Influence of socio-cultural and economic risk factors in the spread of hiv/aids and other sexually transmitted diseases: a case study of Kisumu municipality, Nyanza Province.

Abstract

This study was carried out within Kisumu Municipality. It looks at the risk factors predisposing society and especially women to STDs,HIV/AIDS. Women, at the moment, are most vulnerable to IDVI AIDS; it has been found that women are more infected than men and at earlier ages and in Kenya. And majority of the rural inhabitants are women and children, who represent over half of the population and more than % of the rural dwellers (CBS, 1989). The study's main objective was to document the influence of socio-cultural and economic risk factors in the spread of STD's/HIV within Kisumu Municipality. In order to understand these factors, the following were set establish the degree to which these risk factors were facilitating the transmission of SID's including HIV, explore the dynamicsof HfV transmission and prevention such as the acceptability and impediment to the use of condoms. In order to assist in the investigations of the above objectives, a number of hypotheses were formulated. These revolved around the hypothesis that cultural and economic issues are related to health and concurrently, that this affects community's health status, especially with the AIDS scrounge as an intervening factor. The study also assumed that limited socio-economic options, the inability to negotiate risk increases the likelihood of exposure to the risk of infection. Failure to acknowledge risk deters the perceptions of preventive and protective strategies. The methods used in data organization and analysis included both the quantitative and qualitative techniques. Quantitative data from a study carried out in Kisumu municipality (1997) was used. Cross tabulations and logistic regression were the main tools that were used

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to analyze the data. Qualitative information was analyzed theme by theme in relation to the study objectives. At an individual level, the sexual behavior was found to be one of the major risk factors. Findings indicate that the youth begin sexual activities at an early age, making pre-marital sex a major risk factor for HIV especially among young girls. Coercive sex, including rape, is relatively common. HIV prevalence in women is high within the first years of sexual activity, whereas in men, it rises more slowly. A higher number of lifetime sex partners was found to be a risk factor for HIV among both sexes in the main multivariate analysis. Change of behavior was reportedly a difficult practice due to traditions and social attitudes, which militate against AIDS prevention. The sexually active youths on average had experienced intercourse by age 14 or younger and continue to have a series of sexual relations. There are also high levels of extra-marital and concurrent multiple sex partnerships among the respondents. Condom image was found to be poor for reasons that are inherent to the product or based on misconceptions increasing the chances of infection among this sexually active group. HIV levels increase markedly among young women and older men. The study indicates that single or unmarried people have a higher risk of infection as compared to the married ones, however, marriage does not seem to protect an individual from infection. Possibly attributed to the large age-gap between men and women in marital or non­ marital partnerships. Polygamy and wife inheritance (sexual cleansing practices) continues to play an important role in the people's lives and in the spread of HIV. Women respondents complained of the inability to take measures to protect themselves from possible infection due to culture norms, men's double standards (dominance) and economic constraints.

Unemployment status and contacts with CSW as seen from the my status of men who had contact with CSW, which was relatively high, were found to be risk factors for HIV. The study, therefore, recommends that concerted widespread IEC activities are promoted using appropriate channels and that widespread distribution of condoms be prioritized as an integral and vital part of enhancement of sexual health care for prevention of SID's and mv infection.

The study also recommends further research in risk factors especially those affecting younger age groups, who are more, exposed and who will give a clearer picture of recent new infections and any behavior change characteristics. In conclusion, the study did achieve most of its objectives and we can conclude that the socio-cultural and economic factors prevailing in the study area have a great impact on the sexual behavior, the health decisions and exposes individuals to the risk of HIV/AIDS infection. And unless the economic situation is improved and harmful cultural practices and irresponsible and unprotected sex checked, the fight against AIDS will not be won. Solutions, therefore, demand change in attitudes and behavior (emphasis the message of condom, fidelity and abstinence,' both at the personal and community level.