Men's perception of their own risk exposure to HIV infection and responsive behaviour: A case study of Kibera slums in Nairobi

Abstract

Acquired Immune Deficiency Syndrome (AIDS) is a serious public health problem in Africa with the most affected countries found in sub-Saharan Africa especially those located in the east, central, and southern part of the continent. In Kenya, one in 11 adults is infected with the virus that causes AIDS. The aim of this study was to assess men's perception of their own risk exposure to HN infection and responsive behaviours and in so doing explore ways in which men can be made to change their sexual behaviours in order to curb the high rates of HIV infections. Reasons specifically why this study was carried out was to gain men's understanding and meaning of risk of HIV infection, identify men's notion of vulnerability to HIV infection, understand how men rank risk (in terms of which behaviours they see being most likely to lead them to HN infection), to determine how men negotiate and avoid these risks, and lastly to assess methods that men use to deal with these risk factors. Method A survey using a questionnaire was conducted to select a sample using simple random sampling technique. Participants in the study were 199 men between the ages 17 - 45, both married and unmarried men residing in five villages in Kibera slums, Nairobi Kenya. Result Two hundred questionnaires were distributed to the five interviewers for data collection. One hundred and ninety nine questionnaires were returned and one never returned. The results given in this study is from those respondents who answered various question and 199=100% Respondents were categorized according to their age and social background like religion, education level, and marital status. These four categories were used as the independent variables which others were dependent on. The age categories were three, young «25 year) represented 42.7%, middle age f (26-35 years) represented 43.7% and lastly old age (>36 years) represented 13.5%. Marital status- 105 respondents were single while the remaining 94 were married. For the married ones, 81.7 % had one wife and 18.3% had more than one wife. The main reason given by those in polygamous families why they married many wives was to have one in their urban and rural home and because first wife could not satisfy them sexually. Married men reported having other sexual partners other than their wife(s). Single men reported having sexual partners. In a period of 6 months before the study, these single men reported having between three and twelve sexual partners. Knowledge about HIV/AIDS was 97.5% and the single most source of HIV/AIDS information was mass media contributing to 67.1 % followed by personal observation with a percentage of 10.5. Majority of respondents knew that AIDS kills (53%) while 40% of respondents knew that AIDS has no cure. Modes of transmission that most men reported to be familiar with were: through sexual intercourse and blood transfusion. Perception of risk- majority of men thought that anybody is vulnerable of being infected with HIV but when it comes down to individual perception to vulnerability, men underestimate the risk they are in that can lead to HlV infection. In this study group, 25 % of respondents considered themselves to be at no risk of HIV infection, 52% said they were at low risk, 20% were at high risk of getting HIV while 3% were already infected with HIV. Behaviours that these men considered high-risk behaviours were promiscuity and drug I alcohol abuse. On the other hand having multiple sex partners, unprotected sex and alcohol abuse were see as the major risk factors that would increase the chances of a man being infected with HlV. Condom use: married men reported that they use condoms with their wife(s) to protect themselves from contracting STI's (75%). When going out for extramarital sex, 29 respondents reported that they used a condom last time they had sex out while 14 reported that they had unprotected sex last lime they had an extramarital sex These men when asked if they thought whether they could get infected with HIV when having sex with non-steady partners, 19% of them said that there was no possibility of being infected. Protective measures or responsive behaviours to counteract HIV risk factors that men reported to use were: being faithful to one partner, abstinence for single men, being "saved" and prayers, and reducing number of sexual partners. Conclusion Men underestimate their risk of HIV infection despite engaging in behaviour they consider risky. Many of them continue having multiple sex partners, having unprotected sex with unsteady partners and married men engaging in extramarital affairs, behaviours these men reported to be the most risky and which increase chances of one getting AIDS. Social backgrounds like education level, marital status do not seem to influence sexual behaviours. Majority of men in this study exhibited similar sexual behaviours despite coming from different social background. Sexual desire and recognition by peers drives men into behaviours that put their lives in danger. Sex and masculinity are instilled by society as a whole and reinforced by peer pressure. Hence men hang around public places where they engage in sex talk with their peers and they encourage each other on how one can have the best sex encounter, these talks accompanied by' 'alcohol and other drugs mostly end up in unprotected sexual encounters with unfamiliar partners. Hence comprehensive sex education indicating consequences of unprotected sex and risk of HIV need to be taught to men so that they can change their sexual behaviours as this would change the course of HIV infection in Kenya and Africa as a whole.