Routes of Spread of Hiv Infection Into Rural Communities of Ethiopia: Limu District, South Shoa Region
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Date
1992-03
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Addis Ababa University
Abstract
A multistage, qualitative and descriptive study was carried
out in Limu District, central Ethiopia. Routes of spread of HIV
infection from urban to rural populations were first identified and
then verified. Sexual and non-sexua l risk practices of rural
farmers were also studied. Qualitatively, through a focus group
discussion with urban prostitutes and interviews with community
elders, religious leaders, and health professionals potential
routes were identif i ed. These were verified by interviewing 20 of
soldiers, merchants, and students. Four drivers and 2 former
peasant association chairmen were also interviewed. High risk
sexual practices were verified in these subgroups. In 45 to 50% of
the subgroup subjects extramarital sexual intercourse in the past
3 months was reported. In 25 to 37% sex with urban sex workers was
reported. Condom use was found to be very low, varying from 10 to
30%. Knowledge about AIDS and condoms was not satisfactory. Risk
perceptions for AIDS were low and changes in risk behaviour were
not impressive. Urban sex workers also verified these routes by
confirming sexual contact with these rural subgroups of population.
A total of 502 rural farmers were interviewed for high risk
behaviours for HIV infection. Extramarital (multipartner) sexual
relations in the past 3 months was reported in 13.5% of the
farmers. Sex with urban sex workers as the last e xtramarital sex
in the past 3 months was reported in 6.7% of the males. Condom use
was very low. Past history for STD's was assessed. Gonorrhoea was the most commonly reported illness at 10 .2%. Non-sexua l risk
practices were also studied. In the study population, 23.9% of the
males had received an injection in the past 3 months. Of these,
27% were received in the villages. A history of tattooing, blood
letting, ear piercing, and scarification were reported in 2 to 6%.
A total of 58.6% of the rural farmers have heard about AIDS. Out
of these 94.5% knew at least one correct mode of transmission of
AIDS. Twenty eight percent of the population believe that they can
get AIDS and 30% have changed behaviour. In this study there was
no association beteween knowledge and high risk sexual or nonsexual
practices.
This study revealed that certain sub-groups of rural
population particularly the former military, merchants and students
have the potential to spread HIV infection into rural communities
and a high proportion of rural farmers exhibit high risk practices,
hence immediate intervention is recommended.