study of men working in the informal sector in Nairobi
HIV / AIDS has caused more death and suffering in the world than any other scourge known in history. In Kenya, as a result of HIV / AIDS, there are many orphaned children languishing in poverty, and are often disinherited by their immediate and extended families. The life expectancy of Kenyans has been considerably reduced by the impact of HIV / AIDS from 55 to 45 years. Despite the miseries caused by the scourge and in spite of the abundant information on prevention of HIV / AIDS many people have not adopted positive sexual behaviour. Thus in order to find lasting solutions to the problem, this study sought to examine Communication and other related factors that could be influencing sexual behaviour among men. Given that the media has over the years taken a leading role in HIV / AIDS Prevention Campaigns, the study sought to establish the extent to which Mass Communication has impacted on behaviour change. Other related factors that fundamentally affect man such as Socio-Economic and demographic factors were also investigated, in order to ascertain whether they affect behaviour change. Communication factors that were found to be influencing HIV /Prevention Campaigns were summed up in the S-M-C-R model as: Source, Message, channel, receiver and the effects of communication whereby it was established that the main source of information on HIV /Preventive Campaigns is the radio. However most respondents preferred discussing HIV preventive messages with peers/friends through interpersonal communication than through the radio. The study sought to unearth how age and other demographic factors influenced behaviour change and established that men aged between 15 and 45 years were very active sexually and that majority of them used condoms although not regularly. Their failure to use condoms as prescribed was interpreted as failure of HIV /preventive campaigns to produce desired results. Hence the justification to identify and establish factors hindering adoption of safe sex as prescribed. Culture was found to be deeply rooted in the lives of many respondents, hence a factor of great influence to behaviour change. Some of the men admitted that they practiced polygamy; some • confirmed that they consented to wife-inheritance and more still majority confirmed that they had unprotected multiple sexual relationships because according to their cultural beliefs it was proof of manhood. VI The significance of the study is that, it aims at empowering men with HIV preventive messages in order to involve them in the fight against HIV / AIDS. This is based on the recognition that in Africa, as elsewhere in the world, man enjoys a privileged social position in that they are leaders in the home and society; hence If enlisted m the fight against HIV AIDS they would use the leadership role and change the course of the epidemic. This is because men are the decision-makers in the families and on sexual matters. They are the ones who decide mostly who to have sex with, when and how hence, if targeted with effective messages men are better placed than women to bring a turn around in the course of HIV / AIDS epidemic. Yet the common practice by the N GOs has been mostly to target the women who barely make sexual decisions. Therefore this study sought to target men in order to establish Communication, Socio-economic and demographic factors that have been hindering them from adopting positive sexual behaviour, with a view removing the barriers. After thorough investigations this study established that: There are a number of communication barriers encountered by men when seeking information on safe sex. In this study 79% of the respondents pointed to lack of open communication and misinformation as some of the communication barriers. It was confirmed that radio has been very instrumental in creating awareness. In this regard KBC has more listenership than the other radio channels. It was established further that most of the preventive messages were received through the radio. However, it was confirmed that over-reliance on radio communication/messages as a means of attaining change in sexual behaviour was in itself a communication barrier. This was revealed through focused group discussions and key informant interviews who pointed out that interpersonal communication among peers and colleagues at work place was a more preferred medium of communication than radio, thus more effective for behaviour change campaigns. The study established that the men are the ones who make decisions on sexual matters that is where, how and when to have sex and with who, and in concurrence with the above view, 52% of the respondents confirmed that men are the decision makers on sexual matters in the family. Some social barriers were also found to be discouraging positive sexual behaviour. In this regard, the •study focused on wife inheritance, polygamy, and Christian values while others like circumcision, witchcraft, and evil spirits were clumped together under other traditional practices. The respondents who practiced the above traditions, ,were classified as follows: wife inheritance 2%, polygamy 10%, Vll other traditional practices 63% and Christian values 26%. It was also confirmed that 22% of the respondents do not use condoms because it is against their religious teachings. Among the low-income groups it was established that low income is one of the hindrances to adoption of safe sex methods. In this regard it was revealed that 54% of the respondents earned less than Ksh.5,OOO/= per month. As a result they could not afford adequate housing for their families and therefore were forced to live separately from their wives (who are left in the rural homes). This scenario creates a conducive environment for extra-marital relationships as the man ends up acquiring gltlfriends in the city; as confirmed by key informant and focused group discussions. The study established further that low income accounts for irregular use of condoms by majority of the respondents. This was summed up from focused group discussion: "if we cannot adequately afford the basic necessities, such as food, shelter and clothing, how would we budget for purchasing of condoms on a monthly basis?" It was confirmed that the quality of the condoms was another important factor that contributed to adaptability or non-adaptability. From the study 67% of the respondents preferred the Trust condom citing that it was of high quality compared to the rest. The free GoK condoms were the most unpopular, and poor quality was cited as the reason for its unpopularity. The study confirmed that condom use would be the most preferred preventive method if quality is improved. This study was conducted through a field survey in Nairobi among men working in the informal sector in Kenyatta market area and its environs. The main tools of data collection were structured questionnaires, focused group discussions and Key Informant Interviews conducted among 320 men identified through random selection. In view of the above findings, the challenge for HIV / AIDS preventive campaigners is to design effective messages and to encourage interpersonal communication among peers and friends as it was confirmed to be more effective than radio communication. To this effect, 52.2% of the respondents indicated that they would prefer to discuss sexual matters with their peers/ friends compared to only 20.2% who preferred to discuss with their wives/partners. A major recommendation given was the need for further studies to establish whether men in the informal sector are HIV /Risk-groups. It was established that the respondents are vulnerable to HIV Infections because 64.1% of them admitted having multiple sexual relationships and a good number also admitted engaging in unprotected/careless sex. It was also confirmed that 59.9% of the Vlll respondents do not know their HIV status and had no intention of knowing, as they feared that the results could confirm them to be HIV-positive following their carefree life styles. The above conclusions are alluding to the fact that men in the informal sector could be HIV Risk-groups. Therefore, there is urgent need to establish whether they are HIV Risk-groups so that the campaigners would target them with appropriate messages.