High-Risk Sex Practice And Its Determinants Among Hiv-Positive Women On Hiv Care Services: A Case Of Thika Level 5 Hospital, Kiambu, Kenya

ABSTRACT

HIV/AIDS remains a major health issue in Kenya and in the whole world. Over 34 million people are currently living with the HIV and a majority of them are in the Sub-Sahara Africa; a big pool for potential HIV transmission. In Kenya, out of a population of 40 million, over 1.6 million are HIV infected and approximately 100,000 new infections are realized yearly, most of them through unprotected sexual intercourse. This study sought to estimate the prevalence of high-risk sex and to identify its determinants among the HIV-positive women undergoing HIV care in Thika Level 5 Hospital. A total of 467 participants were drawn through systematic random sampling from the population of HIV positive women attending HIV care services. Data was collected from those who passed the inclusion and exclusion criteria by using face-to-face interviews. The data was analyzed using Statistical Package for Social Sciences (SPSS) where descriptive statistics and inferential statistics were computed. The results showed that high-risk sex is prevalent among the HIV-positive women undergoing care as 39% of the respondents reported not to have used condoms during their last sexual activity. Disclosure of HIV status, Relationship control, Time on ART, Drugs use, and Stigma in bivariate analyses was significantly associated with high-risk sex at the significance level of 0.05. In the multivariate analysis the variables Time on ART, Partner type and Disclosure*Stigma interaction term remained significant in predicting high-risk sex. The study associated long Time on ART to high-risk sex. Casual partnerships were 7 times associated with high-risk sex than regular partnerships. A combined Non-disclosure and Stigma influenced high-risk sex practice two-fold. The study concluded therefore, that the determinants of high-risk sex among the HIV-positive women on care are long time on ART, Casual or mixed sexual relationships, Stigma, and Non-disclosure. The study recommended that the PLHIV should be given the right preventive information and be cautioned that being on ART for long is not a permit to stop using condoms. Stigma coping-skills training should be given to the patients and be made to accept and live with their condition without transmitting the virus to others. The government and the donor community have also been urged to provide resources to help develop interventions that reinforce safe sex practices and also put up infrastructure for improving the socio-economic conditions of the PLHIV.