Sexual practices among HIV discordant couples attending the HIV/AIDS patient support center, Nyanza Provincial Hospital,Kenya.

Abstract

Background: Acquire immune Deficiency Syndrome (AIDS) is one of the most serious public health challenges facing Kenya today. Prevalence of HIV-discordance among couples in sub-Saharan Africa is high. Discordant couples represent a critical risk group and improved counseling protocols that clearly explain discordance, emphasize high risk of transmission, and support risk reduction are urgently needed. They also need special care and psychosocial support. Prevention is one of the main activities of curbing this scourge. Change in sexual behavior occupies a key-position in the fight against AIDS in sub-Saharan Africa. Objective: The main objective of this study was to determine the sexual practices among HIV discordant couples attending the patient Support Center, Nyanza provincial hospital, Kenya. Design: Qualitative cross-sectional survey of couples attending Patient Support Center (CCC), New Nyanza General Hospital, Kisumu. Method: Interviewer administered questionnaires were used to collect sociodemographic variables from all the participants. In -depth and Focus Group Discussion (FGD) guides were used to collect information from the participants. Transcriptions were coded to identify common themes related to sexual practices. l0 In-depth interviews (IDI) were conducted with 5 discordant couples to identify sensitive information on their sexual practices. All the interviews were tape recorded, transcribed and translated to English. 3 FGD were conducted to validate the responses in the in depth interview. Results: Engaging in extra marital affairs was common despite being aware of the consequences. None of those interviewed said they could make any contractual agreement for outside sexual relationship. Not all the respondents used condoms as a safer way of prevention of infection. Although many participants cited need for children as a reason for not using condoms during sexual intercourse, not many gave religion as a reason for not using condom. Abstinence was common in couples who had low interest in sex. The family income was impaired in HIV discordant relationships. « Conclusion: The findings showed that most HIV discordant couples engage in unsafe sexual practice such as not using condom although most of them perceived that condoms could protect the negative partner from HIV infection. VCT centers should" develop special counseling protocols for prevention of HIV transmission within discordant couples.