Routes of Spread of Hiv Infection Into Rural Communities of Ethiopia: Limu District, South Shoa Region

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Addis Ababa University


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.