Assessment of HIV-risk behaviors and HIV infection among HIV voluntary counseling and Testing centers attendiees in Hararregion,Ethiopia.
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Date
2010-02
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Addis Abeba University
Abstract
Background: Risk factors for HIV transmission in sub-Saharan African
including Ethiopia are the same as other countries in the region. However,
information on risk factors associated with HIV infection among HIV-VCT
centers attendees are insufficient to make useful recommendations on
HIV/AIDS prevention and control in Harari region; therefore assessment of
high risk behaviors for HIV transmission in this regard is useful.
Objective: To assess the level of HIV-risk behaviors and their association with
HIV infection among HIV -VCT centers attendees in Harari region.
Methods: An unmatched case-control study was conducted among HIV-VCT
centers attendees from Sep 2008 to May 2009 in all health facilities providing
HIV-VCT services in Harari region. A total of 429 participants grouped in to
cases (n=143) and controls (n=286) were recruited and assessed for various
socio-demographic and other important health variables. The assessment was
supplemented with Focus group discussion two in each sex. The quantitative
data were entered and analyzed using SPSS Version 15. The descriptive
statistics was used to show the magnitude of various characteristics. Bivarate
analysis was used to see the association of different variables. Odds ratio with
95% CI was computed to assess the presence and degree of association
between variables. Step wise logistic regression analysis was also applied to
identify the important HIV-risk behaviors among HIV-VCT attendees. The
qualitative data was analyzed using thematic analysis approach.
Result: A total of 429 HIV-VCT attendees, of which 143 cases and 286 controls
were participated. Of the 139(97.2%) cases and 219(76.6%) controls who ever
had sex, 108(77.7%) cases and 136(62%) controls had two or more life time
sexual partners. Sexually experienced 93(66.9%) cases and 184(84.0%)
controls reported having sex in the 12 months preceding the study. Of those
who had sex in the last 12 months, 29(31.2%) of cases and 13(7.1%) controls
had history of STIs. 14(28.6%) of male cases and 10(11.1%) male controls had
sex with CSWs in the last 12 months, of which 6(42.9%) of cases and 5(38.9%)
controls had reported inconsistent condom use. Ever had sexual intercourse,
having two or more life time sexual partners and having history of STIs in the
last 12 months were positively and significantly associated with HIV infection.
This finding was strengthened by qualitative study where the majority of the
discussants in both sexes agreed on unprotected sex, having two or more life
time sexual partners and history of STIs as the risk sexual behaviors.
Conclusion and recommendation: The major HIV-risk factors identified are
ever had sexual intercourse, having two or more life time sexual partners and
having History of STIs in the past 12 months. These findings suggest a need for
designing HIV/AIDS prevention strategy focused on: reduction in number of
sexual partners, improved sexually transmitted infection prevention and
control, and an increase in condom use. In addition, prevention efforts should
focus on high risk groups, particularly in urban areas where the HIV
prevalence is higher such as daily laborer and housewives.
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Keywords
HIV risk behaviors, HIV infection, HIV-VCT centers attendees.