Sexual Partners and Risk Behaviors among People Living with HIV (PLHIV) in Kisii County, Western Kenya

Abstract

Safer sexual behaviors among PLHIVs offer cost efficient and effective opportunity to reduce new infections and improving PLHIVs quality of life. Need exists to better understand PLHIVs sexual partnerships and riskbehavior trends to foster safer sex. This study sought to determine the number and type of sexual partnerships as well as risk behaviors among PLHIVs in Kisii County, Kenya. Methods: 340 PLHIVs were interviewed. Results: Most PLHIVs (88%) had one sexual partner in preceding 12 months, 11% had multiple partners; 24% of PLHIVs' primary sexual partners had other partners known to the PLHIVs, 20% of whom lived with those partners. Most PLHIVs reported discussing HIV prevention (82%), taking HIV test (69%), disclosing HIV status (87%) and using condoms at last sex (79%) with primary partners, but these reduced with partners considered secondary. Those depending on kin as primary income source were least likely to have discussed HIV prevention with partners (p = 0.001) while knowledge of ARVs was positively associated with increased likelihood to discuss HIV prevention with partner (p =0.024). Most PLHIVs (78%) had last sex with stable partner, females were more likely to report casual partners at last sex (p = 0.008). Many (23%) PLHIVs had last sex with drunk partners, females were more likely to report drunk partners at mlast sex (p = 0.008). Only 65% consistently used condom in preceding 12 months, 77% used condoms at last sex. Those aged 18 - 24 (p = 0.001) and those depending on kin as primary income source (p = 0.002) were less likely to have used condom at last sex. Knowledge of mother to child HIV transmission (p = 0.036) and ARVs (p = 0.002) were positively associated to condom use at last sex. HIV and STI prevention were major condom use reasons at last sex, accounting 87% and 9% respectively; while reduced pleasure (34%), partner being cautious (23%) and intending pregnancy (36%) were main non-use reasons at last sex. PLHIVs attending lower-level facilities had better consistency (p=0.007) and condom-use at last sex levels (p=0.024) probably attributable to poor patient-clinician ratios in higher-level facilities. Conclusions and Recommendations: Most PLHIVs uphold safer sex practices, especially with partners they consider primary, but high risk behaviors still exhibit. We recommend targeted behavior change initiatives for PLHIVs in multiple partnerships, those aged 18 - 24 and those who depend on kin as a primary income source